bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alfuzosin 10 mg once daily improves sexual function in men with lower urinary tract symptoms and concomitant sexual dysfunction
Authors: Van Moorselaar R. Jeroen A. , Hartung Rudolf , Emberton Mark , Harving Niels , Matzkin Haim , Elhilali Mostafa , Alcaraz Antonio , Vallancien Guy ,   ALF‐ONE Study Group
Published: February 2005

Associate EditorMichael G. WyllieEditorial BoardIan Eardley, UKJean Fourcroy, USASidney Glina, BrazilJulia Heiman, USAChris McMahon, AustraliaBob Millar, UKAlvaro Morales, CanadaMichael Perelman, USAMarcel Waldinger, NetherlandsOBJECTIVETo assess the effect on sexual function of alfuzosin 10 mg once daily, a uroselective α1‐blocker, in men with lower urinary tract symptoms (LUTS) suggestive of bladder outlet obstruction.PATIENTS AND METHODSIn all, 3076 men (mean age 65.9 years) were treated for 1 year with alfuzosin 10 mg in ‘real life’ practice. They were asked to complete the International Prostatic Symptom Score (IPSS), its appended eighth question (bother score) and the Danish Prostatic Symptom Score questionnaire for sexual dysfunction (DAN‐PSSsex). The results were analysed at the endpoint in the intent‐to‐treat population.RESULTSAt baseline, 2434 (79.1%) men were sexually active and answered correctly at least one item of the DAN‐PSSsex. Sexual dysfunction was highly prevalent (reduced stiffness of erection, 65.3%; reduced volume of ejaculate, 63.2%; pain/discomfort on ejaculation, 20.2%), and was strongly related to the severity of LUTS and impairment of quality of life. At the endpoint, alfuzosin significantly improved the total IPSS (−6.1, − 32%) and bother score (−1.4, − 33.2%, both P < 0.001) over baseline. In those men with sexual dysfunction there were significant improvements in weighted scores related to reduced rigidity of erection (−0.5), reduced amount of ejaculate (−0.4) and pain/discomfort on ejaculation (−1.2, all P < 0.001) over baseline. The perceived improvements were more marked in men with severe LUTS or a severe bother score at baseline.CONCLUSIONSSexual dysfunction is highly prevalent in men with LUTS and related to the baseline IPSS and bother score. Alfuzosin 10 mg once daily for 1 year is effective in improving LUTS and quality of life, and is well tolerated. It may even improve sexual function in those men with concomitant erectile and/or ejaculatory dysfunction.
The role of indirect radionuclide cystography during the acute phase of pyelonephritis in young women
Authors: Pinthus Jehonathan H. , Oksman Yakov , Leibovitch Ilan , Goshen Elinor , Dotan Zohar A. , Schwartz Arnon , Ramon Jacob , Zwas S. Tzila , Mor Yoram 
Published: February 2005

Authors from Israel have investigated the use of dynamic renal scans in young female patients with acute pyelonephritis, combined with indirect radionuclide cystography. They found that using these techniques may avoid up to half of the delayed voiding cysto‐urethrograms, preventing the related inconvenience and cost.OBJECTIVETo review our experience using dynamic 99mTc‐diethylenetriamine penta‐acetic acid renal scintigraphy combined with indirect radionuclide cystography (IRC) in the acute phase of pyelonephritis, as a possible alternative to the conventional imaging, as investigating acute pyelonephritis usually includes imaging the upper urinary tract during the acute phase, to exclude obstruction, and delayed voiding cysto‐urethrography (VCUG) when underlying vesico‐ureteric reflux (VUR) is suspected.PATIENTS AND METHODSBetween 1997 and 1999, 47 young women (median age 22 years, range 18–37) were hospitalized for acute pyelonephritis. The combined study was used during the acute phase of the disease, usually within 24 h of hospitalization. The principle of IRC is based on the reappearance of radioactivity in the ureters or kidneys after previously detecting renal clearance of an intravenously injected radioisotope. The increase in radioactivity over the ureters or kidneys indicates VUR. The subsequent follow‐up included VCUG, after recovery and at least 6 weeks after discharge.RESULTSOverall, 47 patients had early IRC studies; obstruction of the urinary tract during the acute phase of the disease was excluded in all. In 13 (28%) of the patients early IRC studies showed VUR involving 21 upper tract units. The renal parenchymal scan was impaired in 17 (36%) patients, and six of these 17 also had detectable concomitant reflux on IRC. Overall, 24 IRC studies (51%) were considered positive, showing VUR, renal parenchymal pathology or both; 23 (49%) were normal. Follow‐up VCUG was used in 32 patients (68%); only three (9%) detected VUR. All of the patients with VUR on follow‐up VCUG had also had an abnormal early IRC study, showing either reflux (two) or findings suggestive of pathological renal parenchyma (one).CONCLUSIONSIn addition to the well‐established role of renal scintigraphy in excluding obstruction of the collecting system, early IRC is characterized by high sensitivity and accurate negative predictive value for detecting VUR. It can therefore be used to screen adults presenting with acute pyelonephritis for the presence of VUR. Patients with an abnormal IRC require follow‐up VCUG after complete recovery, while those with a negative study may be managed expectantly, with no further radiological evaluation. This proposed strategy may avoid up to half of the delayed VCUG studies, preclude the related inconvenience, and substantially reduce the costs.
Buccal mucosal urethroplasty: a versatile technique for all urethral segments
Authors: Dubey Deepak , Kumar Anant , Mandhani Anil , Srivastava Aneesh , Kapoor Rakesh , Bhandari Mahendra 
Published: February 2005

Authors from India describe their experience in a series of patients with bulbar urethral strictures in whom they used a buccal mucosal graft. They found this to be the most versatile substitute.OBJECTIVETo present our experience with buccal mucosa urethroplasty for substitution of all segments of the anterior urethra, as the buccal mucosal graft (BMG) has emerged as the tissue of choice for single‐stage reconstruction of bulbar urethral strictures, but its use for reconstructing meatal, pendulous and pan‐urethral strictures has not been widely reported.PATIENTS AND METHODSBetween January 1998 and October 2003, 92 patients had a BMG substitution urethroplasty at our institution; 75 had a single‐stage dorsal onlay BMG urethroplasty (bulbar 41, pendulous 16 and pan‐urethral 18; six combined penile skin flap and BMG) and 17 (pendulous five, pan‐urethral 10, bulbar two) a two‐stage urethroplasty. Recurrence rates, complications and cosmetic outcomes were analysed retrospectively.RESULTSOver a median (range) follow‐up of 34 (8–72) months, 66 (88%) patients with a one‐stage reconstruction (14/16 pendulous; 37/41, 90%, bulbar; 15/16 pan‐urethral) remained stricture‐free. The mean (range) time to recurrence was 9.4 (3–17) months. Of the nine recurrent strictures, six were managed by one‐stage optical urethrotomy and three required a repeat urethroplasty. In patients who had a staged procedure, after a mean follow‐up of 24.2 (9–56) months, one had complete graft loss, requiring re‐grafting, five required stomal revision after stage 1, and only two (12%) developed a recurrent stricture after the two‐stage urethroplasty.CONCLUSIONA one‐stage dorsal onlay BMG urethroplasty provides excellent results for strictures involving any segment of the anterior urethra. The BMG appears to be the most versatile urethral substitute, as it can be successfully used for both one‐ and two‐stage reconstruction of the entire anterior urethra.
Proliferating‐cell nuclear antigen (PCNA) as an independent prognostic marker in patients after prostatectomy: a comparison of PCNA and Ki‐67
Authors: Taftachi Reza , Ayhan Ayse , Ekici Sinan , Ergen Ali , Ozen Haluk 
Published: February 2005

OBJECTIVETo investigate the prognostic value of prostatic tumour cell proliferation, as measured by Ki‐67 and proliferating cell nuclear antigen (PCNA), and to compare these measures in men at low and high risk for progression of tumour.PATIENTS AND METHODSTwo groups of patients with prostate cancer, i.e. ‘metastatic’ (M, 22) who had pT3b‐4aN0M0 and pTanyN1M0, and ‘nonmetastatic’ (NM, 18), who had ≤pT3aN0M0 disease, were selected from a well‐examined and mapped group of 114 treated by radical prostatectomy. Patients in the NM group were selected by the criteria of having a Gleason score of ≤ 7. To assess proliferation, 1000 cells were counted at × 400 magnification by two observers and the percentage of tumour cells positively stained with Ki‐67 and PCNA defined as the Ki‐67 and PCNA labelling index (LI), respectively. The two LI were compared in the NM and M groups, and the correlation of the LIs with pathological stage, progression and prostate‐specific antigen (PSA)‐free survival evaluated. Prognostic values of the LI were analysed using multivariate analysis.RESULTSThe mean (range) follow‐up was 33 (4–78) months. The mean LIs were higher in the M than the NM group for both PCNA and Ki‐67 (P = 0.02 and 0.019, respectively). Both LIs were markedly different between the groups when stratified by progression, with both significantly higher in men with progression in the NM group. Both LIs had a significant association with Gleason score, pathological stage, progression and PSA‐free survival. In multivariate analysis the PCNA LI, surgical margin status and pathological stage were independent factors for progression.CONCLUSIONTumour cell proliferation as assessed by Ki‐67 or PCNA correlate significantly with progression. The PCNA LI was an independent predictor of progression, especially in patients with a low risk of progression according to predefined criteria.
A clinicopathological study of the expression of extracellular matrix components in urothelial carcinoma
Authors: Ioachim Elli , Michael Michalis , Stavropoulos Nicolaos E. , Kitsiou Evangelia , Salmas Marios , Malamou‐Mitsi Vasiliki 
Published: February 2005

OBJECTIVETo measure the immunohistochemical expression of the extracellular matrix (ECM) components tenascin, fibronectin, collagen type IV and laminin in urothelial carcinomas, and to correlate their expression with clinicopathological features to clarify the prognostic value of these molecules and their role in tumour progression.MATERIALS AND METHODSTumour specimens obtained during transurethral resection of bladder tumour (TURBT) from 103 patients (82 men and 2 1 women, mean age 66.7 years, range 27–89) were studied retrospectively. The expression of tenascin, fibronectin, collagen type IV and laminin was correlated with clinicopathological features (tumour grade and stage, multiplicity, simultaneous in situ component, the proliferative activity as estimated by the two proliferation associated indices, Ki‐67 and proliferating cell nuclear antigen, the recurrence rate, and the progression of invading tumour). Specimens investigated for tenascin expression from patients with superficial bladder cancers were categorized into 28 treated by TURBT only and 53 who had TURBT followed by intravesical instillations of interferon.RESULTSCytoplasmic tenascin expression was detected in tumour cells in 20% of specimens. Tenascin was expressed in the tumour stroma in 76% of specimens, and was positively correlated with tumour grade and stage. Stromal tenascin expression was positively correlated with proliferative activity, and with the expression of fibronectin and collagen type IV. Fibronectin was expressed in the tumour stroma in 89% of specimens and was positively correlated with tumour stage, proliferative activity, and expression of collagen type IV and laminin. Collagen type IV was expressed in 93% of specimens, and was positively correlated with tumour grade and stage. Laminin was expressed in 78% of specimens and had no significant correlation with the clinicopathological features. Patients treated with TURBT alone and who had low levels of tenascin had a longer tumour‐free interval than those with high levels of tenascin.CONCLUSIONLevels of tenascin might be valuable for predicting the risk of early recurrence. The expression of tenascin, fibronectin and collagen type IV seems to be correlated with more aggressive tumour behaviour. Furthermore, their interrelationships could indicate that they are involved in the remodelling of bladder cancer tissue, probably influencing tumour progression.
Gleason grade remains an important prognostic predictor in men diagnosed with prostate cancer while on finasteride therapy
Authors: Carver Brett S. , Kattan Michael W. , Scardino Peter T. , Eastham James A. 
Published: February 2005

The controversial topic of the effect of finasteride therapy on Gleason grade, raised by the Prostate Cancer Prevention Trial, is discussed by authors from New York. They assessed a series of patients who had been treated with finasteride, and who subsequently had a radical prostatectomy, to see if this pharmaceutical agent prevented accurate Gleason grade assignment and prediction of biochemical recurrence. They found that Gleason grade remains an important prognostic predictor in men diagnosed with prostate cancer while on finasteride therapy.Authors from Amsterdam assessed the accuracy of ultrasonography‐guided fine‐needle aspiration cytology as a method of detecting occult lymph node metastases in patients with penile cancer, and found that it can be used as an initial investigation in such patients, with helpful clinical outcomes.OBJECTIVETo evaluate men treated with finasteride for lower urinary tract symptoms, who subsequently were diagnosed with prostate cancer and had a radical prostatectomy (RP) at our institution, to determine if finasteride therapy prevented accurate Gleason grade assignment and prediction of biochemical recurrence.PATIENTS AND METHODSBetween May 1996 and July 2003, 45 men were identified who had RP and had previously been treated with finasteride for ≥ 6 months before the diagnosis of prostate cancer. Clinical and pathological information was gathered from a RP database. Serum prostate‐specific antigen (PSA) level, duration of finasteride therapy, biopsy Gleason grade, clinical stage, RP Gleason grade and pathological stage were reviewed. Freedom from recurrence was predicted using validated nomograms before and after RP, and compared against actuarial 5‐year freedom from recurrence using the Kaplan‐Meier method.RESULTSThe mean duration of finasteride therapy before diagnosis was 23.6 months, the mean serum PSA (doubled to account for finasteride use) 11.02 ng/mL and mean biopsy Gleason score 6. When comparing the biopsy and RP specimen Gleason score, it was downgraded by 1 point in six men, upgraded by 1 point in eight, and upgraded by 2 points in one. The Gleason score was constant in 30 patients. The nomograms predicted freedom from recurrence in 83% and 85%, respectively; the 5‐year actuarial freedom from recurrence was 86%.CONCLUSIONFinasteride does not appear to compromise the assignment of Gleason grade for use in prediction tools before or after RP in men undergoing prostate biopsy or RP. The actuarial 5‐year freedom from recurrence was similar to that predicted by the validated nomograms. Gleason grade remains an important prognostic predictor in men treated with finasteride and undergoing RP for clinically localized prostate cancer.
Interest Rate Pass-Through: Empirical Results for the Euro Area
Authors: Bondt Gabe J. de 
Published: February 2005

AbstractThis paper empirically examines the interest rate pass-through at the euro area level. The focus is on the pass-through of official interest rates, approximated by the overnight interest rate, to longer-term market interest rates, which, in turn, are a proxy for the marginal costs for banks to attract deposits or grant loans, and therefore passed through to retail bank interest rates. Empirical results, on the basis of a (vector) error-correction and vector autoregressive model, suggest that the pass-through of official interest to market interest rates is complete for money market interest rates up to three months, but not for market interest rates with longer maturities. Furthermore, the immediate pass-through of changes in market interest rates to bank deposit and lending rates is found to be at most 50%, whereas the final pass-through is typically found to be close to 100%, in particular for lending rates. Empirical results for a sub-sample starting in January 1999 show qualitatively similar findings and are supportive of a quicker interest rate pass-through since the introduction of the euro. It is shown that the difference between the adjustment speed of bank deposit and lending rates (typically around one versus three months since the common monetary policy) can to a large extent significantly be explained by credit risk considerations.
Britain and Europe: An Unforgettable Past and an Unavoidable Future
Authors: STEPHENS PHILIP 
Published: February 2005

The title of this article is taken from the opening lines of Hugo Young's brilliant history of Britain's relationship with Europe, This Blessed Plot. That book begins with a sentence that says it all: 'This is the story of 50 years in which Britain struggled to reconcile the past she could not forget with the future she could not avoid.' Those words were written in the spring of 1998. Despite the early promise of Tony Blair's European policy, little has changed since. For France and Germany, the institutions of Europe represent a uniquely successful attempt to exorcise the past. For its part, Britain lives in the shadow of its history.The struggle to reconcile national identity with strategic interests is as acute as it has ever been. For all that Mr Blair's government has done something in recent years to make Britain's case in Europe, it has failed to make Europe's case in Britain.
MCTD – Mixed Connective Tissue Disease
Authors: Haustein Uwe‐Frithjof 
Published: February 2005

ZusammenfassungDie Mixed connective tissue disease (MCTD) zeichnet sich als eine Krankheitsentität mit Überlappungssymptomen des Lupus erythematodes (LE), der systemischen Sklerodermie (SSc), Dermatomyositis/Polymyositis (DM/PM) sowie der Rheumatoid‐Arthritis (RA) aus. Als diagnostische Kriterien gelten der serologische Nachweis von hohen Antikörpertitern gegen U1RNP und das Vorkommen von mindestens 3 der 5 folgenden klinischen Symptome: Ödem der Hände, Synovitis, Myositis, Raynaud‐Phänomen und Akrosklerose. Pathogenetisch werden neben genetischen auch infektiöse (virale) Aspekte diskutiert. Die Anerkennung der MCTD als eigene Krankheitsentität ist nicht unumstritten, Bezeichnungen wie „undifferenzierte Bindegewebserkrankung” oder „Überlappungssyndrome” helfen nicht weiter. Jeweils ein Viertel bzw. ein Drittel der MCTD‐Patienten gehen im Krankheitsverlauf in einen LE bzw. in eine SSc über. Therapeutisch werden Glukokortikoide in Kombination mit Immunsuppressiva sowie Endothelin‐Rezeptor‐Antagonisten empfohlen. Doppelblindstudien fehlen. Die Prognose ist relativ gut. Unter den Todesursachen dominieren pulmonale Hypertonie, respiratorische und Herzinsuffizienz sowie Infektionen.
Roles of Tumor Necrosis Factor Alpha (TNF-α) and the p55 TNF Receptor in CD1d Induction and Coxsackievirus B3-Induced Myocarditis
Authors: Huber S. A. , Sartini D. 
Published: February 2005

ABSTRACTGiving C57BL/6 mice 104PFU of coxsackievirus B3 (H3 variant) fails to induce myocarditis, but increasing the initial virus inoculum to 105or 106PFU causes significant cardiac disease. Virus titers in the heart were equivalent at days 3 and 7 in mice given all three virus doses, but day 3 titers in the pancreases of mice inoculated with 104PFU were reduced. Tumor necrosis factor alpha (TNF-α) concentrations in the heart were increased in all infected mice, but cytokine levels were highest in mice given the larger virus inocula. TNF-α−/−and p55 TNF receptor-negative (TNFR−/−) mice developed minimal myocarditis compared to B6;129 or C57BL/6 control mice. p75 TNFR−/−mice were as disease susceptible as C57BL/6 animals. No significant differences in virus titers in heart or pancreas were observed between the groups, but C57BL/6 and p75 TNFR−/−animals showed 10-fold more inflammatory cells in the heart than p55 TNFR−/−mice, and the cell population was comprised of high concentrations of CD4+gamma interferon-positive and Vγ4+cells. Cardiac endothelial cells isolated from C57BL/6 and p75 TNFR−/−mice upregulate CD1d, the molecule recognized by Vγ4+cells, but infection of TNF−/−or p55 TNFR−/−endothelial cells failed to upregulate CD1d. Infection of C57BL/6 endothelial cells with a nonmyocarditic coxsackievirus B3 variant, H310A1, which is a poor inducer of TNF-α, failed to elicit CD1d expression, but TNF-α treatment of H310A1-infected endothelial cells increased CD1d levels to those seen in H3-infected cells. TNF-α treatment of uninfected endothelial cells had only a modest effect on CD1d expression, suggesting that optimal CD1d upregulation requires both infection and TNF-α signaling.
Recombinant Modified Vaccinia Virus Ankara Expressing the Spike Glycoprotein of Severe Acute Respiratory Syndrome Coronavirus Induces Protective Neutralizing Antibodies Primarily Targeting the Receptor Binding Region
Authors: Chen Zhiwei , Zhang Linqi , Qin Chuan , Ba Lei , Yi Christopher E. , Zhang Fengwen , Wei Qiang , He Tian , Yu Wenjie , Yu Jian , Gao Hong , Tu Xinming , Gettie Agegnehu , Farzan Michael , Yuen Kwok-yung , Ho David D. 
Published: February 2005

ABSTRACT
Immunization with a killed or inactivated viral vaccine provides significant protection in animals against challenge with certain corresponding pathogenic coronaviruses (CoVs). However, the promise of this approach in humans is hampered by serious concerns over the risk of leaking live severe acute respiratory syndrome (SARS) viruses. In this study, we generated a SARS vaccine candidate by using the live-attenuated modified vaccinia virus Ankara (MVA) as a vector. The full-length SARS-CoV envelope Spike (S) glycoprotein gene was introduced into the deletion III region of the MVA genome. The newly generated recombinant MVA, ADS-MVA, is replication incompetent in mammalian cells and highly immunogenic in terms of inducing potent neutralizing antibodies in mice, rabbits, and monkeys. After two intramuscular vaccinations with ADS-MVA alone, the 50% inhibitory concentration in serum was achieved with reciprocal sera dilutions of more than 1,000- to 10,000-fold in these animals. Using fragmented S genes as immunogens, we also mapped a neutralizing epitope in the region of N-terminal 400 to 600 amino acids of the S glycoprotein (S400-600), which overlaps with the angiotensin-converting enzyme 2 (ACE2) receptor-binding region (RBR; S318-510). Moreover, using a recombinant soluble RBR-Fc protein, we were able to absorb and remove the majority of the neutralizing antibodies despite observing that the full S protein tends to induce a broader spectrum of neutralizing activities in comparison with fragmented S proteins. Our data suggest that a major mechanism for neutralizing SARS-CoV likely occurs through blocking the interaction between virus and the cellular receptor ACE2. In addition, ADS-MVA induced potent immune responses which very likely protected Chinese rhesus monkeys from pathogenic SARS-CoV challenge.