bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seborrhoeic keratosis and malignancy: Collision tumour or malignant transformation?
Authors: Vun Yin , De’Ambrosis Brian , Spelman Lynda , Muir James B , Yong‐Gee Simon , Wagner Godfrey , Lun Karyn 
Published: April 2006

SUMMARYA retrospective study of 813 histological specimens reported as seborrhoeic keratoses included 43 (5.3%) associated with non‐melanoma skin cancer. Intraepidermal carcinoma (squamous cell carcinoma in situ) was the most common of these (36). There were five basal cell carcinomas (one with intraepidermal carcinoma also) and two invasive squamous cell carcinomas. No melanomas were reported. Twenty‐seven of the intraepidermal carcinomas appeared to arise within the seborrhoeic keratosis as did one of the invasive squamous cell carcinomas. Of these 28 lesions, the head was the most common site. Fourteen were clinically diagnosed as a non‐melanoma skin cancer with only nine clinically felt to be a seborrhoeic keratosis. These lesions may represent malignant transformation within the seborrhoeic keratosis. Twelve specimens reported adjacent dual pathologies, with the trunk and limbs the most common sites. Seven were diagnosed clinically as a skin malignancy, whereas three were thought to be solar keratoses. Clinically, the remaining two were seborrhoeic keratoses. The origin of the malignancy in these cases is less obvious and may represent collision tumours. Three curette specimens could not be assessed for architecture.
Severe toxic epidermal necrolysis precipitated by amphetamine use
Authors: Roberts Hugh , Chamberlain Alexander , Rennick Gordon , McLean Catriona , Gin Douglas 
Published: April 2006

SUMMARYA 48‐year‐old man presented with a maculopapular truncal rash 9 days following intravenous amphetamine use. He subsequently developed widespread bullae over his trunk and upper limbs. Treatment was initially commenced with intravenous hydrocortisone. A diagnosis of toxic epidermal necrolysis was made and the treatment was changed to intravenous immunoglobulin at a lower dose than requested. At the height of the reaction, there was 90% body surface area involvement with tri‐mucosal involvement. His response to the intravenous immunoglobulin was poor and was complicated by infection with methicillin‐resistant Staphylococcus aureus, Candida albicans and Pseudomonas aeruginosa. Gradual re‐epithelialization took place over the next 6 weeks.
Colloid milium arising on a non‐sun‐exposed area in an adult
Authors: Lim Cathy , Li Michael 
Published: April 2006

SUMMARYA 59‐year‐old woman presented with multiple translucent papules on the inner surface of the tragus of the right ear. Initially they were treated with cryotherapy, with a later biopsy revealing the diagnosis of colloid milium. The histology was unusual for adult colloid milium as the lesion lacked a Grenz zone and evidence of solar elastosis. This together with a lack of aetiological factors made it difficult to classify the subtype of colloid milium.
Invasive squamous cell carcinoma arising in refractory perianal Bowen's disease in a HIV‐positive individual
Authors: Herat Asoka , Shirato Kyoko , Damian Diona L , Finlayson Robert , Whitfeld Margot 
Published: April 2006

SUMMARYA 54‐year‐old HIV‐positive homosexual man presented with erythematous and pigmented plaques on background erythema in the perianal region, histologically consistent with Bowen's disease. Perianal Bowen's disease represents high‐grade anal intraepithelial neoplasia, which is considered a precursor lesion of invasive anal squamous cell carcinoma. This patient's anal intraepithelial neoplasia was unresponsive to multiple treatment modalities including cryotherapy, serial curettage and cautery, topical 5‐fluorouracil and 5‐aminolaevulinic acid photodynamic therapy. He progressed to develop a poorly differentiated squamous cell carcinoma of the anus three and a half years after the Bowen's disease was diagnosed. The squamous cell carcinoma was treated with combined chemoradiation. A recurrence of high‐grade anal intraepithelial neoplasia was noted 6 months after completion of chemoradiation.
Pseudoporphyria secondary to narrowband UVB phototherapy for psoriasis
Authors: Oh Carol , Jones Brad , Solomon Rustum , Egan Conleth A 
Published: April 2006

SUMMARYA 59‐year‐old woman undergoing narrowband UVB phototherapy for treatment of psoriasis presented suddenly with tense blisters on both hips. The blisters were asymptomatic and disappeared within 24 hours. Histopathology together with a negative porphyrin screen made the diagnosis of pseudoporphyria. Blood tests including a full blood count, urea and electrolytes, liver function tests and antinuclear autoantibodies were normal. The patient was otherwise healthy; there was no history of extensive sun exposure, sunbeds or medication with non‐steroidal anti‐inflammatory drugs. This presentation of pseudoporphyria secondary to narrowband UVB radiation is unusual, as UVB radiation is not known to be associated with pseudoporphyria.
Useful subcutaneous suture technique to optimize wound edge apposition and avoid ‘dog ears’
Authors: Vinciullo Carl 
Published: April 2006

SUMMARYThe key to obtaining excellent scars is perfect wound edge apposition with little or no tension across the sutured wound. Unsightly ‘dog ear’ protrusions at the ends of the wound should be avoided as they can detract from the cosmetic result. A simple, practical and efficient surgical technique is described, which can provide the optimal conditions for a perfect scar.
Occupational allergic contact dermatitis to cobalt octoate included as an accelerator in a polyester resin
Authors: Anavekar Namrata S , Nixon Rosemary 
Published: April 2006

SUMMARYA 46‐year‐old woman, who worked as a laminator of spa baths, presented with hand dermatitis, which was suspected to be related to her occupation. Patch testing revealed strong reactions to both cobalt chloride and a polyester resin that the patient had been using at her workplace. She also reacted to latex and had been wearing cotton gloves underneath rubber gloves at work. It was later discovered that cobalt octoate (synonym: cobalt‐2‐ethylhexanoate), a compound not listed on the manufacturer's material safety data sheet, was included as an accelerator in the polyester resin. She was then tested to cobalt octoate, which was also strongly positive. Her successful treatment included protection of her hands at work with cotton lined PVC gloves. This case highlights the role of cobalt salts as sensitizers and their presence as accelerators used in polyester resins, and the importance of recognizing concomitant latex allergy that may complicate occupational dermatitis. It also illustrates the difficulties in relying on material safety data sheets to identify all possible allergens.
Seborrhoeic keratoses with associated lesions: A retrospective analysis of 85 lesions
Authors: Lim Cathy 
Published: April 2006

SUMMARYSeborrhoeic keratoses are benign epidermal neoplasms that are rarely associated with other skin lesions especially malignancies. In this study, the aim was to assess the incidence of associated lesions occurring either adjacent to or contiguous with a seborrhoeic keratosis. A retrospective case series over a 12‐month period was carried out. In total, 639 consecutive histologically diagnosed seborrhoeic keratoses were identified, of which 85 (9%) were found to be associated with other lesions. Of these associated lesions, 44 (7%) were malignant, with four of these found to be arising within the seborrhoeic keratosis. These associated lesions included premalignant lesions, malignancies, melanocytic lesions and miscellaneous lesions. Men (59%) were affected more commonly than women. The average age was 74 years (range 33–98 years). Seborrhoeic keratoses associated with other lesions were found most commonly on the head and neck. The incidence of associated lesions, in particular malignancy arising within seborrhoeic keratoses may be higher than previously thought. This may be an incidental phenomenon, or seborrhoeic keratosis could represent a precursor lesion. Therefore, seborrhoeic keratoses that have undergone recent clinical change should be considered for biopsy and histological examination.
Rapid detection of the fluoroquinolone resistance‐associated ParC mutation in Neisseria gonorrhoeae using TaqMan probes
Authors: SHIGEMURA KATSUMI , SHIRAKAWA TOSHIRO , TANAKA KAZUSHI , ARAKAWA SOICHI , GOTOH AKINOBU , FUJISAWA MASATO 
Published: April 2006

Backgrounds:  In fluoroquinolone‐resistant Neisseria gonorrhoeae, the amino acid mutations in the fluoroquinolone‐resistant determining region (QRDR) of the parC gene are an important factor. The aim of the present study was to develop a rapid detection method of a serine 88 to proline substitution in parC which we previously showed as having significantly higher fluoroquinolone minimal inhibitory concentrations (MIC) using the TaqMan discrimination system.Methods:  We extracted DNA from 90 urine or urethral swab samples obtained from male patients with urethritis caused by N. gonorrhoeae. After DNA extraction, they were subjected to real‐time polymerase chain reaction (PCR) using a TaqMan discrimination system and compared with the results of conventional DNA sequencing.Results:  Of the 90 samples, the TaqMan technique result showed 13 samples that were classified as having a serine 88 to proline mutation in parC, and 77 samples that did not have a serine 88 to proline mutation in parC. The classifications of all samples completely corresponded to those determined by conventional DNA sequencing. We also found that N. gonorrhoeae with a serine 88 to proline mutation in parC have a significantly higher MIC to ciprofloxacin than that without a serine 88 to proline mutant in parC.Conclusions:  The present genotyping method of real‐time PCR using a TaqMan discrimination system could be applied to the rapid detection of a serine 88 to proline amino acid mutation in parC of N. gonorrhoeae. This point mutation is significant for the determination of fluoruquinolone resistance. This rapid detection system may lead to the prevention of use of noneffective antimicrobial agents and a decrease of resistant strains.
Significance of Fas expression alteration during tumor progression of renal cell carcinoma
Authors: SEJIMA TAKEHIRO , MIYAGAWA IKUO 
Published: April 2006

Background:  In order to characterize the alteration of apoptotic regulatory molecule expression during tumor progression of renal cell carcinoma (RCC), we compared the expression between tumor and normal tissues, and evaluated the relationship of the expression in tumors with pathological and clinical characteristics.Methods:  Competitive reverse transcription–polymerase chain reaction (RT–PCR) and immunohistochemistry (IHC) allowed the determination of Fas and bcl‐2 mRNA and protein expression in surgically resected tumor and normal tissue of 50 RCC.Results:  The mRNA expression of Fas and bcl‐2 in RCC was significantly reduced compared to that in normal tissues. An IHC analysis was supportive of the RT–PCR results. In terms of relationships with pathological and clinical characteristics, the mRNA and protein expression of Fas in high‐stage or high‐grade tumors was significantly higher than that in low‐stage or low‐grade tumors. Moreover, a statistically poor prognosis was observed in tumor cases expressing a high amount of mRNA. In bcl‐2 analysis, the mRNA and protein expression was significantly reduced in clear cell tumors compared to chromophobe cell tumors.Conclusion:  It is suggested that the reduced expression of Fas and bcl‐2 in RCC compared with the expression in normal kidney is a prominent alteration of apoptotic regulatory molecules. The alteration of the up‐regulated Fas expression might be characterized during the tumor progression stage. It is also suggested that the effect of alteration of bcl‐2 expression might be minimal during the tumor progression stage because of the reduced expression in tumors of the clear cell type, which is the most dominant cell type in RCC.
Three‐year results of treatment for prostate cancer with low‐dose rate temporary iridium‐192 brachytherapy
Authors: MOMMA TETSUO , SAITO SHIRO , TOYA KAZUHITO , YOROZU ATSUNORI , DOKIYA TAKUSHI , MURAI MASARU 
Published: April 2006

Aim:  To report the 3‐year treatment results of definitive irradiation by using a temporary interstitial implant with low‐dose rate iridium‐192 with or without external beam radiotherapy in the treatment of localized prostate cancer.Methods:  One‐hundred and forty‐three patients with pathologically defined prostate carcinoma were treated from December 1997 to April 2003. The patients were classified into a low‐risk group (T2, PSA ≤ 20 ng/mL and Gleason score ≤ 6) or a high‐risk group (T3, PSA > 20 ng/mL or Gleason score ≥ 7). Low‐risk patients were treated with low‐dose‐rate iridium brachytherapy as monotherapy delivering 70 Gy. High‐risk patients were treated with the combination of brachytherapy and external beam radiotherapy delivering 40 Gy and 36 Gy, respectively. Kaplan–Meier estimates of prostate‐specific antigen (PSA) progression‐free survival rate were analysed. To assess the treatment quality in different periods, PSA progression‐free survival rates in late era (year of 2000 and after) and in early era (before 2000) were compared. Morbidity was graded according to the Radiation Therapy Oncology Group grading scale.Results:  One hundred and nineteen patients were analysed, of which 86 patients underwent monotherapy with an iridium implant, and 33 were treated with the combination of external beam radiotherapy. Twenty‐four patients were excluded from the analysis because the classification of risk group did not suit the criteria. The total (n = 119) PSA progression‐free survival rate at 3 years was 80.3%. The PSA progression‐free survival rate at 3 years for the monotherapy group (n = 86) and the combination therapy group (n = 33) were 78.2% and 86.9%, respectively. There were 23 patients who were followed for more than 36 to 63 months, and, during this period, only 1 patient who received the monotherapy was diagnosed as PSA failure at 50 months. The 3‐year PSA progression‐free survival rate of monotherapy in late era was significantly higher than that in early era; however, no significant difference was seen in the combination treatment. Morbidity for the combination treatment was low; however, for the monotherapy, three patients developed severe rectal ulcers, and colostomies were made.Conclusions:  The PSA progression‐free survival rate after low‐dose rate iridium‐192 brachytherapy with or without external beam radiotherapy can be satisfactory and longer follow up is necessary to compare the efficacy of other treatments.
Is interval from an initial biopsy a significant predictor of prostate cancer at repeat biopsies?
Authors: SATOH AKINORI , MATSUMOTO KAZUHIRO , NAKAMURA SO 
Published: April 2006

Background:  Currently, there are no clear criteria for indicating repeat biopsies in patients with negative results at an initial biopsy of the prostate. The aim of the present study is to determine the clinical and pathological parameters which predict prostate cancer at repeat biopsies with special attention to the interval between biopsies in addition to prostate specific antigen (PSA) and its derivatives.Methods:  We reviewed 100 patients who underwent an initial biopsy that proved negative for prostate cancer and required repeat biopsies between November 1996 and November 2003. Clinical parameters such as age, PSA and its derivatives, interval between biopsies, number of cores taken and initial biopsy histology were analyzed.Results:  In total, 31 patients (31.0%) were found to have prostate cancer, 18 (25.7%) of 70 patients by the second biopsy and 13 (46.4%) of 28 patients by the third biopsy. Two patients underwent the fourth biopsy, which revealed no prostate cancer. The patients with a positive biopsy had a significantly longer interval between the biopsies than the patients with a negative biopsy (P = 0.0036). Furthermore, in both univariate and multivariate logistic regression analysis, only the interval between the biopsies proved to be an independent predictor of positive results at repeat biopsies (P = 0.0094 and 0.0019).Conclusions:  Only the biopsy interval was a significant predictor of prostate cancer at repeat biopsies in both univariate and multivariate analysis.
Application of cardiopulmonary bypass for resection of renal cell carcinoma and adrenocortical carcinoma extending into the right atrium
Authors: OCHI TATSUMASA , TANJI NOZOMU , SHIMAMOTO KENJI , IKEDA TETSUHIRO , TOSHINO AKIHIKO , YOKOYAMA MASAYOSHI 
Published: April 2006

Aim:  The application of cardiopulmonary bypass to atrial involvement represents an important advance that has improved the safety and technical efficacy of a difficult surgical undertaking. Our experiences of the management of extended thrombi into the right atrium in patients with retroperitoneal malignancy using a cardiopulmonary bypass were discussed.Methods:  Data were reviewed for five patients (two men and three women; mean age, 60.4 years; range, 49–79 years) with retroperitoneal tumors displaying intracardiac tumor extension. Tumors originated in the right kidney in four patients, and in left adrenal gland in one patient. Cardiopulmonary bypass was used in all cases.Results:  Mean total blood loss was 6059 mL. Mean operative time was 14.7 h. No intra‐ or postoperative complications due to surgical technique were encountered, and no significant bleeding occurred during incision of the inferior vena cava or after removal of tumor thrombus. The follow‐up period ranged from 3 to 20 months with a mean of 12.6 months. Of the five patients, three died of metastatic diseases, one died of liver dysfunction and one remains disease free as of 18 months postoperatively.Conclusions:  Our experience indicates that this procedure can be safely used for atrial involvement. Although superior long‐term survival cannot be shown yet, favorable early results and a lack of perioperative complications were identified.
Outcome analysis for conservative management of Peyronie's disease
Authors: HASHIMOTO KOHEI , HISASUE SHIN‐ICHI , KATO RYUICHI , KOBAYASHI KO , SHIMIZU TAKASHI , TSUKAMOTO TAIJI 
Published: April 2006

Background:  We retrospectively analysed the outcomes of conservative management of Peyronie's disease and determined the factors predicting successful outcome.Methods:  The study involved 31 patients with Peyronie's disease who were treated at our institute between 1985 and 2003. We assessed the efficacy of vitamin E for the improvement of the symptoms, and the factors which contributed to successful outcome with conservative management using multivariate analysis.Results:  There was no statistically significant difference in the relief rate between the vitamin E and no‐medication groups. The overall estimated relief rate was 67.5% at 2 years from presentation. The multivariate analysis revealed plaque size to be the only significant factor predicting the relief from all symptoms in patients with conservative management. The rate was 100% in patients having a plaque size of 20 mm or smaller and 20.0% in those having a size of larger than 20 mm (P = 0.005).Conclusions:  We could not confirm the benefit of vitamin E for Peyronie's disease. Plaque size was the only significant factor predicting the relief from all symptoms. Patients with larger plaque might fail to respond to the conservative management.
Urinary macromolecules and renal tubular cell protection from oxalate injury: Comparison of normal subjects and recurrent stone formers
Authors: TSUJIHATA MASAO , TSUJIKAWA KOZO , TEI NORIHIDE , YOSHIMURA KAZUHIRO , OKUYAMA AKIHIKO 
Published: April 2006

Aim:  To determine whether urinary macromolecules (UMM), which are the high molecular weight substances in urine, can provide protection against the oxalate‐associated injury to the renal tubular cells.Methods:  UMM were extracted from 24‐h urine of 12 healthy adult male volunteers and 13 recurrent‐stone‐former male patients. Urine parameters in relation to urolithiasis were measured, including the level of glycosaminoglycans (GAG) in the UMM. Madin‐Darby canine kidney (MDCK) cells were used to evaluate the protective activity of UMM from oxalate‐induced cytotoxicity by LDH release measurement and methyl‐thiazolyl tertrazolium (MTT) assay.Results:  Considering urinary parameters, citrate was significantly higher in urine from normal subjects than stone‐former subjects; the other parameters show no differences between the groups. Total UMM and the level of GAG in the UMM were also significantly higher in the normal subject group. Compared with normal subject and stone‐former subject UMM, after cells were treated with the UMM and then exposed to oxalate solution, LDH release was significantly higher in stone‐former group. In the MTT assay, we found that more viable cells were observed after treatment with UMM compared to control in both groups. Moreover, UMM from the normal subjects showed higher protective activity against oxalate‐related cytotoxicity than UMM from the stone‐former subjects.Conclusion:  UMM protected renal epithelial cells from oxalate‐related injury. This protective activity was found to be higher in normal subject UMM than stone‐former UMM. Among other factors, a higher concentration of GAG and citrate in normal subject UMM might affect some parts in this finding.
Five years experience of transrectal high‐intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer
Authors: UCHIDA TOYOAKI , OHKUSA HIROSHI , YAMASHITA HIDEYUKI , SHOJI SUNAO , NAGATA YOSHIHIRO , HYODO TORU , SATOH TAKEFUMI 
Published: April 2006

Background:  High‐intensity focused ultrasound (HIFU) is a minimally invasive technique used in achieve coagulation necrosis. We evaluated biochemical disease‐free survival rates, predictors of clinical outcome and morbidity in patients with localized prostate cancer treated with HIFU.Methods:  A total of 181 consecutive patients underwent HIFU with the use of Sonablate (Focus Surgery, Indianapolis, IN, USA). Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The median age and pretreatment prostate‐specific antigen (PSA) level were 70 years (range 44–88) and 9.76 ng/mL (range 3.39–89.60). A total of 95 patients (52%) were treated with neoadjuvant hormones. The median follow‐up period for all patients was 18.0 months (range 4–68).Results:  The biochemical disease‐free survival rates at 1, 3 and 5 years in all patients were 84%, 80% and 78%, respectively. The biochemical disease‐free survival rates at 3 years for patients with pretreatment PSA less than 10 ng/mL, 10.01–20.0 ng/mL and more than 20.0 ng/mL were 94%, 75% and 35%, respectively (P < 0.0001). Multivariate analysis identified pretreatment PSA (P < 0.0001) as a independent predictor of relapse.Conclusion:  High‐intensity focused ultrasound therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, especially those with a pretreatment PSA level less than 20 ng/mL.