bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methylation is the initial reaction in anaerobic naphthalene degradation by a sulfate‐reducing enrichment culture
Authors: Safinowski Michael , Meckenstock Rainer U. 
Published: September 2005

SummaryThe sulfate‐reducing culture N47 can utilize naphthalene or 2‐methylnaphthalene as the sole carbon source and electron donor. Here we show that the initial reaction in the naphthalene degradation pathway is a methylation to 2‐methylnaphthalene which then undergoes the subsequent oxidation to the central metabolite 2‐naphthoic acid, ring reduction and cleavage. Specific metabolites occurring exclusively during anaerobic degradation of 2‐methylnaphthalene were detected during growth on naphthalene, i.e. naphthyl‐2‐methyl‐succinate and naphthyl‐2‐methylene‐succinate. Additionally, all three enzymes involved in anaerobic degradation of 2‐methylnaphthalene to 2‐naphthoic acid that could be measured in vitro so far, i.e. naphthyl‐2‐methyl‐succinate synthase, succinyl‐CoA:naphthyl‐2‐methyl‐succinate CoA‐transferase and naphthyl‐2‐methyl‐succinyl‐CoA dehydrogenase were also detected in naphthalene‐grown cells with similar activities. Induction experiments were performed to study the growth behaviour of the cell when transferred from naphthalene to 2‐methylnaphthalene or vice versa. When the cells were transferred from naphthalene to 2‐methylnaphthalene they grew immediately, indicating that no new enzymes had to be induced. On the contrary, the transfer of cells from 2‐methylnaphthalene to naphthalene caused a lag‐phase of almost 100 days demonstrating that an additional catabolic enzyme has to be activated in this case. We propose the methylation as a novel general mechanism of activation reactions in anaerobic degradation of unsubstituted aromatic hydrocarbons.
Is adjuvant chemotherapy for bladder cancer safer in patients with an ileal conduit than a neobladder?
Authors: Manoharan Murugesan , Reyes Martha A. , Kava Bruce R. , Singal Rakesh , Kim Sandy S. , Soloway Mark S. 
Published: September 2005

OBJECTIVETo assess the safety of adjuvant chemotherapy in patients with neobladder reconstruction in comparison to ileal conduit, as radical cystectomy and urinary diversion is an effective curative surgical treatment for muscle‐invasive and high‐risk superficial bladder cancer, and adjuvant chemotherapy is usually considered for patients with clinical stage > T2 and nodal metastasis.PATIENTS AND METHODSWe analysed retrospectively patients who had had a radical cystectomy and urinary diversion between 1992 and 2004. Patients with high‐risk disease who had adjuvant chemotherapy were identified and stratified based on the type of urinary diversion (ileal conduit or neobladder). The chemotherapy regimen, complications from the adjuvant chemotherapy and other relevant data were analysed.RESULTSOverall, 343 patients had radical cystectomy, 40 had adjuvant chemotherapy; 25 had an ileal conduit and 15 had a neobladder. Patient characteristics including age, stage and follow‐up were similar. In all, 55% of patients had grade 1 toxicity, 23% grade 2, 18% grade 3, and 13% grade 4. No patients had serious organ toxicity and none died. There were no significant differences in the toxicity among the two groups.CONCLUSIONSAdjuvant chemotherapy appears to be safe in patients with a neobladder and equally safe in patients with an ileal conduit. Hence neobladder reconstruction should not be denied to patients with bladder cancer who are at high risk of recurrence and who might require adjuvant chemotherapy.
The percentage of positive biopsy cores as a predictor of disease recurrence in patients with prostate cancer treated with radical prostatectomy
Authors: Antunes Alberto A. , Srougi Miguel , Dall’oglio Marcos F. , Crippa Alexandre , Campagnari João C. , Leite Kátia R.M. 
Published: September 2005

OBJECTIVETo analyse the prognostic value of the percentage of positive biopsy cores (PPBC) in determining the pathological features and biochemical outcome of patients with prostate cancer treated by radical prostatectomy, as published data evaluating the prognostic value of PPBC in such patients have limitations.PATIENTS AND METHODSA group of 534 patients with clinically localized prostate cancer was selected. The PPBC was defined as the number of positive biopsy cores/total number of biopsy cores × 100, and grouped into categories of <25%, 25.1–50%, 50.1–75% and 75.1–100%. Patients were divided in low‐, intermediate‐ and high‐risk groups according to the usual variables.RESULTSThe mean follow‐up was 60.5 months. PPBC was associated with the preoperative serum prostate‐specific antigen (PSA) level, biopsy Gleason score and clinical stage. On multivariate analysis, PPBC was a significant predictor of extraprostatic disease and seminal vesicle involvement. Of patients in the four PPBC categories, 16%, 27%, 33% and 60%, respectively, had biochemical recurrence (P < 0.001), and on Cox regression analysis, PPBC was an independent predictor of disease recurrence. After segregating patients into risk groups the PPBC further stratified patients using thresholds of 75% (P = 0.006), 25% (P = 0.026) and 50% (P = 0.011) for low‐, intermediate‐ and high‐risk groups, respectively.CONCLUSIONSWe confirmed, with a longer follow‐up, the clinical utility of the PPBC in determining the pathological features and biochemical outcome of patients with prostate cancer treated with radical prostatectomy, and established thresholds for use in patients in the three risk groups.
Factors contributing to the racial differences in prostate cancer mortality
Authors: Tewari Ashutosh , Horninger Wolfgang , Pelzer Alexandre E. , Demers Raymond , Crawford E. David , Gamito Eduard J. , Divine George , Johnson Christine Cole , Bartsch George , Menon Mani 
Published: September 2005

OBJECTIVETo analyse, in a retrospective cohort study, differences in rates of surgical treatment for prostate cancer between African‐Americans and White Americans, and to evaluate the extent to which these differences are associated with disparities in survival rates between these groups.PATIENTS AND METHODSClinical, pathological, and demographic data from 4279 men diagnosed with clinically localized prostate cancer between 1980 and 1997 were used. The variables assessed included age, disease stage, tumour grade, comorbidities, treatment method, and socio‐economic status (SES). Kaplan‐Meier survival curves were generated and compared using log‐rank tests. The Cox proportional hazards method was used for analyses involving adjustments for potential confounding factors.RESULTSThe surgical treatment rate was 17% for African‐American and 28% for White patients (P < 0.001). In those patients treated conservatively or by radiation therapy, both crude and cancer‐specific survival rates were lower for African‐Americans than for Whites (P < 0.001). However, for patients undergoing surgery, differences in survival between African‐Americans and Whites were not statistically significant. According to our models, SES explained 50% and surgical treatment rates ≈ 34% of the differences in survival between African‐Americans and Whites.CONCLUSIONSThis analysis suggests that the lower prostate cancer survival rates for the African‐Americans in the present population can be largely explained by differences in SES and lower surgical treatment rates. Efforts to increase awareness of treatment options among African‐American patients may be a way of improving survival in this group.
Visual estimation of tumour extent is not an independent predictor of prostate specific antigen recurrence
Authors: Jones Timothy D. , Koch Michael O. , Lin Haiqun , Cheng Liang 
Published: September 2005

OBJECTIVETo analyse tumour extent as a predictor of cancer progression after radical prostatectomy (RP), using a multivariate Cox regression model, as several variables (e.g. Gleason grade and tumour stage) are well‐established prognostic factors in prostate cancer but it is uncertain if the visual estimation of tumour extent (percentage of carcinoma) is an independent predictor for prostate cancer recurrence.PATIENTS AND METHODSTumour extent was estimated in the RP specimens from 504 men with clinically localized prostate cancer; clinical follow‐up data were available for 459 men. The mean (range) follow‐up was 44.3 (1.5–144) months. Cancer progression was defined by the development of biochemical recurrence, local recurrence, or distant metastasis. Multivariate analysis was used to assess tumour extent as a predictor of cancer progression.RESULTSOf the 459 patients, 157 had cancer progression; the mean tumour extent was 36% and 24% in those with and without cancer progression, respectively (P < 0.001). Univariate analysis showed a significant association between the visual estimation of tumour extent and tumour stage, Gleason grade, surgical margins, extraprostatic extension, seminal vesicle invasion, lymph node metastasis, and preoperative serum prostate‐specific antigen level (all P < 0.001). However, in a multivariate Cox regression model controlling for pathological stage, Gleason score, and surgical margin status, the visual estimation of tumour extent was no longer a significant predictor of cancer progression (P = 0.84).CONCLUSIONThe visual estimation of tumour extent was associated with various established prognostic factors for prostate cancer, and with cancer progression in a univariate analysis, but it was not a significant predictor of cancer progression in the multivariate analysis controlling for pathological stage, Gleason score, and surgical margin status.
Fluorescence in situ hybridization for detecting transitional cell carcinoma: implications for clinical practice
Authors: Laudadio Jennifer , Keane Thomas E. , Reeves Hugh M. , Savage Stephen J. , Hoda Rana S. , Lage Janice M. , Wolff Daynna J. 
Published: September 2005

OBJECTIVETo determine the diagnostic sensitivity of genetic studies using fluorescence in situ hybridization (FISH) for detecting both new and recurrent cases of transitional cell carcinoma (TCC) in a routine clinical practice setting, as bladder cancer has a significant risk of recurrence and progression to invasive disease and thus sensitive surveillance testing is very important.PATIENTS AND METHODSFISH was performed using the UroVysionTM kit (Vysis Inc., Downers Grove, IL, USA) Consecutive patients were assessed using FISH, both to evaluate those with a history of TCC or with suspicious symptoms, and the FISH results were compared with concurrent biopsy and cytological assessments.RESULTSIn all, 521 consecutive FISH tests from 300 patients were evaluated; 47% had a history of bladder cancer and 53% had suspicious symptoms. Of the 521 FISH tests, 24% were positive; concurrent cytology was available for 84% of the FISH tests, with a concordance rate of 78% (6% were positive for both and 72% were negative by both tests). For the discordant cases, FISH was positive and cytology negative in 21% of cases, and cytology was positive with a negative FISH for 1%. In all, 99 FISH tests had concurrent biopsy data. Of the 44 cases histologically positive for TCC, 32 were FISH‐positive, resulting in an overall sensitivity (95% confidence interval) of 73 (60–88)%. FISH detected 95% of cases with high‐grade carcinoma, while only seven of these 17 were positive by concurrent cytological assessment. FISH detected 56% and cytology detected 32% of low‐grade lesions. FISH detected all nine new cases with positive histology. Overall, the specificity of FISH was 65 (53–78)%. Of 112 patients with previous TCC, 28 had a recurrence; 22 of these had positive FISH results.CONCLUSIONFISH analysis has a high sensitivity for detecting new cases of TCC, as well as recurrences. From the present data FISH is considerably more sensitive and only slightly less specific than cytology in diagnosing TCC. Therefore, we recommend FISH as a useful initial diagnostic tool in patients suspected of both new and recurrent TCC.
Can removal of back teeth contribute to chronic earwax obstruction?
Authors: Fransman Denny 
Published: September 2005

SummaryImpacted earwax is extremely common in people with learning disabilities. Although it is not a serious medical condition it causes a number of very unpleasant problems. These symptoms include discomfort in and around the ear, hearing loss, dizziness and noises in the ears. It also causes secondary problems with ear infections and hearing aid use. This paper reviews the clinical symptoms of impacted earwax and investigates possible causality. Evidence shows that people with learning disabilities are twice as likely to have impacted wax than the general population. The reason for this association is unclear. In the present study, the correlation between the occurrence of chronic wax obstruction and a reduced ability to chew due to the absence of back (molar) teeth was investigated. In the current pilot we have used clinical records to establish the presence of chronic wax obstruction and postal questionnaires to ascertain participants’ dental status. The results of this study show a positive relationship between chronic earwax obstruction and the absence of back (molar) teeth. These findings have significant implications and should be considered when planning the health care of people with learning disabilities.
XY females: revisiting the diagnosis
Authors: Minto Catherine L. , Crouch Naomi S. , Conway Gerard S. , Creighton Sarah M. 
Published: September 2005

Objectives  To investigate the accuracy of assigned diagnosis in XY female intersex conditions.Design  Cross sectional hospital case notes review.Setting  Tertiary hospital multidisciplinary intersex clinic.Sample  Forty‐six adult intersex women with a complete or mosaic XY karyotype.Methods  All clinical features and investigation results were reviewed and a diagnosis was assigned. This was compared to the original diagnosis assigned.Main outcome measures  Data collected included presentation, all investigations, subsequent clinical course and all treatments (medical and surgical). These data were employed to assign an up‐to‐date intersex diagnosis, which was compared with the recorded diagnosis in the hospital case notes. Diagnoses were then rated according to level of accuracy.Results  The 47.8% patients had an accurate diagnosis, 32.6% of diagnoses were inaccurate and currently under review, 13% had a wrong diagnosis and 6.5% remain with an unknown aetiology for their XY intersex condition.Conclusions  Diagnostic accuracy is assumed to be high when evaluating published work on these conditions; however, this study shows 52.1% of patients have unknown, inaccurate or wrong diagnoses. Assigning the wrong diagnosis may be harmful, for example, if it leads to irreversible virilising changes or development of a gonadal malignancy, and for all cases excludes accurate condition management and genetic counselling for both the patient and their immediate family.
Marriage still protects pregnancy
Authors: Raatikainen Kaisa , Heiskanen Nonna , Heinonen Seppo 
Published: September 2005

Objective  To assess the risk factors and outcome of pregnancy outside marriage in the 1990s, in conditions of a high percentage of extramarital pregnancies and high standard maternity care, used by the entire pregnant population.Design  Hospital‐based cohort study.Setting  A university‐teaching hospital in Finland.Population  The 25,373 singleton pregnancies of known marital and cohabiting status.Methods  Odds ratios (ORs) with 95% confidence intervals were calculated to estimate the effect of extramarital childbearing on pregnancy outcome. Multiple logistic regression analyses were conducted to control for confounding maternal risk factors.Main outcome measures  Small‐for‐gestational age (SGA) infants, preterm birth (less than 37 completed weeks), low birthweight (LBW; under 2500 g).Results  Of the study population, 67.5% were married and 32.5% were unmarried; 24.2% of all mothers were cohabiting. Unmarried status was strongly associated with social disadvantage and particular risk factors, specifically unemployment, smoking and previous pregnancy terminations, which in turn had an impact on obstetric outcome. There were significantly more SGA infants among unmarried mothers (P < 0.001), with an absolute difference of 45%; more preterm deliveries (P= 0.001), with an absolute difference of 17.5%; and more LBW infants (P < 0.001), with an absolute difference of 26%. The differences in adverse pregnancy outcomes between study groups (i) all unmarried women, (ii) cohabiting women and (iii) single women, remained significant after multivariate analysis at adjusted ORs of 1.11, 1.11 and 1.07 for SGA, 1.17, 1.15 and 1.21 for LBW and 1.15, 1.15 and 1.29 for the preterm births, respectively.Conclusion  Even in the 1990s when cohabitation was already common, pregnancy outside marriage was associated with an overall 20% increase of adverse outcomes, and free maternity care did not overcome the difference.
Antral follicle count, anti‐mullerian hormone and inhibin B: predictors of ovarian response in assisted reproductive technology?
Authors: Muttukrishna S. , McGarrigle H. , Wakim R. , Khadum I. , Ranieri D.M. , Serhal P. 
Published: September 2005

Objective  The objective of this study was to evaluate the relationship between anti‐mullerian hormone (AMH), inhibin B and antral follicle count (AFC) with ovarian response.Design  Retrospective study.Setting  Fertility unit.Sample  AFC was recorded, and a serum sample obtained on day 3 from all patients undergoing in vitro fertilisation (IVF). Patients were given 300 IU/L recombinant follicle stimulating hormone (FSH; Gonal F). The following day blood samples were collected.Methods  Serum samples were assayed for FSH, AMH and inhibin B using commercial immunoassay kits and oestradiol using an in house assay.Main outcome measures  Response to gonadotrophin stimulation and the number of eggs collected.Results  AFC was negatively correlated to age (r=−0.426, P < 0.001). Delta inhibin B (levels of inhibin B on day 4 minus day 3) had the best association to the number of eggs collected (r= 0.533, P < 0.001) followed by basal AMH (r= 0.51, P < 0.001) and AFC (r= 0.505, P < 0.001). The number of eggs fertilised was significantly associated with basal AMH (r= 0.592, P < 0.001) and inhibin B (r= 0.548, P < 0.001). AMH with a cutoff of 0.2 ng/mL had the best sensitivity (87%) and specificity (64%) in predicting poor response. A cumulative score using basal FSH, basal AMH, delta E2 (levels of oestradiol on day 4 minus day 3), delta inhibin B, AFC and age gives the best predictive statistics to identify poor responders with 87% sensitivity and 80% specificity and a positive likelihood ratio of 4.36.Conclusion  Delta inhibin B had the best positive association with the number of eggs collected and basal AMH is the single best predictor of poor response. AFC has a significant association with the number of eggs collected and is predictive of clinical pregnancy. It is evident that a single parameter is of limited value in predicting ovarian response. However, we have demonstrated a cumulative score using all the above markers could be useful in predicting poor response.
A randomised controlled trial comparing two temporising management strategies, one with and one without plasma volume expansion, for severe and early onset pre‐eclampsia
Authors: Ganzevoort Wessel , Rep Annelies , Bonsel Gouke J. , Fetter Willem P.F. , van Sonderen Loekie , De Vries Johanna I.P. , Wolf Hans ,   for the PETRA investigators
Published: September 2005

Objectives  Plasma volume expansion may benefit both mother and child in the temporising management of severe and early onset hypertensive disorders of pregnancy.Design  Randomised clinical trial.Setting  Two university hospitals in Amsterdam, The Netherlands.Population  Two hundred and sixteen patients with a gestational age between 24 and 34 completed weeks with severe pre‐eclampsia, haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome or severe fetal growth restriction (FGR) with pregnancy‐induced hypertension, admitted between 1 April 2000 and 31 May 2003.Methods  One hundred and eleven patients were randomly allocated to the treatment group, (plasma volume expansion and a diastolic BP target of 85–95 mmHg) and 105 to the control group (intravenous fluid restriction and BP target of 95–105 mmHg).Main outcome measures  Neonatal neurological development at term age (Prechtl score), perinatal death, neonatal morbidity and maternal morbidity.Results  Baseline characteristics were comparable between groups. The median gestational age was 30 weeks. In the treatment group, patients received higher amounts of intravenous fluids (median 813 mL/day vs 14 mL/day; P < 0.001) with a concomitant decreased haemoglobin count (median −0.6 vs−0.2 mmol/L; P < 0.001). Neither neurological scores nor composite neonatal morbidity differed. A trend towards less prolongation of pregnancy (median 7.4 vs 11.5 days; P= 0.054) and more infants requiring oxygen treatment >21% (66 vs 46; P= 0.09) in the treatment group was observed. There was no difference in major maternal morbidity (total 11%), but there were more caesarean sections in the treatment group (98%vs 90%; P < 0.05).Conclusion  The addition of plasma volume expansion in temporising treatment does not improve maternal or fetal outcome in women with early preterm hypertensive complications of pregnancy.
Bleeding profiles and effects on the endometrium for women using a novel combination of transdermal oestradiol and natural progesterone cream as part of a continuous combined hormone replacement regime
Authors: Vashisht Arvind , Wadsworth Fred , Carey Adam , Carey Beverley , Studd John 
Published: September 2005

Objective  Many women are seeking alternatives to conventional forms of hormone replacement. This study evaluates the endometrial effects of natural progesterone cream used in conjunction with transdermal oestradiol.Design  Open plan study conducted over 48 weeks.Setting  Tertiary referral London teaching hospital.Population  Women at least two years postmenopausal.Methods  Women were recruited nationally. They applied 40 mg transdermal natural progesterone cream and 1 mg transdermal oestradiol daily.Main outcome measures  Endometrial histology, assessed by pipelle endometrial biopsy, ultrasound assessment of endometrial thickness and bleeding diaries.Results  Fifty‐four women were recruited of which 41 completed the study. Mean age was 57.4 years. Thirty‐two percent of women had evidence of inadequate endometrial opposition (proliferative or hyperplastic) at the end of 48 weeks. At baseline, women had a mean endometrial thickness of 3.3 mm, which had significantly thickened to a mean of 5.3 mm by 24 weeks (P < 0.001). By 48 weeks, there was significantly greater increase in endometrial thickness from baseline in those women who displayed inadequate endometrial opposition, compared with those women who had adequate endometrial opposition (P= 0.004). At 24 weeks, 48% of women had remained entirely amenorrhoeic. By the end of the study, 35% of women had been entirely amenorrhoeic and 50% had had either no bleeding or spotting alone. The number of bleeding episodes did not reduce with time.Conclusions  The dose of natural progesterone cream in this study was insufficient to fully attenuate the mitogenic effect of oestrogen on the endometrium. We would not recommend this combination of hormones to be used by postmenopausal women.