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  • 1
    ISSN: 1520-5118
    Source: ACS Legacy Archives
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition , Process Engineering, Biotechnology, Nutrition Technology
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1520-5851
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology , Energy, Environment Protection, Nuclear Power Engineering
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 12 (2005), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Background: The objective of the present study was to investigate the significance of pelvic lymphadenectomy during radical prostatectomy in Japanese men with prostate cancer. Methods: A total of 178 consecutive patients who underwent radical prostatectomy and standard pelvic lymphadenectomy targeting the external iliac nodes and obturator fossa for clinically localized prostate cancer were studied. The median observation period of this series was 18 months (range: 3–36 months). Results: Lymph node metastases were detected in 13 patients; that is, positive nodes were located in the external iliac nodes alone in seven patients, the obturator fossa alone in four patients, and both external iliac nodes and obturator fossa in two patients. Of these 13 patients, all of the seven with more than one positive node demonstrated biochemical recurrence, whereas five of the six with single node involvement remained without signs of biochemical recurrence. Furthermore, a single positive node was located in the external iliac region in five of the six patients. When a group at high-risk for lymph node metastasis was defined as those meeting more than two of the following three criteria: (i) pretreatment serum prostate specific antigen value ≥ 20 ng/mL; (ii) biopsy Gleason sum ≥ 8; or (iii) percentage of positive biopsy core ≥ 50%, the incidence of lymph node metastasis was 24.5% in the high-risk group and 0.8% in the low-risk group. Conclusions: These findings suggest that limited dissection of the obturator node alone may not be sufficient for Japanese men undergoing radical prostatectomy; therefore, we recommend performing standard pelvic lymphadenectomy targeting both the external iliac nodes and the obturator fossa for patients at high-risk of lymph node involvement.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 12 (2005), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background:  The objectives of the present study were to characterize, according to tumor significance, the clinicopathological features of patients with prostate cancer who underwent radical prostatectomy, and to determine useful parameters for predicting insignificant disease before surgery.Methods:  In this series, we included 195 patients who underwent radical prostatectomy for clinically organ-confined prostate cancer at our institution between January 1999 and November 2003. Several clinicopathological factors were analyzed, focusing on whether the largest tumor volume in radical prostatectomy specimens was ≥0.5 cm3 or 〈0.5 cm3, which is the criterion defined to distinguish insignificant cancer from significant cancer.Results:  Potentially insignificant cancer was detected in 28 of 195 patients (14.4%). There were significant differences between patients with insignificant disease and those with significant disease in serum prostate specific antigen (PSA) as well as all biopsy parameters, with the exception of biopsy Gleason score. Furthermore, final pathological examination demonstrated that these two patient groups showed significant differences in Gleason score and the incidence of extraprostatic disease extension. Pearson's correlation analysis showed that tumor volume in the prostatectomy specimens was significantly associated with serum PSA and all biopsy parameters; however, each of the correlations was comparatively weak. There was no single parameter that could viewed as a useful predictor of tumor significance. The best model for predicting insignificant tumor was the combined use of biopsy Gleason score 〈7 and percent of positive biopsy core (PPBC) 〈15%; however, the further addition of serum PSA 〈10 ng/mL to these two parameters failed to enhance the predictive value of cancer significance.Conclusions:  These findings indicate that clinicopathological findings suggesting favorable features are well observed in patients with potentially insignificant prostate cancer compared to those with significant prostate cancer, and the combination of a biopsy Gleason score 〈7 and PPBC 〈15% might be useful as a predictor of insignificant disease.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The objective of the present study was to determine whether the percentage of free/total prostate-specific antigen (f/tPSA) in patients scheduled to undergo radical prostatectomy for clinically localized prostate cancer can preoperatively predict organ-confined versus extraprostatic disease.Methods: Serum levels of fPSA and tPSA were measured in 97 patients with clinically organ-confined disease before they underwent radical prostatectomy. The relationships of tPSA, f/tPSA and the pathological stage of the prostatectomy specimens were analyzed. Furthermore, the ability of f/tPSA to predict the pathological features was compared with those of tPSA and systematic biopsy findings.Results: Organ-confined and extraprostatic extension diseases were present in 51 and 46 men, respectively. tPSA in patients with extraprostatic diseases was significantly higher than that in those with organ-confined diseases; however, there was no significant difference in f/tPSA between these two groups. There was also a significant difference in tPSA levels at each pathological stage, while f/tPSA did not parallel the pathological stage. Furthermore, there was no additional information concerning the extent of prostate cancer obtained when f/tPSA was combined with tPSA or with the percent of positive biopsy cores, which is the most significant predictor of the extent of prostate cancer among factors associated with systematic biopsy.Conclusion: f/tPSA could not predict the final pathological features in patients with clinically localized prostate cancer before radical prostatectomy. Moreover, the predictive value provided by tPSA or systematic biopsy findings was not improved by combined analysis with f/tPSA.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background:  The objectives of the present study were to investigate whether buttressing sutures, which prevent the bladder neck from pulling open as the bladder fills, can promote earlier recovery from urinary incontinence after radical retropubic prostatectomy (RRP) and to identify possible risk factors associated with urinary incontinence after RRP.Methods:  The present study included 72 patients who underwent non-nerve-sparing RRP without neoadjuvant therapy between January and December 2003. Among these 72 patients, intussusception of the bladder neck was performed in 24 who consented to this procedure. In the present series, continence was defined as the absence of any need to use sanitary pads or diapers. Continence was evaluated by a patient interview 1, 3 and 6 months after RRP.Results:  There were no significant differences in clinicopathological characteristics between patients with and without intussusception of the bladder neck. The percentage of continent patients 1, 3 and 6 months after RRP was 34.7%, 63.9% and 95.8%, respectively, and there were no significant differences in continence between the two groups at any time point. Among several factors examined, only bladder neck preservation was an independent predictor of recovery from urinary incontinence 1 and 3 months after RRP.Conclusions:  These findings suggest that it would be important to preserve the bladder neck for early return to continence after non-nerve-sparing RRP; however, intussusception of the bladder neck may not offer significant improvement in earlier return of urinary control.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The objective of the present study was to evaluate the efficacy of adjuvant androgen suppression in conjunction with external beam irradiation after radical prostatectomy in patients with pathologically confirmed extraprostatic disease.Methods: Between July 1988 and October 1999, 38 patients with pT3N0 or pT3N1 prostate cancer received adjuvant hormonal therapy and external beam irradiation following radical retropubic prostatectomy and pelvic lymphadenectomy. Administration of luteinizing hormone-releasing hormone analog or castration were initiated as an adjuvant androgen suppression within 4 weeks after surgery, whereas pelvic irradiation was performed at a median dose of 50 G within 3 months after surgery. The prognostic advantage of this combined adjuvant therapy was analyzed.Results: During the median observation period of 92 months, biochemical recurrence occurred in four of the 38 patients and five patients died. Of these five patients, only one died of prostate cancer progression. The 10-year biochemical recurrence-free, cancer-specific and overall survival rates of the 38 patients were 86.7%, 90.9% and 78.7%, respectively. Among several factors examined, only tumor grade was significantly associated with biochemical recurrence-free survival in these patients; however, there were no factors that were independent predictors for biochemical recurrence, based on multivariate analysis. Furthermore, biochemical recurrence-free survival in the 38 patients was significantly superior to that in 54 patients with locally advanced disease who did not receive any postoperative therapies until biochemical recurrence; however, there was no significant difference in cancer-specific and overall survival between these two groups.Conclusion: Despite retrospective analysis with a relatively small number of patients, results of the present study suggest favorable effects of the combined adjuvant treatments with androgen ablation and pelvic irradiation on cancer control for patients with pT3N0 or pT3N1 disease. However, considering the absence of a significant difference in cancer-specific and overall survival between patients with and without adjuvant treatments, it might not be necessary to routinely perform combined hormonal and radiation therapies in an adjuvant setting for pT3N0 or pT3N1 prostate cancer.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The objective of the present study was to investigate whether obtaining an increased number of biopsy cores by sampling additional areas, along with the standard sextant biopsy, results in a higher rate of detection of potentially insignificant prostate cancer.Methods: We included 130 patients who underwent radical retropubic prostatectomy at our institution between January 1999 and June 2003 after being diagnosed as having prostate cancer based on systematic prostate biopsies that included the areas examined by standard sextant biopsies and the bilateral anterior lateral horns (ALHs) of the peripheral zone (PZ). Several clinicopathological factors were analyzed, focusing on the significance of additional sampling from ALHs in relation to the incidence of potentially insignificant cancer, which was defined as organ confined disease with tumor volume less than 0.5 cc and Gleason scores 〈7.Results: According to the location of positive biopsy results, these 130 patients were divided into three groups as follows: 61 patients (46.9%) with cancer detected from the cores taken by standard sextant biopsy only (group A), 15 (11.6%) from ALHs of the PZ only (group B), and 54 (41.5%) from both sites (group C). There were no significant differences in age, incidence of abnormal digital rectal examination, prostate volume, or biopsy Gleason score among these three groups; however, pretreatment serum PSA value in group C was significantly higher than that in groups A or B. Pathological examinations of radical prostatectomy specimens demonstrated that there were no significant differences in the incidence of lymphatic invasion, vascular invasion and perineural invasion, or Gleason score among the three groups; however, group C had a significantly larger tumor volume than groups A or B. Furthermore, insignificant tumor was detected in eight patients in group A (13.1%), two in group B (13.3%), and four in group C (7.4%).Conclusion: These findings suggest that the additional sampling of biopsy cores from ALHs does not appear to increase the detection of potentially insignificant cancer, and that biological tumor characteristics seem to be similar irrespective of cancer location on the needle biopsy.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 12 (2005), S. 0 
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background:  The objective of this study was to determine whether vascular invasion (i.e. lymphatic and blood vessel invasion) could be a useful prognostic predictor in patients with locally invasive transitional cell carcinoma (TCC) of the bladder who underwent radical cystectomy.Methods:  This series included 114 consecutive patients undergoing radical cystectomy for primary TCC of the bladder between November 1989 and July 2003. Several clinicopathological characteristics of these patients were analyzed, focusing on the association between vascular invasion and disease recurrence after radical cystectomy.Results:  Lymphatic and blood vessel invasions were detected in 55 (48.2%) and 33 (29.8%) specimens, respectively. Lymphatic invasion was significantly associated with pathological stage, tumor grade, lymph node metastasis, blood vessel invasion and disease recurrence, whereas blood vessel invasion was significantly related to pathological stage, lymph node metastasis, lymphatic invasion and disease recurrence. Recurrence-free survival in patients with lymphatic invasion was significantly lower than that in those without lymphatic invasion, and a similar significant difference in recurrence-free survival was observed between patients with and without blood vessel invasion. However, multivariate analysis using the Cox proportional hazards model showed that only pathological stage and lymph node metastasis could be used as independent predictors for disease recurrence after radical cystectomy.Conclusions:  Despite a significant association between several prognostic parameters, vascular invasion was not an independent predictor of disease recurrence; therefore, if there are other conventional parameters available, there might not be any additional advantage to considering the presence of vascular invasion when predicting the prognosis of patients undergoing radical cystectomy for TCC of the bladder.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1335
    Keywords: Microcystin ; Nodularin ; Protein phosphatase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Microcystins and nodularin, isolated from toxic blue-green algae, are hepatotoxic monocyclic polypeptides. Both microcystins and nodularin inhibited in vitro protein phosphatase activity present in a cytosolic fraction of mouse liver, bound to the okadaic acid receptors, protein phosphatases 1 and 2A, and thus resulted in the increase of phosphoproteins; this was referred to as the apparent “activation” of protein kinases. Their concentrations causing 50% of the maximal effects are comparable to that of okadaic acid, a potent protein phosphatase inhibitor and a potent tumor promoter, in the nanomolar range of concentration. The increase of phosphoproteins was observed in rat primary cultured hepatocytes and was subsequently associated with morphological changes, which appeared to be a step in the process of hepatotoxicity. The well-known hepatotoxic compounds,α-amanitin and phalloidin, did not show any effects similar to those of microcystins, nodularin and okadaic acid. It is suggested that the hepatotoxicity of microcystins and nodularin may result from inhibition of protein phosphatases and the increase of phosphoproteins.
    Type of Medium: Electronic Resource
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