bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significance of cagA status and vacA subtypes of Helicobacter pylori in determining gastric histopathology: Virulence markers of H. pylori and histopathology
Authors: Kaklikkaya Nese , Cubukcu Kivanc , Aydin Faruk , Bakir Tulay , Erkul Suat , Tosun Ilknur , Topbas Murat , Yazici Yelda , Buruk Celal Kurtulus , Erturk Murat 
Published: February 2006

AbstractBackground:  It has been suggested that Helicobacter pylori strains containing the cytotoxin‐associated gene A (cagA), and s1m1 genotype of vacuolating cytotoxin gene A (vacA) may have been associated with peptic ulcer disease. The aim of the present study was to analyze such an association of cagA presence and vacA subtypes of H. pylori with histopathological findings in patients with gastritis.Methods:  Sixty‐five independent H. pylori strains isolated from Turkish patients with gastritis were analyzed. The antral biopsy specimens were processed for culture and histopathology. Histopathological features were recorded and graded according to updated Sydney system. The vacA subtypes and cagA gene were tested by polymerase chain reaction.Results:  Mild degree of antral density was associated with mild degree of gastric neutrophil infiltration (P = 0.010). Positive cagA status correlated significantly with the presence of atrophy (P = 0.035) and neutrophil infiltration (P < 0.001), but not with H. pylori density (P = 0.754) nor the degree of mononuclear cell infiltration (P = 0.945). The vacA subtypes were independent of gastric histopathology. The odds ratios for atrophy and neutrophil infiltration of cagA+ versus cagA– strains were 3.62 (95% confidence interval [CI]: 1.04–12.66) and 53.18 (95%CI: 11.08–255.23), respectively.Conclusion:  The presence of the cagA gene is strongly associated with atrophic and active gastritis. Distinct vacA subtypes of H. pylori appear to have no association with histopathological findings of gastritis.
Methimazole protects lungs during hepatic ischemia–reperfusion injury in rats: An effect not induced by hypothyroidism
Authors: Tütüncü Tanju , Demirci Çagatay , Gözalan Ugur , Yüksek Yunus Nadi , Bilgihan Ayse , Kama Nuri Aydin 
Published: February 2006

AbstractBackground:  Hepatic ischemia–reperfusion injury may lead to remote organ failure with mortal respiratory dysfunction. The aim of the present study was to analyze the possible protective effects of methimazole on lungs after hepatic ischemia–reperfusion injury.Methods:  Forty male Wistar albino rats were randomized into five groups: a control group, in which bilateral pulmonary lobectomy was done; a hepatic ischemia–reperfusion group, in which bilateral pulmonary lobectomy was done after hepatic ischemia–reperfusion; a thyroidectomy–ischemia–reperfusion group (total thyroidectomy followed by, 7 days later, bilateral pulmonary lobectomy after hepatic ischemia–reperfusion); a methimazole–ischemia–reperfusion group (following methimazole administration for 7 days, bilateral pulmonary lobectomy was done after hepatic ischemia–reperfusion); and a methimazole +l‐thyroxine–ischemia–reperfusion group (following methimazole and l‐thyroxine administration for 7 days, bilateral pulmonary lobectomy was performed after hepatic ischemia–reperfusion). Pulmonary tissue specimens were evaluated histopathologically and for myeloperoxidase and malondialdehyde levels.Results:  All of the ischemia–reperfusion intervention groups had higher pulmonary injury scoring indices than the control group (P < 0.001). Pulmonary injury index of the ischemia–reperfusion group was higher than that of both the methimazole‐supplemented hypothyroid and euthyroid groups (P = 0028; P = 0,038, respectively) and was similar to that of the thyroidectomized group. Pulmonary tissue myeloperoxidase and malondialdehyde levels in the ischemia–reperfusion group were similar with that in the thyroidectomized rats but were significantly higher than that in the control, and both the methimazole‐supplemented hypothyroid and euthyroid groups.Conclusion:  Methimazole exerts a protective role on lungs during hepatic ischemia–reperfusion injury, which can be attributed to its anti‐inflammatory and anti‐oxidant effects rather than hypothyroidism alone.
ProSealTM laryngeal mask airway in 120 pediatric surgical patients: a prospective evaluation of characteristics and performance
Authors: WHEELER MELISSA 
Published: February 2006

SummaryBackground:  The ProSealTM LMA (PLMATM) has recently been introduced in pediatric sizes (1.5, 2, 2.5, 3). Limited pediatric data have been published.Methods:  After Institutional Review Board (IRB) approval, the PLMATM was placed in 120 children aged 4 months to 13 years (5–50 kg). The following data were collected prospectively: induction agent, number of placement attempts (limited to three), placement success or failure, PLMATM size, leak pressure, ventilatory pattern [spontaneous (SV) or controlled positive pressure ventilation (PPV)], success or failure of gastric suction tube placement, hypoxemia, dislodgement, laryngospasm, bronchospasm, aspiration, and traumatic placement.Results:  The PLMATM was easily placed in children with a higher first attempt success rate (94%) than reported for adults. Overall PLMATM and gastric tube placement were both 100% successful. Leak pressures were similar to those reported for the PLMATM in adults and higher than reported for the ClassicTM LMATM in children. No bronchospasm, laryngospasm, hypoxemia, dislodgement, or aspiration occurred.Conclusions:  Although the PLMATM can be used with SV or PPV, the higher leak pressure achieved with the PLMATM, and the ability to evacuate fluid and air from the stomach suggest that it may be a useful alternative to tracheal intubation for procedures in which PPV is desired in children aged 4 months to 13 years.
15  The influence of androgen deprivation therapy on cavernous nerve grafts
Authors: SYME D.B.Y. , CORCORAN N.M. , BOUCHIER‐HAYES D.M. , COSTELLO A.J. 
Published: February 2006

Introduction:  Postradical prostatectomy erectile dysfunction is thought to be neurogenic in origin, and some attempts to improve potency have focussed on regenerating the cavernous nerves. Testosterone has profound positive effects on nerve regeneration. The present study aims to evaluate whether testosterone has any effect on the regeneration of cavernous nerves.Materials and Methods:  Forty‐five male Sprague–Dawley rats underwent bilateral cavernous nerve neurotomy followed by unilateral nerve graft using genitofemoral nerve. Animals were then randomised to castrate, intact and testosterone treated arms. At 3 months electrostimulation was performed measuring intracavernosal pressure responses. Grafted nerve segments were then harvested for histological analysis.Results:  Significant difference in maximal intracavernosal pressure (MICP) response between groups – mean MICPs were 24, 47 and 59 for castrate, intact and testosterone treated groups respectively (P = 0.003, anova). Total axon counts within grafted segments did not differ significantly between treatment groups, but concentration of nNOS‐containing axons was significantly decreased in castrate animals.Conclusions:  Castration resulted in a significant reduction in erectile response to electrostimulation following interpositional nerve grafting. These effects appear to be due to changes in axonal regeneration in differing androgen environments, especially in the regeneration of nNOS containing axons. Clinically, this implies that nerve grafts will be of little functional use in the face of androgen ablation.
Patterns of spread in an orthotopic mouse model of bladder cancer
Authors: BRENNAN J.P. , CHAFFER C.L. , SLAVIN J. , TEMELCOS C. , GOAD J. , WILLIAMS E.D. 
Published: February 2006

Purpose:  To develop an orthotopic model of muscle‐invasive transitional cell carcinoma (TCC) of the bladder which models primary tumour growth and metastasis.Methodology:  Cell lines were derived from the TCC cell line T24 (Tsu‐Pr1) using in vivo selection for metastatic ability (Chaffer et al. Clin Exp Metastasis 2005; 22(2): 115–25). Each of these cell lines (Tsu‐Pr1 and sub‐lines, B1 and B2) was then injected intramurally into the mouse bladder wall (n = 25 × 3). The cell lines were also injected intravesically and intraperitoneally (n = 15 × 3 in each group).Results:  There were no differences between the three sub‐lines in primary tumour formation, presence of macroscopic metastases and survival. This model produced more macroscopic and lymph node metastases in comparison with other orthotopic models reported in the literature. After intraperitoneal injection, the B2 cell line produced a higher number of discrete intra‐abdominal masses in comparison with the parental line. This is likely to be related to the phenotype of the cells with parental cells being more mesenchymal, versus the B2 sub‐line, which has more epithelial characteristics.Conclusion:  The TSU‐Pr1 series is a useful, clinically relevant model of muscle‐invasive TCC. In addition, this model may also provide insights into the role of mesenchymal‐epithelial transition in the metastatic process.
42  Percutaneous nephrostomy insertion for patients with bilateral ureteric obstruction caused by prostate cancer
Authors: NARICULAM J.A. , MURPHY D.G. , SWINN M.J. 
Published: February 2006

Introduction:  Ureteric obstruction is a severe complication of advanced prostate cancer. Percutaneous nephrostomy (PCN) can decompress the obstructed kidney(s) and treat renal failure. This study assessed whether PCN added any survival benefit and whether bilateral PCN were necessary when both ureters were obstructed.Methods:  The notes of 20 patients, who underwent urinary diversion by PCN for ureteric obstruction, were retrospectively analysed. Data pertinent to the mode of presentation, survival times and urine output of respective nephrostomies were retrieved.Results:  Seventeen of the 20 patients (85%) presented with acute renal failure. 18 of the 20 patients presented with bilateral hydronephrosis. Of these, 12 patients had bilateral PCN insertion and 6 patients had unilateral PCN insertion. In those 12 patients who had bilateral PCN, 8 (66%) had a greater urine output in one PCN than the other. In the six patients who had unilateral PCN insertion, five of them had their renal failure treated. The mean survival time following PCN was 6.5 months.Conclusion:  Percutaneous nephrostomy insertion will prevent immediate death in patients. However, long term survival is limited to 6.5 months. The above results would suggest that acute renal failure requiring palliative decompression may be best treated by unilateral as opposed to bilateral nephrostomy. However, a larger randomised controlled prospective study would be helpful to further assess this observation.
50  The role of hand assisted laparoscopic nephrectomy
Authors: MARTINDALE A. , APPANNA T.C. , GOAD J. , TEMELCOS C. , CLARKE A. , ASOPA R. , CLEEVE L. , NIALL O. 
Published: February 2006

Objectives:  We have been performing laparoscopic nephrectomies since 2002 and have used the hand assisted technique on a regular basis. We aim to report our results and to comment on the use of the hand port.Patients and Methods:  A combination of retrospective and prospective data collection was used to obtain patient demographics, operative details, pathology information and outcome data for all patients who underwent laparoscopic nephrectomy between April 2002 and June 2005 at St. Vincent's Hospital and the Melbourne Urology Group in Melbourne.Results:  We performed 78 laparoscopic nephrectomies, 47 of which were hand assisted in the specified time period on patients with a mean age of 63.4 years. 38% of the public patients were operated on by a non‐consultant as the primary surgeon and the median operating time was 180 min. No differences were observed between pure and hand assisted laparoscopy (HAL) in terms of patient recovery, morbidity, in patient stay and analgesic use.Conclusions:  We have found the hand port to be a safe and effective tool for nephrectomy without the inherent risks of pure laparoscopy. As an incision is required to remove the kidney from the abdomen it seems illogical not to utilise that incision from the beginning of the case. The benefits are safer port placement, tactile feedback and early control of heavy bleeding. We would therefore advocate its use in all extirpative renal surgery.
53  Salvage laparoscopic pyeloplasty
Authors: CHANG C.M. , GIANDUZZO T. , EDEN C.G. 
Published: February 2006

Introduction:  Greater experience with urological laparoscopy has lead to increasing interest in its use for reconstructive surgery, such as pyeloplasty. We compared the outcomes of primary versus salvage laparoscopic pyeloplasty (LP) in a single surgeon series of 124 LP.Patients and Methods:  One hundred and twenty‐four cases of laparoscopic pyeloplasty (LP) were performed, 11 of which followed failed primary treatment at other institutions: balloon dilatation (n = 3); endopyelotomy (n = 3); open pyeloplasty (n = 3); endopyelotomy plus balloon dilatation (n = 1); and open pyeloplasty plus balloon dilatation (n = 1). Nine patients had renal calculi. A four‐port balloon‐dissecting extraperitoneal laparoscopic approach was used in all but one patient who had a horseshoe kidney, necessitating a transperitoneal approach.Results:  The operating time was 29 min longer in the secondary pyeloplasty group compared to primary cases (173.3 vs. 144.0 min), but the conversion rate (0% vs. 1.6%) and duration of postoperative hospitalisation (2.5 vs. 2.7 nights) were no greater. The complication rates were 3.6% and 9.1%. The success rates were 98.2% and 90.9% (P = 0.63) at a mean follow‐up of 20.2 and 19.7 months.Conclusion:  Extraperitoneal laparoscopic dismembered pyeloplasty is capable of addressing all causes of UPJ obstruction with excellent functional results and low morbidity, and in an operating time similar to that of open pyeloplasty. Secondary LP does not increase hospitalization, conversion or complication rates.
57  Preservation of the lateral prostatic fascia during extraperitoneal laparoscopic nerve‐sparing prostatectomy
Authors: MOON D. , CHANG C. , EDEN C. 
Published: February 2006

Introduction:  Recent evidence suggests that cavernous nerves run within layers of the lateral prostatic fascia. It has been proposed that a nerve sparing technique should therefore include preservation of this fascial layer in addition to the main bulk of the neurovascular bundle posterolateral to the prostate.Materials and methods:  All patients on whom laparoscopic nerve‐sparing prostatectomy was performed (potent patients <70 years of age, PSA <10, primary Gleason score ≤3), underwent a ‘curtain dissection’ with preservation of the endopelvic and lateral prostatic fasciae. To avoid injury to the cavernosal nerves, no energy source was used and the tips of the seminal vesicles were preserved. We present an operative video demonstration of this technique.Results:  This procedure can be performed without an increase in operative time or blood loss. Finer points of technique are displayed and explained.Conclusion:  Preservation of the lateral prostatic fascia and the nerves running within its layers is feasible during nerve‐sparing laparoscopic radical prostatectomy. We have now performed this procedure on fifty patients, and future clinical follow‐up will assess whether this technique is associated with improved functional results.
60  Robotic laparoscopic versus open radical retropubic prostatectomy: comparison of positive surgical margin rate by a single surgeon
Authors: VAN APPLEDORN S. , BOUCHIER‐HAYES D.M. , O'MALLEY P.J. , KHAIRA H. , COSTELLO A.J. 
Published: February 2006

Introduction:  A non‐laparoscopically trained genitourinary surgeon began performing robotic‐assisted laparoscopic radical prostatectomies (RLRP) in December, 2003 using the da Vinci (Intuitive Surgical Sunnyvale, CA) robotic system. It remains unclear if RLRP offers a similar degree of cancer control to open radical retropubic prostatectomy (RRP). We examined the pathological outcomes of patients who underwent RLRP and compare them to a similar cohort who previously underwent RRP by the same surgeon.Materials and Methods:  Two consecutive patients who underwent RLRP from December, 2003 to April, 2005 were analysed. Their age, PSA, pathological stage and margin status were prospectively collected. 102 consecutive patients who underwent RRP from April 1999 to November 2003 were used for comparison.Results:  The mean age of RLRP patients was 60.7 (range 47–73) and their mean PSA was 7.78 (1.3–21.2). Thirteen patients were stage pT3a while the remaining 89 were pT2. Fourteen patients (13.7%) had foci of adenocarcinoma at the inked surgical margin. The RRP patients had a mean age of 59.3 (45–72) and a mean PSA of 9.9 (0.9–37.6). Four patients were pathologic stage T3b, 29 patients were pT3a, and the remaining 69 were pT2. 27 RRP patients (26.4%) had tumour present at the inked margin of surgical resection.Conclusion:  RLRP can be successfully performed by a laparoscopic naïve surgeon. The surgical margin status of RLRP patients is better than a cohort treated with RRP by the same surgeon. It will require further analysis to verify if this corresponds with improved recurrence‐free rates, but initial results are promising.
61  Laparoscopic radical prostatectomy: the impact of obesity
Authors: MOON D. , GIANDUZZO T. , CHANG C. , PATIL N. , SINGH R. , EDEN C. 
Published: February 2006

Introduction:  The literature‐based evidence as to whether or not obesity has any impact on the outcomes of radical prostatectomy is contradictory. This study investigates the effect of obesity on the peri‐operative parameters of patients undergoing laparoscopic radical prostatectomy (LRP).Materials and methods:  The database entries and case notes of 532 consecutive patients undergoing LRP from March 2000 to August 2005 were retrospectively examined. Complete data were available on 505 (95%) patients, 108 (21%) of whom were obese (BMI ≥ 30 kg/m2). All patients had clinical stage T ≤ 3aN0M0 prostate cancer and had their procedure performed or supervised by the same surgeon.Results:  Patients’ PSA, Gleason score, clinical stage and prostate weight were similar. Non‐obese and obese patients mean values for operating time = 182 and 197 min (P = 0.01), blood loss = 310 and 350 ml (P = 0.66), hospital stay = 3.0 and 3.3 nights (P = 1.00) complications = 3.5% and 4.6% (P = 0.77), positive margins = 15.4% and 20.6% (P = 0.26) and biochemical recurrence = 3.8 and 3.7% (P = 1.00) at a mean follow‐up of 9.7 and 12.0 months, respectively.Conclusion:  The operating time was significantly longer for obese patients but this was only by a mean of 15 min. All other parameters were comparable in the two groups. Obese patients can expect a similar outcome to their non‐obese counterparts following LRP when operated on be an experienced surgeon.
62  Does obesity influence operative course or complications of robot assisted laparoscopic prostatectomy
Authors: KHAIRA H.S. , O'MALLEY P. , PETERS J.S. , COSTELLO A.J. 
Published: February 2006

Introduction and Objective:  To determine if obesity is associated with greater intra or peri‐operative complications in patients undergoing Robot Assisted Laparoscopic Prostatectomy (RALP).Methods:  Between 8/2003 and 9/2005 prospective data collection was performed for all patients undergoing RALP. Obesity was defined by BMI > 30 Kg/m2. Operative times were documented to determine duration for: overall case, robotic assistance, vesico‐urethral anastomosis.Results:  Two hundred and forty three patients underwent RALP by one of two surgeons. 202 were classified as non‐obese and 41 obese. Preoperative and postoperative characteristics were similar: mean age 61.1 vs. 59.8 years, preoperative PSA 8.1 vs. 7.4, prostate volume was 46.6 vs. 45.3 cc, length of stay 3.2 vs. 3.4 days, time of indwelling catheter 8.2 vs.7.8 days. Operative times were less for the non‐obese group compared with the obese group: total OR Time 188 vs. 206 min (P < 0.05), Robot Time 135 vs. 147 min (P < 0.10), Anastomotic Time 31 vs. 35 min (P < 0.10). In the non‐obese group there were seven (3.5%) prolonged drain tube leaks versus four (9.8%) in the obese group (P < 0.10).Conclusions:  Obesity was associated with longer overall operative times, which reinforces the suspicion that RARP is more challenging in this population. Overall complication rates were not significantly different; however there was a trend towards longer drain tube output amongst obese patients. Ongoing follow‐up will determine if obesity predisposed to greater long‐term morbidity.
66  The advantage of finger guided prostate biopsies in addition to transrectal ultrasound guided prostate biopsies in patients with palpable disease
Authors: HUYNH C.C. , AWAD N. , FULTON M. 
Published: February 2006

Introduction:  Transrectal ultrasound guided biopsies of the prostate (TRUSGB) allows direct visualisation instead of finger‐guided approximation of prostatic anatomy. However, the efficacy of the inclusion of finger guided prostate biopsy (FGPB) of suspicious, palpable prostatic areas has not been reported.Method:  Between February 2002 and September 2005, 287 consecutive patients being investigated for prostate cancer underwent 310 prostate needle biopsies (PNB) by a single surgeon. 240 cases were judged to have palpable disease, forming our study group. We defined palpable disease as any abnormality even the subtlest. The study group underwent both TRUSGB and FGPB. The operative and pathology reports of these patients were reviewed and tabulated. The additional information garnered by FGPB was analysed.Results:  One hundred thirty‐three of 240 (55.4%) cases were diagnosed with prostate cancer, where 18 (7.5%) would not have been detected had they not had additional FGPB. Furthermore, of the 115 positive biopsies picked up by TRUSGB, 100 (87%) were also positive with FGPB. Within this concordant set, 27 FGPB cases were positive in regions different to that found in TRUSGB. The extra data gained provides a better estimation of tumour volume, which aided in decision‐making.Conclusion:  In patients with palpable disease, the addition of finger guided prostate biopsy of these areas, increased the positive predictive value over transrectal ultrasound prostate biopsies alone. Additional information obtained in terms of tumour volume and tumour positive areas helps in tailoring a management plan for the patient. This technique should be considered in all patients with palpable disease.