bluuebunny/crossref_metadata_2025_split huggingface dataset:
Testosterone recovery and changes in bone mineral density after stopping long‐term luteinizing hormone‐releasing hormone analogue therapy in osteoporotic patients with prostate cancer
Authors: Weston Robin , Hussain Asad , George Emmanuel , Parr Nigel J. 
Published: March 2005

OBJECTIVETo investigate the rate of testosterone recovery and changes in bone mineral density in patients found to be osteoporotic while receiving luteinizing hormone‐releasing hormone (LHRH) analogues after changing to antiandrogen monotherapy in an attempt to reduce further demineralization.PATIENTS AND METHODSFifteen patients receiving LHRH analogue therapy for ≥ 1 year were identified as osteoporotic by distal forearm dual X‐ray densitometry. They were then converted to antiandrogen monotherapy, and prostate specific‐antigen (PSA) and total testosterone monitored at 3‐monthly intervals. The forearm densitometry was repeated at 1 year.RESULTSAll patients had some testosterone recovery; the mean (range) duration to initial detectable testosterone was 12.8 (6–22) months. Six patients had a normal testosterone level after a mean of 17.5 (14–30) months. In the year after stopping LHRH analogue therapy the mean bone mineral density (t‐score) decreased by 7.2%.CONCLUSIONSOsteoporotic patients, after stopping LHRH analogues, continue to have suppressed levels of testosterone which have a detrimental effect on bone mineral density. We therefore would not advocate conversion to antiandrogen monotherapy to improve bone density, and suggest alternative therapeutic intervention e.g. bisphosphonate therapy, for these patients.
The assessment of patient life‐expectancy: how accurate are urologists and oncologists?
Authors: Wilson James R.M. , Clarke Michael G. , Ewings Paul , Graham John D. , MacDonagh Ruaraidh 
Published: March 2005

OBJECTIVETo assess the degree of accuracy, precision and consistency with which consultant urologists, oncologists and junior doctors predict a patient's 10‐year life‐expectancy.SUBJECTS AND METHODSEighteen doctors of varying seniority independently examined 70 patient case scenarios containing detailed medical histories; 13 of these cases were duplicate scenarios. Bland‐Altman analyses were used to compare doctors’ estimates of the probability of each hypothetical patient surviving 10 years with that calculated using actuarial methods. Intra‐ and interdoctor reliability were also assessed.RESULTSCompared with actuarial estimates, doctors underestimated the 10‐year survival probability by an overall mean of 10.8% (95% confidence interval, 10.1–11.5%). The 18 individual doctors ranged from a mean underestimation of 33.2% to a mean overestimation of 3.9%. Variation around these means was considerable for each doctor, the standard deviations being 14.5–20.9%. Inter‐doctor reliability was 0.58, while overall intra‐doctor reliability was 0.74, but for individual doctors was 0.31–0.94. Junior doctors were less accurate in their predictions than the senior doctors. Five doctors tended to overestimate where life‐expectancy was poor and underestimate where it was good.CONCLUSIONSDoctors were poor at predicting 10‐year survival, tending to underestimate when compared with actuarial estimates. There was also substantial variability both within and between doctors. The inaccuracy, imprecision and inconsistency amongst the doctors in assessing patient life‐expectancy is an important finding and has significant implications for managing patients. Many patients may be denied treatment after a pessimistic assessment of life‐expectancy and (less commonly) some may inappropriately be offered treatment after an optimistic assessment. The particular inaccuracy in junior doctors compared with their senior colleagues also highlights the need for training. The development of a tool to assist in both training and clinical practice has the potential to improve doctors’ decision‐making and patient care.
Combined external urethral bulking and artificial urinary sphincter for urethral atrophy and stress urinary incontinence
Authors: Rahman Nadeem U. , Minor Thomas X. , Deng Donna , Lue Tom F. 
Published: March 2005

OBJECTIVETo describe a technique of externally bulking the urethra with a soft‐tissue graft before placing another artificial urinary sphincter (AUS), as when placing another AUS for recurrent male stress urinary incontinence (SUI) other manoeuvres, e.g. placing a tandem cuff or transcorporal cuff, must be used to obtain urinary continence in an atrophic urethra, and each is associated with morbidity.PATIENTS AND METHODSFrom January 2003 to July 2004, five patients (mean age 74 years, range 62–84) treated by radical prostatectomy were referred for recurrent SUI after placing an AUS (four, including one with urethral erosion) or a male sling (one, with a resulting atrophic urethra). Each patient was treated with an external urethral bulking agent (Surgisis® ES, Cook Urological, Spencer, Indiana) and had an AUS placed.RESULTSIn each patient the greatest urethral circumference was <4 cm. To place a functional 4 cm cuff, the diameter of the urethra was enhanced by wrapping it with Surgisis ES. Continence was significantly improved in all patients except one 84‐year‐old man who had the replanted artificial sphincter removed because of erosion 14 months after surgery.CONCLUSIONIn cases of severe recurrent SUI from urethral atrophy after placing an AUS, externally bulking the urethra with Surgisis ES before placing another AUS is well tolerated, and gives satisfactory results.
The effect on erectile function of 103palladium implantation for localized prostate cancer
Authors: Ponholzer Anton , Oismüller Renée , Somay Canatay , Büchler Felix , Maier Ulrich , Hawliczek Robert , Rauchenwald Michael , Madersbacher Stephan 
Published: March 2005

OBJECTIVETo determine in a prospective study the effect on erectile function of 103Pd brachytherapy for localized prostate cancer, using a validated questionnaire.PATIENTS AND METHODSBetween July 1999 and April 2003, 113 men with localized prostate cancer were treated by permanent implantation of 103Pd seeds, of whom 78 with a follow‐up of 30 months were included in this study. No patient received supplemental external beam radiation therapy. At baseline and 3‐month intervals, erectile function (EF) was assessed by the EF domain score of the International Index of Erectile Function‐15 (IIEF‐15); 77% received (neo)adjuvant antiandrogen therapy for up to 3 months.RESULTSAt baseline, 27 (35%) patients had no erectile dysfunction (ED; EF domain score 26–30), 24 (31%) had mild/moderate ED (score 11–25) and 27 (35%) severe ED (score 6–10). The mean EF domain score decreased from 17 to 12 (P < 0.001) after 30 months. Overall, 52 men (67%, including those with severe ED at baseline) remained in the same ED category at 30 months after therapy as before, 12 (15%) deteriorated by one category, 14 (18%) by two or more, and no patient improved. Of the 27 patients fully potent (score 26–30) at baseline, 37% remained so after 30 months, 19% developed mild and the remaining 44% moderate/severe ED. In a multivariate analysis, neither age nor preoperative prostate‐specific antigen level, prostate volume, D90, hormonal treatment, diabetes, smoking or hypertension were predictive of preserving potency (P > 0.05).CONCLUSIONSThere was a high prevalence of pre‐existing ED in these men; 57% of men fully potent or with mild ED at baseline remained so 30 months after brachytherapy.
Synergistic inhibitory effect of high‐intensity focused ultrasound combined with chemotherapy on Dunning adenocarcinoma
Authors: Paparel Philippe , Curiel Laura , Chesnais Sabrina , Ecochard Rene , Chapelon Jean‐Yves , Gelet Albert 
Published: March 2005

OBJECTIVETo evaluate the therapeutic effect of high‐intensity focused ultrasound (HIFU) combined with chemotherapy (paclitaxel + estramustine) on AT2 Dunning adenocarcinoma, as no satisfactory treatment for localized prostate cancer is available for patients with a poor prognosis, e.g. stage T3, a high Gleason score, or a prostate‐specific antigen level of >15 ng/mL.MATERIALS AND METHODSForty‐one Dunning AT2 tumour‐bearing Copenhagen rats were divided into four groups, i.e. control, chemotherapy, HIFU, and chemotherapy + HIFU (the last three treated for 1 week). The growth in tumour volume was recorded for 3 weeks, the point at which tumour volume was considered to have doubled (doubling time). The growth curves of each group were plotted and evaluated statistically.RESULTSAt 30 days of follow‐up the distributions of tumour volume with treatment group were significantly different (P < 0.001); volumes were significantly greater in the control than in the chemotherapy‐only or in the HIFU‐only group (both P = 0.006). The greatest difference was between the chemotherapy + HIFU and the control group. The tumour doubling times were 13.2 days for HIFU‐only, 31.2 days for chemotherapy + HIFU and 7.7 days for the controls.CONCLUSIONThese results suggest that this combined therapy could be useful for treating patients with high‐risk prostate cancer.
Stereotactic electrical stimulation of the pontine micturition centre in the pig
Authors: Dalmose Asger L. , Bjarkam Carsten R. , Djurhuus Jens Christian 
Published: March 2005

OBJECTIVETo apply stereotactic electrical stimulation of the pig brainstem and thus identify a pontine micturition centre.MATERIALS AND METHODSIn 10 anaesthetized female Vietnamese minipigs a needle‐electrode was positioned in the pontine region. Pressure responses in the lower urinary tract identified the micturition centre functionally during electrical stimulation. Stereotactic coordinates were recorded, and the needle visualized by fluoroscopy, magnetic resonance imaging (MRI) or histologically.RESULTSThe stimulation evoked responses similar to voiding, i.e. a urethral pressure decrease followed by a bladder pressure increase; or similar to a continence manoeuvre, i.e. urethral pressure increase and no change in bladder pressure. In a few cases a continence response was evoked by stimulating a site 1 mm away from the site where a voiding response was evoked. The electrode position was detected by the fluoroscopy‐based stereotactic procedure followed by subsequent MRI (one animal), and by histological analysis, verifying it to be in the dorsolateral pontine region.CONCLUSIONSThese results show that a pontine micturition centre exists in pigs similar to that described in rats, cats, dogs and humans.
Assessment of microheterogeneity of blood flow in the rat urinary bladder by high‐resolution digital radiography
Authors: Kimura Takahiro , Yamamoto Tokunori , Sone Atsushi , Takenaka Atsushi , Fujisawa Masato 
Published: March 2005

OBJECTIVESTo assess high‐resolution digital radiography for measuring blood flow and thus examine the microheterogeneity of bladder microcirculation in a rat model.MATERIALS AND METHODSMicroheterogeneity of blood flow in both mucosa and detrusor muscle of eight anaesthetized rats was investigated using an imaging technique with very high spatial resolution (0.1 × 0.1 mm2) using digital radiography combined with the deposition of 3H‐labelled desmethylimipramine. The spatial pattern of blood flow was quantified by the coefficient of variation of the regional flow (CV = sd/mean).RESULTSMuscle blood flow was less than mucous blood flow (muscle : mucosa, 2.9 : 5) in the empty bladder. In the muscle layer the blood flow distribution was more heterogeneous than that in the mucosa, with a mean (sd) CV in muscle and mucosa of 0.33 (0.033) and 0.16 (0.019), respectively (P < 0.001) at the capillary level.CONCLUSIONThere was a heterogeneous distribution of blood flow in the microcirculation to capillary vessels in the muscular layer, possibly reflecting a difference in dynamic blood flow of regional perfusion of the emptied bladder.
Patient perceptions of privacy infringements in an emergency department
Authors: Karro Jonathan , Dent Andrew W , Farish Stephen 
Published: March 2005

AbstractObjective:  To identify the nature, severity, impact, frequency and risk factors for patient perceived privacy infringements in the ED of St Vincent's Health Melbourne with 32 000 emergency attendances per annum.Methods:  Patients 18 years and older attending emergency over a 2‐week period were offered a nine‐item questionnaire using a Likert scale. A privacy incident was defined as: (i) overhearing medical or personal information; (ii) being overheard; (iii) having private body parts exposed or (iv) seeing others’ body parts. Differences between demographic, emergency environment, length of stay and other factors suspected of affecting patient privacy were quantified.Results:  From 1169 emergency presentations, 235 patients returned questionnaires, with 105 of these (45%) reporting a total of 159 privacy incidents. Seventy‐eight patients (33%, 95% CI 28–36%) reported a definite privacy incident and 81 (35%, 95% CI 29–37%) reported a probable privacy incident. Ninety‐six patients (41%, 95% CI 35–47%) reported overhearing other patient's conversations with the staff whereas 36 (15%, 95% CI 11–21%) felt their conversations with staff were overheard by others. Twenty‐seven patients (11%, 95% CI 6–14%) experienced or observed inappropriate exposure of private body parts. Ten patients (4%, 95% CI 2–7%) changed or withheld information from staff because they felt others may overhear it and two refused part of their physical examination because they felt they may be seen by inappropriate people. Twenty‐four patients (10%, 95% CI 6–14%) did not have their expectations of privacy met. The longer a patient was in emergency the greater the number of privacy incidents they experienced (Spearman correlation P < 0.01). Patients in walled cubicles experienced fewer privacy incidents than those in curtained cubicles (P < 0.05).Conclusions:  Patient privacy incidents occur frequently in an ED, risk factors being length of stay and absence of a walled cubicle. Patients who have their conversations overheard are more likely to withhold information from staff and less likely to have had their expectations of privacy met.
A double‐blind, randomized trial of intravenous versus intramuscular antivenom for Red‐back spider envenoming
Authors: Ellis Rodney M , Sprivulis Peter C , Jelinek George A , Banham Neil DG , Wood Simon V , Wilkes Garry J , Siegmund Andrew , Roberts Brigit L 
Published: March 2005

AbstractObjective:  To compare the efficacy of intravenous versus intramuscular antivenom (AV) in the treatment of Red‐back spider (RBS) envenoming.Methods:  Randomized, double‐dummy, double‐blind, multicentre trial of patients with red‐back spider envenoming requiring AV treatment recruited from five hospital EDs in Western Australia.Results:  Thirty‐five patients were recruited; two were excluded; 33 were available for initial analysis, but two who were unblinded after one ampoule of trial AV and given i.v. AV had limited data; 31 remained in the study and had more complete data. After AV, pain scores for both i.m. and i.v. groups improved rapidly. At 24 h, the i.v. group was better with a 55% absolute difference (76% vs. 21%; 95% CI 25–85% difference) in the proportion pain‐free. There were no safety issues.Conclusions:  Red‐back spider antivenom was initially effective by both i.m. and i.v. routes. The study generates the hypothesis that at 24 h, significantly more patients are pain‐free with i.v. administration. Definitive recommendations on the optimal route of administration of RBS AV await the results of further studies.
IgM colocalises with complement and C reactive protein in infarcted human myocardium
Authors: Krijnen P A J , Ciurana C , Cramer T , Hazes T , Meijer C J L M , Visser C A , Niessen H W M , Hack C E 
Published: March 2005

Aims:Reperfusion of ischaemic myocardium after acute myocardial infarction (AMI) can induce ischaemia/reperfusion (I/R) injury, as a result of local activation of the complement system. C reactive protein (CRP) is involved in this activation. This study analysed the potential role of IgM in complement activation in the infarcted human myocardium.Methods:Immunochemical analysis was carried out on heart specimens from 59 patients who died from AMI. Serial slides of frozen tissue from the infarction site were stained for IgM, complement factors C3d and C5b–9 (membrane attack complex), and CRP.Results:IgM deposits were found on the plasma membrane, cross striations, and in the cytoplasm of jeopardised cardiomyocytes in infarcts of one to five days duration. IgM depositions were remarkably similar to those of CRP and both complement factors. The relative staining intensities of IgM and CRP varied greatly among patients.Conclusions:Similar to CRP, IgM targets complement locally to jeopardised cardiomyocytes in the human heart after AMI. Localisation patterns and relative staining intensities suggest that IgM and CRP recognise similar epitopes in the ischaemic heart, but that the relative contribution of each protein to complement activation in the ischaemic myocardium differs among patients.
Neural Correlates of Memory for Items and for Associations: An Event-related Functional Magnetic Resonance Imaging Study
Authors: Achim Amélie M. , Lepage Martin 
Published: March 2005

AbstractAlthough results from cognitive psychology, neuropsychology, and behavioral neuroscience clearly suggest that item and associative information in memory rely on partly different brain regions, little is known concerning the differences and similarities that exist between these two types of information as a function of memory stage (i.e., encoding and retrieval). We used event-related functional magnetic resonance imaging to assess neural correlates of item and associative encoding and retrieval of simple images in 18 healthy subjects. During encoding, subjects memorized items and pairs. During retrieval, subjects made item recognition judgments (old vs. new) and associative recognition judgments (intact vs. rearranged). Relative to baseline, item and associative trials activated bilateral medial temporal and prefrontal regions during both encoding and retrieval. Direct contrasts were then performed between item and associative trials for each memory stage. During encoding, greater prefrontal, hippocampal, and parietal activation was observed for associations, but no significant activation was observed for items at the selected threshold. During recognition, greater activation was observed for associative trials in the left dorsolateral prefrontal cortex and superior parietal lobules bilaterally, whereas item recognition trials showed greater activation of bilateral frontal regions, bilateral anterior medial temporal areas, and the right temporo-parietal junction. Post hoc analyses suggested that the anterior medial temporal activation observed during item recognition was driven mainly by new items, confirming a role for this structure in novelty detection. These results suggest that although some structures such as the medial temporal and prefrontal cortex play a general role in memory, the pattern of activation in these regions can be modulated by the type of information (items or associations) interacting with memory stages.
Development of Sensitivity to Texture and Contour Information in the Human Infant
Authors: Norcia Anthony M. , Pei Francesca , Bonneh Yoram , Hou Chuan , Sampath Vanitha , Pettet Mark W. 
Published: March 2005

Abstract
Texture discrimination and bounding contour extraction are essential parts of the object segmentation and shape discrimination process. As such, successful texture and contour processing are key components underlying the development of the perception of both objects and surfaces. By recording visual-evoked potentials, we investigate whether young infants can detect orientation-defined textures and contours. We measured responses to an organized texture comprised of many Gabor patches of the same orientation, alternated with images containing the same number of patches, but all of random orientation. These responses were compared with a control condition consisting of the alternation between two independently random configurations. Significant difference potentials were found as early as 2–5 months, as were significant odd harmonics in the test conditions. Responses were also measured to Gabor patches organized either as circles (all patches tangent to an imaginary circular path) alternated with pinwheels (all patches having a fixed orientation offset from the path). Infants between 6 and 13 months also showed sensitivity to the global organization of the elements along contours. Differential responses to our texture and contour stimuli and their controls could only have been generated by mechanisms that are capable of comparing the relative orientation of 2 or more patches, as no local information at a single patch distinguished the random and organized textures or the circle and pinwheel configurations.
Atmospheric Data Assimilation with an Ensemble Kalman Filter: Results with Real Observations
Authors: Houtekamer P. L. , Mitchell Herschel L. , Pellerin Gérard , Buehner Mark , Charron Martin , Spacek Lubos , Hansen Bjarne 
Published: March 2005

Abstract
An ensemble Kalman filter (EnKF) has been implemented for atmospheric data assimilation. It assimilates observations from a fairly complete observational network with a forecast model that includes a standard operational set of physical parameterizations. To obtain reasonable results with a limited number of ensemble members, severe horizontal and vertical covariance localizations have been used.
It is observed that the error growth in the data assimilation cycle is mainly due to model error. An isotropic parameterization, similar to the forecast-error parameterization in variational algorithms, is used to represent model error. After some adjustment, it is possible to obtain innovation statistics that agree with the ensemble-based estimate of the innovation amplitudes for winds and temperature. Currently, no model error is added for the humidity variable, and, consequently, the ensemble spread for humidity is too small. After about 5 days of cycling, fairly stable global filter statistics are obtained with no sign of filter divergence.
The quality of the ensemble mean background field, as verified using radiosonde observations, is similar to that obtained using a 3D variational procedure. In part, this is likely due to the form chosen for the parameterized model error. Nevertheless, the degree of similarity is surprising given that the background-error statistics used by the two procedures are rather different, with generally larger background errors being used by the variational scheme.
A set of 5-day integrations has been started from the ensemble of initial conditions provided by the EnKF. For the middle and lower troposphere, the growth rates of the perturbations are somewhat smaller than the growth rate of the actual ensemble mean error. For the upper levels, the perturbation patterns decay for about 3 days as a consequence of diffusive model dynamics. These decaying perturbations tend to severely underestimate the actual error that grows rapidly near the model top.
Analysis of Diurnal Patterns in Winter Precipitation across the Conterminous United States
Authors: Roy Shouraseni Sen , Balling Robert C. 
Published: March 2005

Abstract
Hourly winter (November–March) precipitation data were assembled for nearly 5000 stations in the conterminous United States over the period 1948–98. Despite a potential observation bias in the 24th hour, a general tendency for winter precipitation events was found to occur more frequently near sunrise than for any other time of the day. Based on the standardized amplitude of the first harmonic wave, the pattern is most pronounced in Texas and in an area surrounding Colorado and Wyoming. The pattern also appears significant in the southeastern United States and in northern California based on the variance explained by the first harmonic fit. It is suggested that the diurnal patterns seen in the conterminous United States are related to increased relative humidity values occurring near sunrise and increased wind speeds in the warm sector of cyclonic storms.