bluuebunny/crossref_metadata_2025_split huggingface dataset:
Per‐operative frozen section examination of pelvic nodes is unnecessary for the majority of clinically localized prostate cancers in the prostate‐specific antigen era
Authors: Kakehi Yoshiyuki , Kamoto Toshiyuki , Okuno Hiroshi , Terai Akito , Terachi Toshiro , Ogawa Osamu 
Published: March 2003

Abstract
Background
: The incidence of unsuspected lymph node metastasis seems to be decreasing in the prostate‐specific antigen (PSA) era. It remains controversial as to whether routine pelvic lymph node dissection and per‐operative frozen section examination should be performed. In addition, it is still unclear whether an aggressive approach to local disease by surgery or irradiation confers survival benefits on stage D1 patients.
Methods
: Eighty‐eight consecutive patients with clinically localized prostate cancer who underwent pelvic lymph node dissection prior to radical prostatectomy during the period between 1985 and 1998 were analyzed. The incidence of lymph node metastases after 1992 was compared with that before 1992. Sensitivity and specificity of frozen section examination was assessed. Progression‐free survival and cause‐specific survival curves of node‐positive patients who underwent radical prostatectomy were estimated by the Kaplan–Meier method.
Results
: Six of 17 patients (35.3%) treated before 1992 and five of 71 patients (7.0%) treated after 1992 showed unsuspected lymph node metastasis (P = 0.0059). Eight of 11 node‐positive patients underwent radical prostatectomy and two have so far demonstrated clinical progression and cancer death with a median follow‐up period of 63 months. The 5 year progression‐free rate and the cause‐specific survival rate for these patients were 71.4 and 85.7%, respectively. Sensitivity of frozen section examination for micrometastasis and gross‐metastasis cases, respectively, was 3/6 (50%) and 4/4 (100%), while specificity was 85/85 (100%).
Conclusions
: The incidence of unsuspected lymph node metastases has been significantly decreased in the PSA era. Frozen section examination of pelvic nodes can be omitted and radical prostatectomy is an acceptable choice of treatment in patients without macroscopically apparent nodal metastases.
Renal arteriovenous malformation with thrombus in the inferior vena cava
Authors: Harada Hiroshi , Togashi Masaki , Abe Takashige , Takeyama Yoshihiro , Seki Toshimori , Ohashi Nobuo 
Published: March 2003

Abstract
Background
: Thrombus formation in the inferior vena cava (IVC) is usually seen in cases with malignancy. In contrast, vascular anomalies hardly ever accompany this disorder. Herein, a case of thrombus formation in the IVC associated with renal arteriovenous malformation (AVM) is reported.
Methods/Results
: A 50‐year‐old woman who received transarterial embolization (TAE) for AVM in the right kidney noticed right flank pain with macrohematuria 12 months later. Because radiographic evaluation could not rule out malignancy in the kidney, nephrectomy was performed. During nephrectomy, a palpable thrombus was found in the IVC, so thrombectomy was performed simultaneously. Histopathologic examination revealed an old infarction due to the TAE, circumferential arteriovenous thrombi and a large organized thrombus up to the IVC, but neither renal cell carcinoma nor transitional carcinoma in the kidney.
Conclusions
: Careful observation may be required, even after treatment for renal AVM, such as TAE, to avoid the formation of an IVC thrombus.
Impact of citrate therapy on the circadian rhythm of urinary magnesium ammonium phosphate saturation in normal individuals
Authors: Ogawa Yoshihide , Sugaya Kimio , Koyama Yuzo , Hatano Tadashi 
Published: March 2003

Abstract
Background
: Alkaline citrate has been used widely in the prevention of stone formation. However, the risk of struvite stone during the alkalinizing therapy has not been adequately studied in terms of magnesium ammonium phosphate saturation.
Methods
: The circadian rhythm of the urinary saturation of magnesium ammonium phosphate was estimated by using the differential Gibbs' free energy values of magnesium ammonium phosphate before and during 5 days of treatment with sodium–potassium citrate (1 g t.i.d., 1 g q.i.d. or 3 g t.i.d.) in five healthy male volunteers.
Results
: The magnesium ammonium phosphate saturation varied during the day, peaking far below the solubility product between 08.00 and 10.30 h and between 13.00 and 18.00 h. The mean peak levels were increased by each treatment regimen in comparison with the control day. The mean increase on day 1 was significant between 10.30 and 23.00 h with the 3 g t.i.d. regimen, but the mean saturation still remained below the solubility product throughout the day.
Conclusions
: The urinary magnesium ammonium phosphate saturation appeared hard to exceed the solubility product with a high dose of alkaline citrate.
Expression of the insulin‐like growth factor system and cancer progression in hormone‐treated prostate cancer patients
Authors: Mita Koji , Nakahara Mitsuru , Usui Tsuguru 
Published: March 2003

Abstract
Background
: The insulin‐like growth factor (IGF) system, which is composed of two ligands (IGF‐I and IGF‐II), two receptors (IGFR‐I and IGFR‐II) and six binding proteins (IGFBP‐1 to ‐6), plays an important role in cell biology. To identify the main components in the IGF system that contribute to human prostate cancer progression after hormone therapy, mRNA expression of the IGF system in human prostate cancer tissue was systematically examined.
Methods
: Expression of the IGF system in 24 carcinomas obtained from total prostatectomies after hormone therapy was examined. Expression levels of mRNA of each component of the IGF system were analyzed by quantitative reverse transcription–polymerase chain reaction procedures and compared with clinicopathologic parameters.
Results
: Expression of the IGF system, except IGFBP‐1, was detected in all prostate cancer tissue samples. The expression of IGF‐II and IGFBP‐2 significantly correlated with pathologic stage, lymph node metastasis, histologic differentiation and serum prostate‐specific antigen (PSA) levels after hormone therapy. However, expression of IGF‐I was significantly lower in locally advanced prostate cancer tissue than in tissue from the early stage. Expression of IGFBP‐5 was significantly related to only serum PSA levels after hormone therapy.
Conclusions
: In the IGF system, IGF‐II and IGFBP‐2 play a role in human prostate cancer progression and their increased expression is a possible candidate for a prognostic indicator in hormone‐treated prostate cancer patients.
Necessity of re‐evaluation of estramustine phosphate sodium (EMP) as a treatment option for first‐line monotherapy in advanced prostate cancer
Authors: Kitamura Tadaichi 
Published: March 2003

Abstract Estramustine phosphate sodium (EMP) was first introduced in the early 1970s for the treatment of prostate cancer, when EMP was supposed to have the dual effect of estrogenic activity and cytotoxicity. For the following decades, it was used mainly in hormone‐refractory cases, with a conventional dosage of 4–9 capsules/day, which showed a 30–35% objective response rate. However, a very limited number of cases have been reported that used EMP as a first‐line monotherapy in the conventional dosage. One study showed a response rate of 82%, which is at least as effective as conventional estrogen (diethylstilbestrol; DES) monotherapy. Nevertheless, EMP was almost abandoned for the treatment of prostate cancer because of severe adverse side‐effects, especially in the cardiovascular system and gastrointestinal tract.Recently, two facts have become evident. First, EMP interferes with cellular microtubule dynamics but does not show alkylating effects. Second, EMP is able to produce a complex with calcium when dairy products are taken concomitantly with EMP, resulting in a decrease in the absorption rate of EMP from the gut. Many clinical trials have been undertaken without warning against concomitant dairy product intake since the introduction of EMP. This fact will jeopardize almost all the clinical trials performed before 1990. It is considered that response rates have been underestimated and better results could have been obtained because side‐effects decrease dose‐dependently.Low‐dose EMP monotherapy (2 capsules/day) has been performed infrequently in previously untreated advanced prostate cancer. The only large trial by the European Organization for Research and Treatment of Cancer in 1984 was biased in selecting patients. Nevertheless, the response rate of EMP is comparable to that of DES. In this study, the adverse side‐effects of EMP were less than that of DES. Recently, a study was conducted at the University of Tokyo of 11 patients with advanced prostate cancer on low‐dose EMP as first‐line monotherapy. The study found that the mean serum prostate‐specific antigen level decreased to within the normal range by day 50; mean serum testosterone, leutinizing hormone and follicle‐stimulating hormone reduced to undetectable levels by day 20; and mean serum estradiol increased to a very high level within 1 week. These data implicate that low‐dose EMP can suppress quickly and adequately the pituitary–gonadal axis, although the antitumor effect has not as yet been elucidated.For these reasons, it is necessary to re‐evaluate low‐dose EMP monotherapy in previously untreated advanced prostate cancer.
Is there a role for magnetic resonance imaging in renal trauma?
Authors: Ku Ja‐Hyeon , Jeon Youn‐Soo , Kim Min‐Eui , Lee Nam‐Kyu , Park Young‐Ho 
Published: March 2003

AbstractBackground:Computed tomography (CT) has been the most informative imaging method in renal trauma. Despite the good sensitivity of magnetic resonance imaging (MRI) to the presence of hematoma, edema and ischemia, MRI has not been widely studied in patients with renal trauma. The present study was initiated to evaluate the role of MRI in patients with renal trauma.Methods:Between June 1998 and September 1999, CT and MRI were prospectively performed on 12 patients who suffered from renal trauma and the results reviewed.Results:The presence and size of perirenal hematoma could be detected by both CT and MRI. Magnetic resonance imaging could differentiate intrarenal hematoma from perirenal hematoma more accurately, and provided additional information about the hematoma as T1‐ and T2‐weighted MRI were able to determine recent bleeding in the hematoma by regional differences in signal intensity. Magnetic resonance imaging clearly revealed renal fracture with non‐viable fragment and detected focal renal laceration that was not detected on CT due to perirenal hematoma associated with renal infarction. However, although MRI had many advantages over CT, it had also major drawbacks, which were that it required longer imaging time and increased the cost.Conclusions:Magnetic resonance imaging may be useful in renal trauma. However, it is suggested that MRI should be limited to carefully selected patients, such as those with severe renal injury or equivocal findings on CT.
Preoperative predictors of cancerous involvement of the neurovascular bundles in patients with localized prostate cancer
Authors: INOUE TAKAHIRO , HIOKI TAKUICHI , HAYASHI NORIO , TAKAHASHI SATORU , SHIRAI TOMOYUKI , SUGIMURA YOSHIKI 
Published: March 2003

Abstract Background: The purpose of this study was to identify preoperative variables that would be useful in objectively selecting prostate cancer patients for nerve‐sparing prostatectomy.Methods: Twenty‐six patients with clinical T1c–T2c cancers were evaluated for cancerous involvement in the region of the neurovascular bundles (NVB) from prostatectomy specimens. Preoperative prostate‐specific antigen (PSA) and pathologic features in systematic biopsy specimens also were reviewed.Results: A total of eight (31%) patients had cancerous involvement in the region

of the NVB, including four on the right side, three on the left side and one on both

sides. The percentage of each biopsy specimen occupied by the cancer was scored from

zero to four and defined as the positive biopsy score. Preoperative PSA (P

= 0.046), mean positive biopsy score (total sum of positive biopsy score divided

by number of biopsy specimens; P = 0.001), number of cores containing cancer

(P = 0.011), percentage of cores involved (P = 0.036) and maximum positive

biopsy score (P < 0.001) were significant for predicting cancerous involvement in the NVB region using univariate analysis. However, only the mean positive biopsy score was independently significant according to multivariate analysis. To predict cancerous involvement in the region of each NVB, we found that ipsilateral mean positive biopsy score (total sum of corresponding positive biopsy score divided by number of ipsilateral biopsy specimens), number of cores involved on the ipsilateral side, percentage of cores involved on the ipsilateral side and maximum positive biopsy score on the ipsilateral side were significant predictive variables: the ipsilateral mean positive biopsy score being most appropriate for clinical practice.Conclusion: Ipsilateral mean positive biopsy score in systematic biopsy specimens can be an appropriate variable for selecting patients with localized prostate cancer for nerve‐sparing prostatectomy.
Clinical efficacy and safety of sildenafil citrate (Viagra) in a multi‐racial population in Singapore: A retrospective study of 1520 patients
Authors: Lim Peter Huat Chye , Li Man Kay , Ng Foo Cheong , Chia Sing Joo , Consigliere David , Gooren Louis , Ng Kok Kit , Munisamy Malathy , Perianan Moorthy 
Published: March 2003

AbstractBackground: Sildenafil citrate (Viagra), a selective inhibitor of cGMP‐specific phosphodiesterase type‐5, has been used as an oral therapeutic drug for erectile dysfunction. The present paper is a clinical study of the success rate and side‐effects of the use of sildenafil in a multi‐racial population in Singapore.Methods: From April 1999 to May 2000, 1520 patients were given sildenafil citrate. Of these, 912 patients (mean age, 54.6 years; age range, 22–99 years) were followed up and evaluated for clinical efficacy and safety of the drug. The mean duration of erectile dysfunction (ED) and follow‐up periods were 31.5 and 3.0 months, respectively.Results: Satisfactory erections assessed by single global efficacy question (GEQ) occurred in 83% of patients, major side‐effects in the form of flushing (3.48%), headache (1.97%), blurred vision (1.25%), giddiness (1.18%), warmth (1.11%) and others (4.92%) were recorded in 127 patients (13.9%). Racially, Chinese men with ED had higher efficacy (85.7%), compared to Indian men (74.2%) and Malay men (72.8%). With respect to comorbid profiles, an efficacy of 77.8% (n = 271), 83.9% (n = 292), 86.4% (n = 44) and 83.3% (n = 199) was recorded in diabetic, hypertensive, ischemic heart disease patients and in benign prostatic hyperplasia patients, respectively. Patients who smoked (n = 135) and drank alcohol (n = 118) showed an efficacy of 80%. Baseline hormonal profiles of luteinizing hormone, follicle stimulating hormone, testosterone and prolactin did not affect the success rates of sildenafil citrate. Many patients had earlier received other forms of treatment (medicated urethral suppository for erection (MUSE; 84.9%); vacuum devices (86.8%), traditional medicines (100%) and other oral medications (89.2%)), but this did not influence the success rate of sildenafil citrate. But patients previously treated with prostaglandin‐E intracavernosal injections were less successful on sildenafil citrate (77.3%). In the total cohort, 50 mg sildenafil citrate was an effective dose in 49% of patients and 46.5% patients needed 100 mg sildenafil citrate, while 4.1% of the total cohort needed only 25 mg sildenafil citrate.Conclusion: Oral sildenafil citrate has been shown to be an effective, safe and well tolerated drug in Singaporean men with ED, as in men from other parts of the world.
Medically and economically appropriate follow‐up schedule for prostate cancer patients after radical prostatectomy
Authors: NIWAKAWA MASASHI , TOBISU KEN‐ICHI , FUJIMOTO HIROYUKI , MATSUOKA NAOKI , KAKIZOE TADAO 
Published: March 2003

Abstract
Background
: Our goal was to determine the optimal frequency and method of follow‐up after radical prostatectomy to minimize medical cost without adversely affecting patients.
Methods
:Two hundred and twenty‐one patients who underwent a radical prostatectomy with or without adjuvant androgen deprivation from 1989 to 1999 were selected for the study. Eighty percent of the patients received postoperative androgen deprivation. Tumor recurrence was strictly defined as detectable serum prostate specific antigen (PSA) and/or clinical findings such as local tumor detection or bone metastasis. Thirty of 221 patients experienced tumor recurrence. Risk of tumor recurrence, procedures for detection of recurrence, and PSA doubling time after biochemical failure were analyzed.
Results
:None of the 30 patients who were examined showed definitive local recurrence or metastatic sites on the imaging study at the time of initial PSA detection, and there were no observed recurrences in the absence of detectable serum PSA. In patients who showed elevated PSA within 12 months after radical prostatectomy, PSA levels rapidly increased with doubling times ranging from 1.2 to 13.7 months. Excluding those patients, the doubling time of PSA levels ranged from 2.8 to 31.5 months.
Conclusions
:Prostate specific antigen screening is sufficient to detect treatment failure after radical prostatectomy, irrespective of adjuvant hormone therapy. Based on the calculated doubling time, the longest advisable interval between checks of PSA levels is estimated to be four months within the first year after radical prostatectomy, and biannually or annually thereafter. Continuously elevated PSA levels or clinical symptoms indicate surveys for local recurrences and distant metastases.
Calcium oxalate monohydrate crystal binding substance produced from Madin‐Darby canine kidney cells
Authors: YAMAGUCHI SATOSHI , WIESSNER JOHN , HASEGAWA ANDREW , HUNG LINDA , MANDEL GRETCHEN , MANDEL NEIL 
Published: March 2003

Abstract Background: The interaction between kidney urothelium and crystals is a critical event in the growth of renal calculi. When studying calcium oxalate monohydrate (COM) crystal binding to Madin‐Darby canine kidney (MDCK) cells in culture, we observed that crystals also attached to areas on the coverslips devoid of cells. This phenomenon could be the result of substances produced by the cells that adhere to the glass and subsequently bind COM crystals. We investigated the characteristics of this COM binding substance.Methods: Media was collected from cultures of MDCK cells (conditioned media) and proteins were separated by high performance liquid chromatography. The molecular weights and purity of isolated proteins were determined by polyacrylamide gel electrophoresis. The conditioned media and each separated fraction were applied to glass and to MDCK cells and COM‐binding ability determined using 14C‐labeled crystals. The binding of radio‐labelled calcium oxalate dihydrate, brushite, uric acid, and apatite to coverslips were also studied.Results: Fourteen times more COM bound to coverslips incubated with conditioned media than those with control media. The molecular weight of the protein bound to the glass was determined to be 200 kDa. The COM crystals binding to this protein was 1.5 µg/ng. Other crystals bound to a lesser extent. The incubation of cells with this protein inhibited COM binding by 39%.Conclusion: The MDCK cells produce a 200‐kDa protein that has a high binding affinity for COM crystals. This protein binds to glass and is responsible for crystal binding to areas devoid of cells. This protein also has an inhibitory effect on COM binding to MDCK cells in culture.
Acquired haemophilia in South Australia: a case series
Authors: Burnet S. P. , Duncan E. M. , Lloyd J. V. , Han P. 
Published: March 2003

Abstract Of eight cases of acquired haemophilia presenting over an 8‐year period, six received immunosuppressive treatment, five with cyclophosphamide, vincristine and prednisolone (CVP). Five patients (four on immunosuppressive treatment) entered remission, two patients died and one was lost to follow up. Initially, the remissions were only partial. The median duration until partial remission was 10 weeks (range 1–55 weeks) and until complete remission was 35 weeks (range 2–59 weeks). Partial remission may proceed to complete remission without further chemotherapy. (Intern Med J 2001; 31: 556–559)
Parasitic worms of the central nervous system: an Australian perspective
Authors: Hughes A. J. , Biggs B. A. 
Published: March 2003

Abstract The diagnosis and management of parasitic diseases of the central nervous system (CNS) is difficult, even for infectious diseases physicians and neurologists. Furthermore, few overviews of the spectrum of causative helminths and clinical syndromes have been published. In the present study, we review the seven most common parasitic diseases of the CNS: (i) cysticercosis, (ii) neuroschistosomiasis, (iii) paragon­imiasis, (iv) angio‐strongyliasis, (v) hydatid disease, (vi) sparganosis and (vii) gnathostomiasis. Major syndromes of parasitic disease of the CNS and their differential causes are discussed, including: (i) cystic lesions, (ii) enhancing granulomas (with and without creeping subcutaneous eruptions), (iii) eosinophilic meningoencephalitis and (iv) spinal cord disease. Specific risk factors that predispose to these infections are also discussed and particular attention is drawn to the situation in Australia. (Intern Med J 2002; 32: 541−553)
Anaesthetic management of two paediatric patients with Hecht–Beals syndrome
Authors: Nagata Osamu , Tateoka Akiko , Shiro Ryoji , Kimizuka Mamori , Hanaoka Kazuo 
Published: March 2003

SummaryWe undertook the anaesthetic management of two children with Hecht–Beals syndrome for orthopaedic surgery under general anaesthesia. Both patients had arachnodactyly, kyphoscoliosis, and multiple congenital joint contractures, but limited mandible excursion was not obvious preoperatively in either, although mental retardation made it difficult for them to cooperate with mouth examination. They had no apparent difficulties with their mouths in daily activities. The anaesthesia records of one patient showed that intubation had been difficult in an earlier procedure. The other patient also had a history of difficult intubation, with slight tearing of the corners of her mouth during an intubation procedure. During slow induction of general anaesthesia with sevoflurane, face mask ventilation was easily performed. We attempted to visualize the larynx under anaesthesia with muscle relaxation, but we were unsuccessful because of the limited mouth opening. After several trials, blind oral intubations were fortunately successful in both patients. There were no postoperative problems with the airway.