bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stage specific follow‐up strategy after cystectomy for carcinoma of the bladder
Authors: KURODA MASAO , MEGURO NORIO , MAEDA OSAMU , SAIKI SHIGERU , KINOUCHI TOSHIAKI , USAMI MICHIYUKI , KOTAKE TOSHIHIKO 
Published: March 2003

Abstract
Background
: Follow‐up strategies after cystectomy for carcinoma of the bladder should be determined according to the risk of recurrence, which is stage dependent. We aimed to develop follow‐up protocol for monitoring patients with carcinoma of the bladder for tumor recurrence and diverted urinary tract complications after radical cystectomy.
Methods
:The records of 351 patients with carcinoma of the bladder who underwent cystectomy between 1979 and 1999 were reviewed for dates and presenting symptoms of local and distant recurrences. The results of imaging studies and blood tests were also reviewed. Based on the division of patients into pathological stages of pT1 and lower, pT2, and pT3 and higher groups, we proposed a new follow‐up schedule for carcinoma of the bladder.
Results
:The risk of metastasis was related to the pathological stage of the primary tumor. Recurrence developed in 10 of 124 patients (8%) with pT1 or lower, 17 of 101 patients (17%) with pT2, and 55 of 101 patients (54%) with pT3 or higher disease at a median of 11 (range 6–186), 10 (1–40) and 7 (1–76) months, respectively. Recurrences in patients with pT3 or higher were found earlier and more frequently than those with pT2 or lower. Of 82 patients with metastases, 54 initially were symptomatic, and three of pT1 or lower, six of pT2, and 19 of pT3 or higher were asymptomatic. Based on these results we proposed a stage specific follow‐up protocol.
Conclusions
:A stage‐driven follow‐up strategy for monitoring patients after radical cystectomy can reduce medical expenses while efficiently detecting recurrences and complications.
Utility of immunohistochemical detection of prostate‐specific Ets for the diagnosis of benign and malignant prostatic epithelial lesions
Authors: TSUJIMOTO YUICHI , NONOMURA NORIO , TAKAYAMA HITOSHI , YOMOGIDA KENTARO , NOZAWA MASAHIRO , NISHIMURA KAZUO , OKUYAMA AKIHIKO , NOZAKI MASAMI , AOZASA KATSUYUKI 
Published: March 2003

Abstract
Background
: Human prostate‐specific Ets (hPSE) belongs to the Ets family. It regulates the proliferation, differentiation, and development of prostate epithelial cells. A recent study showed that hPSE can be detected in normal glands but not in cell lines established from prostate cancer (PCA), suggesting a translational disorder of hPSE from mRNA to protein in PCA. Immunohistochemical detection of hPSE could therefore be another method of differential diagnosis of PCA from other proliferative conditions in the prostate.
Methods
:An immunohistochemical detection of hPSE was carried out on the whole mounted prostatectomy specimen obtained from 19 cases with PCA.
Results
:Basal and secretory luminar cells showed a diffuse cytoplasmic staining for hPSE in normal glands, hyperplastic glands, and prostate intraepithelial neoplasia lesions. Whereas approximately 30% of PCA lesions showed a negative staining for hPSE, the positive rate for hPSE between PCA and benign glands or prostate intraepithelial neoplasia (PIN), was statistically significant (P < 0.05). Staining intensities in normal glands, hyperplastic glands, and PIN lesions were similar, but generally stronger than those in PCA lesions.
Conclusions
:Negative immunoreactivity for hPSE strongly suggests malignancy in the prostate glands. Decreased immunoreactivities of glands for hPSE could suggest PCA.
Influence of endometrial thickness and pattern on pregnancy rates in in vitro fertilization‐embryo transfer
Authors:   AYUSTAWATI, Shibahara Hiroaki , Obara Hiromi , Hirano Yuki , Taneichi Akiyo , Suzuki Tatsuya , Takamizawa Satoru , Sato Ikuo 
Published: March 2003

Aim
: Our aim was to investigate the role of endometrial thickness and pattern in the pregnancy rate during an in vitro fertilization‐embryo transfer (IVF‐ET) cycle.
Methods
: Records of patients who underwent IVF‐ET at the Jichi Medical School Hospital during May 1995–December 1999 were evaluated retrospectively. Only cycles, in which endometrial thickness and pattern on the day of human chorionic gonadotrophin (HCG) administration were recorded, were analyzed in this study. Endometrial thickness was divided into three categories (A: < 10 mm, B: 10–14 mm, C: > 14 mm), and endometrial pattern was divided into two categories: triple line and non‐triple line. A total of 156 IVF‐ET cycles from 120 patients was evaluated.
Results
: There were no significant differences for both the endometrial thickness and pattern in the pregnancy rate during the IVF‐ET cycle (P > 0.05). Among the study groups, the triple‐line endometrial pattern was found to be 58.7% in group A, 84.0% in group B and 70% in group C. We found that in the triple‐line endometrial pattern, there was a significant difference between group A and group B (P < 0.01). Triple‐line endometrial pattern appeared significantly in younger women (33 ± 5.4 years) than in non‐triple‐line endometrial pattern (36 ± 5.2 years; P = 0.047). The minimum and maximum endometrial thickness where pregnancy occurred was 6.5 mm (two pregnancies) and 19 mm (one pregnancy), respectively.
Conclusion
: Endometrial thickness and pattern have no influence on the pregnancy rates in an IVF‐ET cycle, but patients with triple‐line endometrial pattern and group B endometrial thickness showed a better pregnancy outcome in the IVF‐ET treatment. (Reprod Med Biol 2002; 1: 17–21)
Cadmium‐induced testicular damage in a rat model of subchronic intoxication
Authors: Aoyagi Teiichiro , Ishikawa Hiromichi , Miyaji Keisuke , Hayakawa Kunihiro , Hata Makoto 
Published: March 2003

Background: Cadmium (Cd)‐induced testicular damage in relation to spermatogenesis has not been well studied. We studied the mechanism of Cd‐induced testicular damage in a rat model of subchronic intoxication.Methods:  Male Sprague–Dawley rats were subcutaneously injected with 0.6 mg Cd/kg per day for 6 weeks. The concentration of Cd in urine, serum and testes was measured by using atomic absorption spectrophotometry. Testicular damage was evaluated by counting the spermatogonia (SG) and spermatocytes (SC) on one cut‐surface of five seminiferous tubules in stages VII or VIII of spermatogenesis every week. The location of intratesticular cadmium was determined by using oxine‐fluorescent cytochemistry.Results: There were no differences in the testes/bodyweight ratio between the study and control groups. The concentration of Cd in the testes increased more than 100‐fold that in serum after week 2, suggesting active testicular Cd accumulation (1–3 mg/g tissue). Cadmium accumulation was detected in SG and SC. The number of SG and SC diminished significantly in the study group (week 2: SG 74%, SC 90%; week 4: SG 47%, SC 75%; week 6: SG 30%, SC 54% of the control, respectively).Conclusions: Cadmium accumulated in SG and SC, consequently reduced the number of these cells, and disturbed the spermatogenesis in this rat model of subchronic Cd intoxication. Therefore, the number of SG decreased in this rat model of subchronic Cd intoxication. (Reprod Med Biol 2002; 1: 59–63).
Non‐invasive markers of bone turnover and plasma cytokines differ in osteoporotic patients with multiple myeloma and monoclonal gammopathies of undetermined significance
Authors: Diamond T. , Levy S. , Smith A. , Day P. , Manoharan A. 
Published: March 2003

Abstract Aims: To determine whether various markers of bone turnover and/or plasma cytokines differ in patients with multiple myeloma (MM) compared with patients with monoclonal gammopathies of undetermined significance (MGUS). Methods: We studied 22 MM patients and 18 MGUS patients presenting over an 18‐month period and compared their data with those from 20 age‐ and sex‐matched patients presenting with primary osteoporosis. According to the Salmon and Durie classification, there were eight patients with stage I, nine with stage II and five with stage III disease. All patients had densitometric evidence of osteoporosis and were classified according to bone marrow evidence of plasma cell dyscrasia. Measured variables included markers of bone formation and bone resorption, and plasma cytokines. Results: Patients with MM and MGUS did not differ with respect to their mean age, male : female sex ratio, height, weight, serum calcium, 25‐hydroxyvitamin D and parathyroid hormone concentrations. Patients with MM had significantly lower concentrations of haemoglobin (109 vs 135 g/L) and serum transforming growth factor (TGF)‐β (261 vs 348 pg/mL) than patients with MGUS, and higher concentrations of serum paraproteins (31.1 vs 7.4 g/L), β2‐microglobulin (3.5 vs 2.2 g/L), % plasma cell numbers (35.3 vs 2.1%) and urinary deoxypyridinoline excretion rates (u‐DPYD; 7.7 vs 5.9 nmol/mmol creatinine; P < 0.05 for all comparisons). In multivariate analysis, the serum paraprotein (β coefficient = –0.067; 95% confidence intervals (CI), –0.019 to –0.005; P = 0.0012), u‐DPYD excretion rates (β coefficient = –0.012; 95% CI, –0.113 to –0.02; P = 0.0058) and serum TGF‐β concentrations (β coefficient = –0.002; 95% CI, –0.0002 to –0.02; P = 0.02) were the most important variables differentiating between MM and MGUS, after excluding lytic bone lesions, % plasma cell numbers and haemoglobin concentrations. Conclusions: The well‐established criteria for diagnosing MM include the presence of lytic bone lesions, plasmacytosis, haemoglobin and paraprotein concentrations. The u‐DPYD excretion rate, a sensitive non‐invasive marker of bone resorption, may help in differentiating between MM and MGUS, as well as serving as a marker of underlying bone disease activity in these patients. (Intern Med J 2001; 31: 272–278)
Towards a molecular approach to gastric cancer management
Authors: Boussioutas A. , Taupin D. 
Published: March 2003

Abstract Gastric cancer is a leading cause of cancer death worldwide. Most patients with gastric cancer present with locally advanced and incurable disease, and overall survival is poor. Considerable research efforts towards the epidemiology and pathogenesis of gastric cancer have not been translated into treatment success. We discuss current concepts of the pathogenesis of gastric cancer and how recent research advances, in particular global gene expression strategies, may improve this understanding, and suggest a framework wherein these approaches may be used. (Intern Med J 2001; 31: 296–303)
What do physicians think about evidence‐based antibiotic use in critical care? A survey of Australian intensivists and infectious disease practitioners
Authors: Sintchenko V. , Iredell J. R. , Gilbert G. L. , Coiera E. 
Published: March 2003

Abstract Background: The analysis of factors that influence prescribing decisions is increasingly important. Antibiotic use is often based on limited evidence and lack of information about clinical decision‐making processes is an important obstacle to improving antibiotic utilization. Aims: To compare the attitudes of intensive care unit practitioners (ICUP) and infectious disease practitioners (IDP) to antibiotic use and to the evidence‐ based information support. Method: A postal survey conducted between March and July 2000 of ICUP and IDP representing all States and Territories in Australia. Results: One hundred and fifty‐three of 224 clinicians returned the questionnaire (68.3% response rate). In choosing an antibiotic, IDP placed significantly more weight than ICUP on the in vitro susceptibility of the pathogen (P = 0.001), antibiotic cost (P = 0.05) and possible development of antibiotic resistance (P = 0.007). More than 95% of both groups believed that unit‐specific antibiotic susceptibility of endemic pathogens was an essential factor in rational prescribing, but only 68.5% of IDP and 38.7% of ICUP use microbiology laboratory databases. When in doubt about appropriate antibiotic use, 63.8% of ICUP seek and 76.3% usually follow the advice of IDP. Both groups agree that published antibiotic guidelines are useful, but IDP were more likely to consult them. ICUP were more likely to believe that guidelines are used to control clinicians rather than to improve quality of care (P = 0.001). A greater proportion of IDP (71.2%) than ICUP (52.5%) believed that antibiotic prescribing in their intensive care unit (ICU) was evidence based but most (91.8% and 86.9%, respectively) agreed that it should be. Conclusions: Australian clinicians have positive views about evidence‐based prescribing and antibiotic guidelines. However, there are clinically significant differences in prescribing behaviour between ICUP and IDP. These may be explained by different disease spectra managed by each group or different cultures, training and/or cognitive styles. Improvements in the understanding of physicians’ information and decision support needs are required to strengthen evidence‐based prescribing. (Intern Med J 2001; 31: 462–469)
Hereditary colorectal cancer: keeping it in the family − the bowel cancer story
Authors: McGrath D. R. , Spigelman A. D. 
Published: March 2003

AbstractUp to 20% of colorectal cancers are thought to have a genetic component. Several familial syndromes are known to confer an increased risk for colorectal cancer. Advances in our understanding of these syndromes has impoved the care delivered to, and the overall survival of, these patients. Genetic testing has great potential to further improve detection and direct subsequent preventative measures. The diagnosis, management and surveillance issues relating to some of the more commonly encountered syndromes − in particular Familial Adenomatous Polyposis and Hereditary Non‐Polyposis Colorectral Cancer − are reviewed.
Lack of clinical utility of the Siriraj Stroke Score
Authors: Hui A. C. F. , Wu B. , Tang A. S. y. , Kay R. 
Published: March 2003

Abstract Background : The ability to distinguish between infarct and haemorrhage is essential to the management of acute cerebrovascular disease. In hospitals where emergency neuroimaging is not available, the use of stroke scores has been proposed to distinguish ischaemic from haemorrhagic stroke. Aims : To determine the accuracy of the Siriraj Stroke Score in distinguishing ischaemic from haemorrhagic stroke in a cohort of Chinese patients. Methods: We prospectively assessed and calculated the Siriraj stroke Score from 253 patients with acute stroke. The sensitivity, specificity, positive and negative predictive values of this score were determined. Results : For cerebral haemorrhage, the sensitivity and specificity were both 90% or above, but the positive predictive value was not greater than 70%. For cerebral infarct, the sensitivity and specificity were around 80%, while the positive predictive value exceeded 90%. Analysis by plotting receiver operating characteristic curves failed to find other cut‐off points that would improve the performance of the Siriraj Stroke Score. Conclusions: Considering the inconsistent results from this study and previous studies of the Siriraj Stroke Score, we suggest that scoring systems that only require a small number of variables are unlikely to achieve the level of accuracy needed for clinical decision‐making. (Intern Med J 2002; 32: 311−314)
Clinical features of Fabry's disease in Australian patients
Authors: Galanos J. , Nicholls K. , Grigg L. , Kiers L. , Crawford A. , Becker G. 
Published: March 2003

Abstract Background:  Anticipating the prospect of specific treatment, we studied a large group of Australians with Fabry's disease.Aims: We aimed to: (i) document the clinical ­features of Fabry's disease in Australian patients, (ii) test the hypothesis that clinical features vary with specific mutation and blood group and (iii) assess small‐fibre peripheral nerve function.Methods: A questionnaire was forwarded to all Australian patients known to us. Patients were invited to attend for clinical, renal cardiac, ophthalmological and neurological assessment.Results: Sixty‐seven patients (29 men and 38 women) from 18 families participated. Diagnosis in index cases was delayed by ≥10 years in nearly all families. Common clinical features are: (i) episodic acropar­aesthesia (100% of hemizygotes; 53% of heterozygotes), (ii) anhydrosis (93%; 1%), (iii) characteristic rash (93%; 13%), (iv) renal disease (69%; 21%), (v) ischaemic heart disease (28%; 26%), (vi) palpitations (62%; 29%), (vii) mitral valve murmurs (37%; 23%) and (viii) premature cerebro­vascular disease (31%; 5%). Ophthalmic findings of cornea verticillata (96%; 76%) and anterior cataract (48%; 14%) were common. Findings were variable within and between families. In women, anhydrosis reliably predicts the presence of significant Fabry's renal disease. Small nerve fibre testing using quantitative sensory testing was clearly abnormal in 95% of male patients, and in those female patients with para­esthesiae.Conclusions: Symptoms of anhydrosis, acroparaesthesiae, rash and renal disease suggest diagnosis of Fabry’s. Women are commonly symptomatic, and the advent of therapy highlights the practical advantage of earlier diagnosis. (Intern Med J 2002; 32: 575−584)
Position of the internal jugular vein in children. A study of the anatomy using ultrasonography
Authors: MALLINSON C. , BENNETT J. , HODGSON P. , PETROS A. J. 
Published: March 2003

SummaryThe relative anatomy of the internal jugular vein (IJV) was studied in 25 patients undergoing cardiac catheterization under general anaesthesia, with the use of a portable ultrasound probe. In 14 of cases the IJV was anterior, 1 anterolateral and in 10 lateral to the carotid artery between the two heads of the sternocleidomastoid muscle. At the level of the cricoid cartilage, in six cases the IJV was anterior, three anterolateral and in 16 of children the IJV was lateral to the carotid artery. When attempting to cannulate the IJV, because of the variability in relationship of the IJV to CA the technique used should be modified depending upon the level at which cannulation is attempted. The position of the IJV in the child appears to be so variable extra care should be taken when cannulating the IJV and it should not be assumed that the techniques used in adults are directly transferable.
The laryngeal mask airway in the difficult paediatric airway: an assessment of positioning and use in fibreoptic intubation
Authors: Walker Robert W.M. 
Published: March 2003

SummaryThe laryngeal mask airway (LMA) was used in 34 children who presented with difficult airways and difficulty in intubation. All 34 children were a grade 3 or grade 4 Cormack and Leehane view at conventional laryngoscopy. The laryngeal mask airway was used as part of the anaesthetic technique. It was either used as the method of airway maintenance during a short procedure or as an aid to fibreoptic intubation. The results of its use in this group of patients showed that overall a good airway was obtained in 73% of patients and an adequate airway in 27%, and in no patient was a poor airway obtained. The fibreoptic positioning of the LMA, taken from the distal aperture of the laryngeal mask airway showed that, overall, in 29.5% of patients a full view of the glottis (grade 1) was obtained, in 29.5% of patients a partial view of the glottis (grade 2) was obtained and in 41% a view of the epiglottis only (grade 3) was obtained. In no patient was a view excluding the epiglottis obtained. In children with a mucopolysaccharide disorder, the number of children who had a grade 3 view increased to 54%. Children with a disorder other than mucopolysaccharidosis had a grade 3 view in only 17% of cases. Children with mucopolysaccharidoses had a grade 1 view in only 14% of cases compared with 58% in the group with other disorders. Of the 34 patients, 21 patients were intubated on 31 separate occasions. There were no failures. The complications of the fibreoptic intubation technique described are outlined.
The effect of propofol on intraoperative electrocorticography and cortical stimulation during awake craniotomies in children
Authors: Soriano Sulpicio G. , Eldredge Elizabeth A. , Wang Frank K. , Kull Lewis , Madsen Joseph R. , Black Peter McL. , Riviello James J. , Rockoff Mark A. 
Published: March 2003

SummaryPropofol has been proposed as a sedative agent during awake craniotomies. However, there are reports of propofol suppressing spontaneous epileptiform electrocorticography (ECoG) activity during seizure surgery, while others describe propofol‐induced epileptiform activity. The purpose of this study was to determine if propofol interferes with ECoG and direct cortical stimulation during awake craniotomies in children. Children scheduled for awake craniotomies for resection of epileptic foci or tumours were studied. An intravenous bolus of 1–2 mg·kg−1 followed by infusion of 100–200 μg·kg−1·min−1 of propofol was administered to induce unconsciousness. Fentanyl (0.5 μg·kg−1) was administered incrementally to provide analgesia. After the cortex was exposed, the propofol infusion was stopped and the patient permitted to awaken. Cortical electrodes were applied. ECoG was recorded continuously on a Grass polygraph. Motor, sensory, language, and memory testing were done throughout the procedure. The cortex was stimulated with a hand‐held electrode using sequential increases in voltage to map the relevant speech and motor areas. We studied 12 children (aged 11–15 years) with intractable seizures. The raw ECoG did not reveal any prolonged β‐waves associated with propofol effect. Electroencephalogram spikes due to spontaneous activity or cortical stimulation were easily detected. Cognitive, memory and speech testing was also successful. We conclude that propofol did not interfere with intraoperative ECoG during awake craniotomies. Using this technique, we were able to fully assess motor, sensory, cognitive, speech and memory function and simultaneously avoid routine airway manipulation.
Onset and duration of action of rocuronium in children receiving chronic anticonvulsant therapy
Authors: Soriano Sulpicio G. , Kaus Sarah J. , Sullivan Lorna J. , Martyn J.A. Jeevendra 
Published: March 2003

SummaryThe onset and time course of action of rocuronium in normal children and children receiving anticonvulsant drugs for prolonged periods was characterized. A single bolus dose of 0.6 mg·kg−1 rocuronium was administered i.v. to seven nonepileptic patients on no medication, and eight patients on chronic anticonvulsant therapy consisting of either phenytoin, carbamazepine, or both who were age and weight matched. Neuromuscular transmission was monitored by the evoked compound electromyography of the thenar muscles using train of four stimulation every 20 s. Recovery times of the first twitch to 10%, 25%, 50%, 75% and 100% of baseline values and recovery index were obtained. The onset times were 1.05±0.5 and 1.41±0.5 min for the control and anticonvulsant groups respectively and were not significantly different. Children receiving chronic anticonvulsant therapy had significantly shorter recovery index than the control group (control 10.4±5.1 min, anticonvulsant 4.8±1.7 min, P<0.05). Furthermore, the duration of recovery to 10%, 50%, 75% and 100% of baseline T1 values was less in the anticonvulsant drug group. Our data confirm resistance to rocuronium in children on chronic anticonvulsant drugs.