bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of the biological features between prostate cancers arising in the transition and peripheral zones
Authors: Sakai Iori , Harada Ken‐Ichi , Hara Isao , Eto Hiroshi , Miyake Hideaki 
Published: August 2005

OBJECTIVESTo investigate differences in the biological features of prostate cancer according to the zonal origin.PATIENTS AND METHODSAmong 172 consecutive patients who had a radical prostatectomy (RP), the study included 124 diagnosed as having either transition zone (TZ) or peripheral zone (PZ) cancer, defined according to whether there was > 70% of the cancer area in the TZ or PZ, respectively. The clinicopathological features were then compared between these groups. In addition, the RP specimens were stained immunohistochemically with antibodies to Ki‐67, Bcl‐2, matrix metalloproteinase‐2 (MMP‐2), MMP‐9 and vascular endothelial growth factor (VEGF).RESULTSTwenty‐four patients were diagnosed as having TZ cancer and the remaining 100 as having PZ cancer. Prostate specific antigen (PSA) values in patients with TZ cancer were significantly higher than in those with PZ cancer. Tumour volume in TZ cancer was significantly greater than that in PZ cancer, but there was no significant difference in biochemical recurrence‐free survival between the groups. Immunohistochemistry showed that despite there being no differences in Bcl‐2 and VEGF expression between TZ and PZ cancers, there was significantly greater expression of Ki‐67, MMP‐2 and MMP‐9 in PZ than TZ cancers.CONCLUSIONSDespite there being no significant difference in biochemical recurrence‐free survival after RP between patients with TZ and PZ cancers, there was less cell proliferation and biomarker levels related to invasive potential in TZ than in PZ cancers.
Local steroid application during nerve‐sparing radical retropubic prostatectomy
Authors: Deliveliotis Charalambos , Delis Athanasios , Papatsoris Athanasios , Antoniou Nikos , Varkarakis Ioannis M. 
Published: August 2005

OBJECTIVETo evaluate the effect on potency rates after surgery of applying local steroids to the neurovascular bundles (NVBs) of the prostate after bilateral nerve‐sparing radical retropubic prostatectomy (BNS‐RRP).PATIENTS AND METHODSSixty potent men undergoing BNS‐RRP for clinically localized prostate cancer were prospectively randomized equally into two groups. In group 1, 10 mL of betamethasone cream 0.1% was applied locally to both NVBs, and group 2 had only the usual BNS‐RRP with no corticoid cream. Complications and potency were evaluated at 3, 6 and 12 months in all patients and compared between the groups.RESULTSAt 12 months, 57% and 60% of patients were potent in group 1 and 2, respectively; the respective mean International Index of Erectile Function (5‐item) scores were 14.76 and 15.43 (P = 0.59). Potency rates at 3, 6 and 12 months were not significantly different between the groups, and the continence rates at 12 months were also similar, with 93% and 90% of patients in groups 1 and 2 being continent, respectively. Ten and five patients in groups 1 and 2, respectively, required a blood transfusion (P = 0.23). There were no fistulae, wound dehiscence or rectal perforations. One patient in group 2 presented 4 months after RRP with a bladder neck contracture.CONCLUSIONSLocal application of betamethasone does not improve or expedite the recovery of erectile function after BNS‐RRP, but there were no complications associated with its use.
Assessing regional hypoxia in human renal tumours using 18F‐fluoromisonidazole positron emission tomography
Authors: Lawrentschuk Nathan , Poon Aurora M.T. , Foo Serene S. , Putra Lydia G. Johns , Murone Carmel , Davis Ian D. , Bolton Damien M. , Scott Andrew M. 
Published: August 2005

OBJECTIVETo assess renal tumours for hypoxic regions using 18F‐fluoromisonidazole (18F‐FMISO) positron emission tomography (PET), a recognized noninvasive method for detecting hypoxia in tumours, as renal cell carcinoma (RCC) can be potentially cured with nephrectomy but recurrence develops in most patients, who then respond poorly to treatments such as chemotherapy, and hypoxia is known to confer resistance to radiotherapy and chemotherapy in many solid tumours.PATIENTS AND METHODSIn all, 17 patients had 18F‐FMISO PET scans before nephrectomy for presumed RCC. Specimens were examined histologically, and immunohistochemistry was used to compare the microvessel density (MVD) as an indicator of angiogenesis in the tumour and normal parenchyma, in 15 patients. Tumour oxygenation was measured invasively in three patients using a polarographic oxygen sensor probe.RESULTSOf the 15 patients with histological results, 11 had RCC and four had other tumours. Although there was a trend there was no statistically significant (P = 0.14) difference in the maximum standardized uptake value (SUVmax) when comparing the region of the kidney involved with RCC; the mean (95% confidence interval) SUVmax in the tumours was 1.3 (0.15), whilst that in the normal contralateral kidney was 1.1 (0.22). The MVD was greater in RCC, at 13.7 (3.1) mean vessels per high‐power field than in normal tissue, at 6.9 (1.9). Hypoxia as measured polarographically was detected in three RCCs (median pO2 9.6 mmHg) compared to normal parenchyma at 37.6 mmHg.CONCLUSIONSAlthough 18F‐FMISO scans showed significant uptake in other solid tumours, there was only mild 18F‐FMISO uptake in the present RCCs. The invasive measurements indicated that there was hypoxia in RCC, but the median pO2 did not fall below 9.5 mmHg. Further direct studies of renal tumour oxygenation combined with therapies directed towards hypoxia may allow a better understanding of the relationship between 18F‐FMISO results and the biological significance of hypoxia in RCC.
Detection of human telomerase RNA in the tumour‐surrounding mucosa of bladder carcinomas as a marker for premalignant transformation
Authors: Leuenroth Sven , Riethdorf Sabine , Erbersdobler Andreas , Riethdorf Lutz , Löning Thomas , Huland Hartwig , Friedrich Martin G. 
Published: August 2005

OBJECTIVESTo investigate tumour tissue and non‐malignant tumour‐surrounding bladder mucosa (NTSBM) for expression of human telomerase RNA (hTR) as a possible marker for premalignant transformation of urothelial cells.MATERIAL AND METHODSFrom 67 patients with superficial transitional cell carcinoma (TCC), sections with representative tumour tissue and NTSBM were selected for evaluation. Sections with moderate or severe dysplasia were omitted from evaluation. hTR expression was detected with in situ hybridization using a 35S‐UTP‐labelled riboprobe, and analysed semiquantitatively by counting the hybridization signals.RESULTSIn 45 of the 67 patients hTR expression was moderate or strong in tumour tissue, and in 20 hTR expression was moderate or strong in NTSBM. Moderate or strong hTR expression was detected in the NTSBM from 19 of 60 patients with pTa/pT1 tumours. Of the 56 patients who were treated conservatively, eight had tumour recurrence, of whom five had moderate or strong hTR expression in the TSBM, compared with only 14 of 48 patients without tumour recurrence.CONCLUSIONDetecting hTR expression and the morphological distribution of hTR hybridization signals in NTSBM by in situ hybridization might indicate premalignant alterations involved in tumour recurrence.
Comparison of tamsulosin and naftopidil for efficacy and safety in the treatment of benign prostatic hyperplasia: a randomized controlled trial
Authors: Gotoh Momokazu , Kamihira Osamu , Kinukawa Tsuneo , Ono Yoshinari , Ohshima Shinichi , Origasa Hideki ,   the Tokai Urological Clinical Trial Group
Published: August 2005

OBJECTIVESTo compare the efficacy and safety of two α1a/α1d adrenoceptor (AR) antagonists with different affinity for the α1AR subtypes, tamsulosin and naftopidil, in the treatment of benign prostatic hyperplasia (BPH).PATIENTS AND METHODSPatients with BPH were randomized to receive either tamsulosin or naftopidil. The primary efficacy variables were the changes in the total International Prostate Symptom Score (IPSS), maximum flow rate on free uroflowmetry, and residual urine volume. The secondary efficacy variables were average flow rate, changes in the IPSS storage score, IPSS voiding score, and quality‐of‐life (QoL) Index score, from baseline to endpoint (12 weeks). Data on all randomized patients were included in the safety analyses for adverse effects and changes in blood pressure.RESULTSOf the 185 patients enrolled data for 144 who were eligible for inclusion in the efficacy analysis were analysed (75 from the tamsulosin and 69 from the naftopidil group). There was no significant difference in any variable at baseline between the groups. There were satistically significant improvements for all primary and secondary variables in both groups, except for residual urine in the tamsulosin group. However, there was no significant intergroup difference in the improvement of any efficacy variable between the groups. The adverse effects were comparable, with no significant differences in systolic and diastolic blood pressure after treatment in both groups.CONCLUSIONSThis study suggests that naftopidil is as effective and safe as tamsulosin. Both drugs were effective in improving storage and voiding symptoms. However, there was no difference in clinical efficacy or adverse effects between the α1 AR antagonists with different affinity to α1 subtypes, α1a and α1d.
Treatment of incontinence after prostatectomy using a new minimally invasive device: adjustable continence therapy
Authors: Hübner Wilhelm A. , Schlarp Oliver M. 
Published: August 2005

OBJECTIVETo evaluate the safety and efficacy of a new minimally invasive urological implant for incontinence after prostatectomy.PATIENTS AND METHODSThe adjustable continence therapy device (ProACTTM, Uromedica, Plymouth, MN, USA) consists of two balloons placed via a perineal approach bilaterally at the bladder neck in patients after prostatectomy. Titanium ports, attached via discrete tubing to each balloon, are placed in the scrotum, allowing for separate volume adjustments of the balloons at any time during and after surgery. Changes in a quality‐of‐life questionnaire (I‐QoL), pad usage and a subjective continence grading score were assessed in 117 consecutive men after implanting the Pro‐ACT, at baseline and at 1, 3, 6, 12 and 24 months.RESULTSAfter a mean (range) follow‐up of 13 (3–54) months and with a mean of 3 (0–15) adjustments, 67% of men were dry, using at most one ‘security’ pad daily; 92% were significantly improved, and 8% showed no improvement. The I‐QoL score improved from a median of 34.7 to 66.3 after 2 years (42 men; P < 0.001), the daily pad count decreased from a mean of 6 (1–24)/day to 1 (0–6)/day at 2 years (P < 0.001). Continence achieved at ≤ 6 months after implantation through incremental adjustment remained durable at ≥ 2 years in most patients. There were complications during and after surgery in 54 patients, mostly minor and decreasing with increasing expertise, primarily reflecting the development and refinement of the new surgical technique and its instrumentation. Re‐implantation for complications was required in 32 patients, with a 75% success rate.CONCLUSIONSThe ProACT peri‐urethral prosthesis produces durable outcomes equivalent or better than other minimally invasive treatments for incontinence after prostatectomy. Its unique design allows for easy adjustment after surgery to achieve the desired urethral resistance, with no further surgical intervention, thus allowing for an optimum balance between voiding pressures and continence. The promising results reported here suggest that this may be an appropriate, effective and durable first‐line treatment to offer men with stress urinary incontinence after prostatectomy.
Prospective analysis of outcomes after microsurgical intussusception vasoepididymostomy
Authors: Chan Peter T.K. , Brandell Roy A. , Goldstein Marc 
Published: August 2005

OBJECTIVETo prospectively analyse the outcomes of microsurgical vasoepididymostomy using the intussusception technique, as vasoepididymostomy is considered the most challenging reconstructive microsurgery in urology.PATIENTS AND METHODSFrom 1998 to 2003, of 324 men with obstructive azoospermia who had undergone microsurgical reconstruction of the reproductive tracts, 68 (21%) had intussusception vasoepididymostomy bilaterally or unilaterally in a functionally solitary testis. The outcomes of these patients were analysed prospectively.RESULTSThe mean age was 39.8 years for the men and 31.8 years for their partners. The causes of obstruction were after vasectomy in 31%, infection in 22%, iatrogenic in 19%, trauma in 1.5%, and idiopathic in 27%. The median duration of obstruction was 18.8 years; 37% of patients had had previous failed attempts at reconstruction. The mean (range) follow‐up was 15.2 (1–36) months. The overall patency (>10 000 sperm/mL) rate was 84% (53/63). Patency was achieved in 60% (38/63) of men at 1 month after surgery. The mean best sperm count was 12.8 (0.01–80) × 106/mL, with a 21 (0–30)% motility. Among patients with a follow‐up of > 1 year, the natural paternity rate was 40%. The median time to achieve a natural pregnancy was 14.3 (3–30) months. Pregnancy was achieved with in vitro fertilization or intracytoplasmic sperm injection in 31% of cases, all using fresh ejaculated sperm.CONCLUSIONSA favourable patency and pregnancy rate can be achieved using microsurgical intussusception vasoepididymostomy. Even when assisted‐reproductive technology is needed, fresh ejaculated sperm can be used without requiring a subsequent sperm retrieval procedure. Thus, microsurgical reconstruction of the reproductive tract should be primary therapeutic method in cases of azoospermia from epididymal obstruction.
Should the upper tracts be imaged for microscopic haematuria?
Authors: Feldstein Murray S. , Hentz Joseph G. , Gillett Michael D. , Novicki Donald E. 
Published: August 2005

OBJECTIVETo determine the relative prevalence of various definitions of microscopic haematuria (MH) in patients with renal neoplasms and controls, and to predict the likely outcome of renal imaging for those definitions.PATIENTS AND METHODSIn a retrospective case‐control study 278 adult men and woman seen between 1998 and 2003 with untreated renal neoplasms were compared to controls matched for age and sex. All cases and controls had renal imaging within 6 months of a urine analysis. Patients were excluded for gross haematuria or other conditions associated with MH but not relevant to upper tract imaging. Adjusted odds ratios (OR) computed for 13 definitions of MH by conditional logistic regression were the primary outcome measures. Additional outcome measures were ORs in selected subsets. Hypothetical performance characteristics of a positive urine analysis were then derived to predict the likely results of detecting renal neoplasms for each definition of MH.RESULTSThe OR (95% confidence interval) for the entire series of cases and controls, both symptomatic and asymptomatic, was 2.0 (1.02–3.92, P = 0.04) for MH defined as ≥ 4 red blood cells per high‐power field (RBC/HPF) and 2.2 (1.09–4.52, P = 0.03) for ≥ 5 RBC/HPF. No significant OR was calculated for ≤ 3 RBC/HPF, nor for a subgroup of patients with MH in a routine urine analysis obtained during a periodic health examination. Symptomatic patients had an OR of 13.68 (1.6–117.1, P = 0.02) for MH defined as ≥ 5 RBC/HPF. The sensitivity of a positive test decreased from 24.8% to 5.04% as the definition for MH became more stringent. The theoretical positive predictive value (assuming a prevalence of renal cell neoplasms of 0.25%) of the most stringent definition of MH was 0.58%.CONCLUSIONSPatients with renal neoplasms have about twice the prevalence of MH with ≥ 4 or 5 RBC/HPF in a single urine sample compared with matched controls, but this difference has little impact on the hypothetical detection rate of renal cancer. Imaging the kidney for low‐grade MH in a routine urine analysis discovered at a periodic health examination in an otherwise asymptomatic patient is tantamount to screening without cause, and can be deferred for selected patients. The clinical context is as important as the degree of MH when deciding to image the kidneys.
Apoptosis and proliferation in human undescended testes
Authors: Ofordeme Kenechukwu G. , Aslan Ahmet R. , Nazir Talat M. , Hayner‐Buchan Alida , Kogan Barry A. 
Published: August 2005

OBJECTIVETo study apoptosis and proliferation in the testes of children with undescended testes; the degree to which undescended testes contributes to a patient's ultimate fertility is debatable, but undescended testes have fewer germ cells, and some have proposed that apoptosis is an important cause.PATIENTS AND METHODSTestis biopsies were taken at the time of orchidopexy in a consecutive series of children undergoing surgical repair for undescended testes. Immunohistological techniques were used to detect apoptosis and proliferation, and the numbers of cells undergoing apoptosis or proliferation per 50 seminiferous tubules were recorded.RESULTSInguinal testes had less apoptosis than abdominal testes, with a mean (sd) of 0.71 (1.31) vs 1.63 (1.95) apoptotic cells per 50 seminiferous tubules (P < 0.02). Similarly, there was less apoptosis in children aged > 1 years than in children aged < 1 years (0.68 (1.40) vs 1.35 (1.56); P < 0.03). Proliferation was very limited in all cryptorchid testes. In contrast to cryptorchid testes, five autopsy controls had many more apoptotic cells, (10.60 (1.34) per 50 seminiferous tubules), and many more proliferating cells, (8.40 (6.43) per 50 seminiferous tubules).CONCLUSIONIn contrast to animal studies, neither apoptosis nor proliferation was common in undescended testes from 6 months of age onward. However, apoptosis was more common in abdominal testes and in children aged < 1 year. It is likely that, if substantial apoptosis occurs in human undescended testes, it occurs before 6 months of age.
Central and Eastern European Agriculture and Environment: The Challenges of Governance at Multiple Levels
Authors: Gatzweiler Franz 
Published: August 2005

AbstractBuilding institutions of sustainability which are able to govern the many resource problems in Central and Eastern European agriculture and environment requires time and coordination. Time is needed to respond to the complexity and diversity of agri‐environmental resource problems and coordination is required to make the institutions work across different levels of decision‐making. The efforts for building such institutions took place within the field of tension between accession and evolution. Accession related institutional change took place within the time frame foreseen by politicians to meet accession criteria. Most local agri‐environmental problems, however, require more time for matching agri‐environmental conditions, with the interests, goals and skills of the different actors involved. Such problems of multiple governance have been successfully addressed in many Western European countries, which calls for an exchange of knowledge between Western and Eastern European resource managers. Partnership is recommended as a particularly useful concept during transition for solving many of the problems faced by the different actors and authorities involved in the challenge of sustainable resource management. This paper demonstrates the challenges of governance at different levels of decision‐making and identifies factors which hamper and promot this process
Agri‐Environment Problems Before and During Transition
Authors: Sumelius John , Bäckman Stefan , Sipiläinen Timo 
Published: August 2005

AbstractAn of overview how agri‐environmental problems in 12 central and eastern european countries (CEECs) changed between 1989 and1998 is provided and related to changes in land ownership. Three groups of countries according to land ownership are identified. The change in environmental problems relating to soil, water, biodiversity, and landscape is described. Referring to quantitative data collected in the CEECs, the main trends and new problems that have emerged during the transition process are identified. Possible links between the organizational character of farms and environmental problems are suggested.
Reviving Pre‐Socialist Cooperative Traditions: The Case of Water Syndicates in Bulgaria
Authors: Theesfeld Insa , Boevsky Ivan 
Published: August 2005

AbstractDuring the post‐Socialist transition period, the Bulgarian irrigation facilities deteriorated to a large extent and no longer meet the needs of the new landowner and agricultural production structure. The Bulgarian government therefore enacted two new laws to encourage collective action and to establish water user associations in order to achieve sustainable water management. In this article, we will question the frequent argument that water user associations could easily be established in Bulgaria, because they are rooted in the water syndicates. The analysis of the historical cooperative movement in Bulgaria shows that the water syndicates were enforced by a top‐down approach and thus these pseudo cooperatives do not represent collective action and hence do not serve as examples for the establishment of water user associations. Besides, empirical findings from village case studies reveal that limited collective memory exists today about former water syndicates' rules‐in‐use and patterns of action. We will explain this breach of tradition by the migration from villages to cities, the suppression of pre‐communist so‐called capitalist behaviour, and the length of the socialist period.
Hospitalization for Pneumonia in the Cardiovascular Health Study: Incidence, Mortality, and Influence on Longer‐Term Survival
Authors: O'Meara Ellen S. , White Mark , Siscovick David S. , Lyles Mary F. , Kuller Lewis H. 
Published: August 2005

Objectives: To estimate the rate of hospitalization for pneumonia in community‐dwelling older adults and to assess its risk factors and contribution to mortality.Design: Prospective observational study.Setting: The Cardiovascular Health Study (CHS) in four U.S. communities.Participants: Five thousand eight hundred eighty‐eight men and women aged 65 and older who were followed for a median 10.7 years.Measurements: Participants were interviewed about medical history and demographics; evaluated for lung, physical, and cognitive function; and followed for hospitalizations, cardiovascular disease, and death.Results: Nearly 10% of the cohort was hospitalized for pneumonia, for a rate of 11.1 per 1,000 person‐years (95% confidence interval (CI)=10.2–12.0). Risk factors included older age, male sex, current and past smoking, poor physical and lung function, and history of cardiovascular disease and chronic obstructive pulmonary disease. Ten percent of participants died during their incident pneumonia hospitalization, and death rates were high in those who survived to discharge. Compared with participants who had not been hospitalized for pneumonia, the relative risk of total mortality was 4.9 (95% CI=4.1–6.0) during the first year after hospitalization and 2.6 (95% CI=2.2–3.1) thereafter, adjusted for age, sex, and race. The respective relative risks were 3.9 (95% CI=3.1–4.8) and 2.0 (95% CI=1.6–2.4) after further adjustment for baseline history of cardiovascular disease; diabetes mellitus; smoking; and measures of lung, physical, and cognitive function.Conclusion: In older people, hospitalization for pneumonia is common and is associated with an elevated risk of death, as shown in this population‐based, prospective cohort.