17 results on '"Thomas E. Stout"'
Search Results
2. MRI/PET Imaging in elevated PSA and localized prostate cancer: a narrative review
- Author
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Thomas E. Stout, Badrinath R. Konety, Niranjan J. Sathianathen, and Subodh Regmi
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medicine.medical_specialty ,PET-CT ,Review Article on Current and Future Topics on Prostate Cancer ,business.industry ,Urology ,Pet imaging ,medicine.disease ,Malignancy ,Elevated PSA ,Prostate cancer ,medicine.anatomical_structure ,Reproductive Medicine ,Prostate ,Glutamate carboxypeptidase II ,Medicine ,Narrative review ,Radiology ,business - Abstract
OBJECTIVE: To review the recent milestones in MRI and PET based imaging and evaluate their evolving role in the setting of elevated PSA as well as localized prostate cancer. BACKGROUND: The importance of multiparametric MRI (mpMRI) and PET based imaging for the diagnosis and staging of prostate cancer cannot be understated. Accurate staging has become another significant milestone with the use of PET scans, particularly with prostate specific radiotracers like 68-Gallium Prostate Specific Membrane Antigen (68Ga-PSMA). Integrated PET/MRI systems are commercially available and can be modulated to evaluate the unique needs of localized as well as recurrent prostate cancer. METHODS: A literature search was performed using PubMed and Google Scholar using the MeSH compliant and other keywords that included prostate cancer, PSA, mpMRI, PET CT, PET/MRI. CONCLUSIONS: mpMRI has now established itself as the gold-standard of local prostate imaging and has been incorporated into international guidelines as part of the diagnostic work-up of prostate cancer. PSMA PET/CT has shown superiority over conventional imaging even in staging of localized prostate cancer based on recent randomized control data. Imaging parameters from PET/MRI have been shown to be associated with malignancy, Gleason score and tumour volume. As mpMRI and PSMA PET/CT become more ubiquitous and established; we can anticipate more high-quality data, cost optimization and increasing availability of PET/MRI to be ready for primetime in localized prostate cancer.
- Published
- 2021
3. Evaluating the Perceived Importance of Male Ejaculatory Function
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Thomas E. Stout, Maria A. Ordonez, Edward Walczak, and Adam De Fazio
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Adult ,Male ,Adolescent ,Ejaculation ,Urology ,Prostatic Hyperplasia ,030232 urology & nephrology ,Personal Satisfaction ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Humans ,Medicine ,Aged ,Aged, 80 and over ,business.industry ,Survey research ,Middle Aged ,Ejaculatory Dysfunction ,Sexual Dysfunction, Physiological ,Sexual Partners ,030220 oncology & carcinogenesis ,Semen volume ,Female ,business ,Clinical psychology - Abstract
Objective To assess the perceived importance of male ejaculatory function (EjF) from the perspective of adult men and their sexual partners. Methods In a large survey study, men were asked about the importance of their own EjF. Sexual partners of men were asked about the general importance their partner's EjF, and whether they would support a partner's decision to pursue BPH treatment despite ejaculatory dysfunction. Results One hundred and two men completed the survey section regarding their own EjF, and 100 participants completed the survey section assessing the importance of their male partner's EjF. While 55% of men agreed or strongly agreed that “ejaculation is an important part of an enjoyable sexual experience,” only 30% of partners similarly agreed or strongly agreed (P = .005). A greater percentage of men (12%) agreed or strongly agreed that they “preferred large semen volume” compared to sexual partners of men (3%), however this was not significant. Sixty eight percent of sexual partners would agree or strongly agree to support their male partner's decision to pursue BPH treatment despite potential ejaculatory dysfunction. Conclusion The perceived importance of EjF differs between men and their sexual partners, as men believe ejaculation to be a more important component of an enjoyable sexual experience than their partners.
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- 2021
4. MP41-18 THE IMPACT OF SARCOPENIA AND OBESITY ON THE TOLERABILITY OF NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH MUSCLE INVASIVE BLADDER CANCER
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Ranveer Vasdev, Jacob Albersheim-Carter, Subodh Regmi, Peter Hanna, Joseph Zabell, Badrinath R. Konety, Arpit Rao, Gautam Jha, Christopher J. Weight, and Thomas E. Stout
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Oncology ,medicine.medical_specialty ,Chemotherapy ,Bladder cancer ,business.industry ,Urology ,medicine.medical_treatment ,Muscle invasive ,medicine.disease ,Obesity ,Cystectomy ,Tolerability ,Sarcopenia ,Internal medicine ,Medicine ,In patient ,business - Abstract
INTRODUCTION AND OBJECTIVE:Neoadjuvant chemotherapy (NAC) followed by radical cystectomy is the standard of care for patients with muscle invasive bladder cancer (MIBC). Careful selection is needed...
- Published
- 2021
5. A Randomized Trial Evaluating the Use of a Smart Water Bottle to Increase Fluid Intake in Stone Formers
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Thomas E. Stout, James E. Lingeman, Amy E. Krambeck, Mitchell R. Humphreys, Anna Zisman, Sarah Elfering, Tim Large, Philipp Dahm, and Michael Borofsky
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Adult ,Kidney Calculi ,Nutrition and Dietetics ,Nephrology ,Surveys and Questionnaires ,Drinking ,Medicine (miscellaneous) ,Humans ,Smartphone ,Diet - Abstract
The aim of this study is to evaluate if the use of a smart water bottle improves urine volume in stone forming patients.Adults with nephrolithiasis and low urine volume (1.5 L) documented on a 24-hour urinalysis (24 hr U) were randomized to receive either standard dietary recommendations to increase fluid intake (DR arm), or DR and a smart water bottle (HidrateSpark®; Hydrate Inc., Minneapolis, MN) that recorded fluid intake, synced to the user's smartphone, and provided reminders to drink (SB arm). Participants completed baseline surveys assessing barriers to hydration. They then repeated a 24 hr U and survey at 6 and 12 weeks, respectively.Eighty-five subjects (44 DR, 41 SB) were enrolled. The main baseline factor limiting fluid intake was not remembering to drink (60%). Follow-up 24 hr Us were available for 51 patients. The mean increase in volume was greater in the SB arm (1.37 L, 95% confidence interval -0.51 to 3.25) than the DR arm (0.79 L, 95% confidence interval -1.15 to 2.73) (P = .04). A smaller percentage of subjects in the SB arm reported not remembering to drink as the main factor limiting fluid intake in the follow-up questionnaire compared to baseline (45.4% vs. 68.4%, P .05). This was not true for the DR arm (40.0% vs. 51.2%, P = .13).Difficulty remembering to drink is a barrier to achieving sufficient fluid intake in stone formers. The use of a smart bottle was associated with greater increases in 24 hr U volumes and less difficulty remembering to drink.
- Published
- 2021
6. A Visual Scale for Improving Communication When Describing Gross Hematuria
- Author
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Thomas E. Stout, Ayman Soubra, and Michael S. Borofsky
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Adult ,Male ,medicine.medical_specialty ,Scale (ratio) ,Visual Analog Scale ,Urology ,Urologists ,030232 urology & nephrology ,Color ,Nurses ,Sample (statistics) ,Visual scale ,Urinary Catheters ,Severity of Illness Index ,Gross hematuria ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Medicine ,Humans ,Medical physics ,Therapeutic Irrigation ,Aged ,Hematuria ,business.industry ,Communication ,Middle Aged ,Degree (music) ,Clinical Practice ,030220 oncology & carcinogenesis ,Female ,business ,Kappa ,Grading scale - Abstract
OBJECTIVE To create and validate a grading scale that facilitates communication between providers managing gross hematuria (GH). METHODS A blood simulant was used to create a spectrum of GH in 5 foley catheter tubes which were shown to a group of experienced urologists. The urologists were asked how they would adjust the continuous bladder irrigation rate if the samples represented the urine of hypothetical patients, and a 5-point scale was created by group consensus with pictures of the representative tubes printed onto a visual aid. Another cohort were then shown the 5 tubes at random and asked to describe the GH. Raters were then shown the visual aid and asked to assign a grade to the same samples. Fleiss’ kappa analysis was used to measure inter-rater agreement, and therefore fidelity of the scale. RESULTS Fourteen urologists were surveyed to determine the samples used to create the 5-point scale. After the scale was created, 43 raters (22 nurses, 16 urologists, and 5 advanced practice providers) attempted match the tubes to their corresponding images on the printout. When asked to describe the degree of GH for the samples as they would in clinical practice, 28 different descriptors were used (mean 8.6 per sample). When using the 5-point GH scale, however, raters exhibited near perfect agreement in matching each sample to its corresponding severity on the scale (κ = 0.93, P CONCLUSION We created a clinically useful GH scale that improves communication and reduces ambiguous language among providers of varying levels of experience.
- Published
- 2020
7. MP78-14 EVALUATING THE PERCEIVED IMPORTANCE OF MALE EJACULATORY FUNCTION
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Adam DeFazio, Thomas E. Stout, and Maria A. Ordonez
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business.industry ,Urology ,media_common.quotation_subject ,Medicine ,business ,Function (engineering) ,Clinical psychology ,media_common - Published
- 2020
8. A Laparoscopic Approach to Parastomal Hernia Repair With Re-Siting of Urinary Stoma
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Khushabu Kasabwala, Sean P. Elliott, Daniel B. Leslie, and Thomas E. Stout
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,Urinary diversion ,Hernia repair ,medicine.disease ,digestive system diseases ,Surgery ,Abdominal wall ,surgical procedures, operative ,medicine.anatomical_structure ,Stoma (medicine) ,Laparotomy ,medicine ,Hernia ,Laparoscopic Port ,Laparoscopy ,business - Abstract
Background Parastomal and ventral hernias are common complications in patients with continent catheterizable channels or incontinent urinary diversions. Patients with neurogenic bladder are at particularly high risk due to weak abdominal wall musculature, and hernia repair often requires resiting of their stoma. While parastomal hernia repair with urinary stoma resiting has acceptable long-term success rates, it often necessitates a laparotomy which is associated with significant morbidity. Objective To describe a novel approach to combined laparoscopic parastomal hernia repair with resiting of the urinary stoma in patients with neurogenic bladder. The video will outline the surgical steps and pitfalls. Materials and Methods The case begins laparoscopically or robotically with adhesiolysis to dissect out the subfascial portion of the channel and the parastomal hernia. The subfascial portion of the channel is dissected out to the anterior abdominal wall, ensuring to preserve its mesentery. The abdomen is then desufflated and the suprafascial portion of the channel is dissected and the channel dropped into the abdomen. The hernia is then repaired laparoscopically using mesh and the channel is brought out through one of the laparoscopic port sites and matured to the skin. Results In our series of 4 patients, this technique was performed for 2 continent catheterizable channels and 2 incontinent diversions. One patient developed a hernia recurrence 7 months later which was repaired laparoscopically. In another, the stoma was successfully resited but the hernia was unable to be repaired laparoscopically due to dense adhesions. Continent and patency outcomes of the urinary stomas were 100% at a mean follow-up of 2 years. Conclusion Laparoscopic parastomal hernia repair with resiting of the urinary stoma has similar long-term success rates compared to that of an open repair and avoids the morbidity of a laparotomy. This repair can be performed for catheterizable channels or incontinent diversions.
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- 2021
9. Technique and Outcomes of Hand-Assist Laparoscopic Continent Cutaneous Ileocecocystoplasty
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Thomas E. Stout, Joseph J. Pariser, Ronak A. Gor, Joshua Roth, and Sean P. Elliott
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medicine.medical_specialty ,Urinary continence ,Pfannenstiel incision ,business.industry ,Urology ,Umbilicus (mollusc) ,Surgery ,Exact test ,Port (medical) ,Hand assist laparoscopic ,Bladder augmentation ,medicine ,business ,Ileocecocystoplasty - Abstract
Background Continent cutaneous ileocecocystoplasty (CCIC) involves reconfiguring the ileocecal segment for use as a bladder augment and continent catheterizable channel. CCIC requires release of the hepatic flexure of the colon, which necessitates a longer midline laparotomy than would be required for a standard bladder augmentation. This is associated with high rates of ventral and parastomal hernias. Objectives To describe the technique of hand-assist laparoscopic CCIC and to compare outcomes to open CCIC. Materials and Methods We found pure laparoscopic colon mobilization difficult due to significant colonic distension in patients with neurogenic bladder and bowel. We modified our approach to hand-assisted laparoscopic mobilization for better retraction of the bowel. A 12-mm camera port is placed through the umbilicus, which later serves as the stoma site, and a 5-mm assist port is placed a handbreadth cephalad to the 12-mm port. A Pfannenstiel incision is made for use as the hand port. After colonic mobilization is completed the remainder of the procedure is performed in an open fashion through the Pfannenstiel incision. The primary outcome was 90-day Clavien grade 2 or greater complications. Secondary outcomes included revision rates, wound infection, urinary continence, operative time, and length of stay. Data was analyzed using Mann-Whitney U test and Fisher's exact test. Results Thirty-two laparoscopic and 21 open procedures were reviewed. Those who underwent open procedures were more likely to have undergone prior catheterizable channel or bladder augmentation (7 vs 1, P Conclusion Hand-assist laparoscopic CCIC offers a minimally invasive alternative to open CCIC with fewer short-term complications and comparable long-term outcomes.
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- 2021
10. Presentation and Management Patterns of Lower Urinary Tract Symptoms in Adults Due to Rare Inherited Neuromuscular Diseases
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Sean P. Elliott, Joshua Roth, Rosalia Misseri, Thomas E. Stout, and Joseph J. Pariser
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Weakness ,Adolescent ,Urology ,030232 urology & nephrology ,Rett syndrome ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Atrophy ,Rare Diseases ,Lower Urinary Tract Symptoms ,Lower urinary tract symptoms ,medicine ,Prevalence ,Humans ,Intermittent Urethral Catheterization ,Muscular dystrophy ,Child ,Aged ,Retrospective Studies ,business.industry ,Urinary retention ,Functional incontinence ,Spinal muscular atrophy ,Neuromuscular Diseases ,Middle Aged ,medicine.disease ,Treatment Outcome ,030220 oncology & carcinogenesis ,Urological Agents ,Female ,medicine.symptom ,business ,Diapers, Adult - Abstract
Objective To describe the urologic sequalae of several rare congenital neuromuscular diseases. Methods We retrospectively reviewed medical records at Gillette Specialty Healthcare (2014-2018) of patients presenting to urology clinic with lower urinary tract symptoms and select rare congenital diseases: muscular dystrophy, spinal muscular atrophy, and Rett syndrome. Results Muscular dystrophies (n = 19) are X-linked myogenic disorders characterized by progressive muscle wasting and weakness. Men present to the urologist at variable ages, typically with complaints of functional incontinence and normal cystometrograms; we manage them with oral anticholinergic medications, condom catheter, or suprapubic catheter. Spinal muscular atrophy (n = 6) is a rare autosomal recessive disease characterized by degeneration of the anterior horn cells in the spinal cord and motor nuclei in the lower brainstem leading to progressive muscle weakness and atrophy. Patients typically present with nephrolithiasis and urinary retention in late adolescence/early adulthood, but timing varies. Filling cystometrograms have been normal. We allow passive retention with intermittent catheterization and creation of catheterizable channels, when indicated. Rett syndrome (n = 5) is a rare, noninheritable genetic condition affecting females characterized by a brief period of normal development followed by loss of speech and purposeful hand use; there are characteristic behaviors. Patients present in early adulthood with complaints of urinary retention. We manage retention with permissive retention or sphincter chemodenervation. Conclusion Several congenital neuromuscular conditions can cause lower urinary tract symptoms when these individuals become adults. We have discussed the clinical characteristics and management of select neurogenic and myogenic bladder conditions seen in adults with congenital conditions.
- Published
- 2019
11. AUTHOR REPLY
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Thomas E, Stout
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Urology - Published
- 2021
12. A Case of Bilateral Cystic Partially Differentiated Nephroblastoma vs Cystic Wilms' Tumor: Highlighting a Diagnostic Dilemma
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J.M. Hicks, Jason Au, Patricio C. Gargollo, and Thomas E. Stout
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Male ,0301 basic medicine ,congenital, hereditary, and neonatal diseases and abnormalities ,Pathology ,medicine.medical_specialty ,Adjuvant chemotherapy ,Urology ,medicine.medical_treatment ,Diagnostic dilemma ,Wilms Tumor ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Polycystic Kidney Diseases ,business.industry ,Cystic nephroma ,Cystic Partially Differentiated Nephroblastoma ,Infant ,Wilms' tumor ,Renal tumor ,medicine.disease ,Kidney Neoplasms ,Nephrectomy ,030104 developmental biology ,030220 oncology & carcinogenesis ,business - Abstract
Cystic partially differentiated nephroblastoma (CPDN) is a rare multicystic renal tumor along the spectrum of cystic nephroma and cystic Wilms' tumor. There have only been two previously reported cases of bilateral CPDN in the literature. We present here a case of bilateral CPDN vs cystic Wilms' tumor treated with neoadjuvant and adjuvant chemotherapy in addition to a bilateral partial nephrectomy. We also review the relevant literature regarding CPDN in an effort to aid in diagnosis and management of these rare cystic renal tumors.
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- 2016
13. Controversies in the Surgical Management of Renal Cell Carcinoma
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Thomas E. Stout and Samit D. Soni
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- 2018
14. Investigational Technologies in the Surgical Management of Renal Cell Carcinoma
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Thomas E. Stout and Samit D. Soni
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- 2018
15. Post-chemotherapy robotic bilateral retroperitoneal lymph node dissection using a novel single-dock technique
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Samit Soni, Thomas E. Stout, and Alvin Goh
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Operative Time ,030232 urology & nephrology ,Blood Loss, Surgical ,Health Informatics ,Antineoplastic Agents ,Inferior mesenteric artery ,03 medical and health sciences ,Retroperitoneal lymph node dissection ,0302 clinical medicine ,Robotic Surgical Procedures ,Testicular Neoplasms ,medicine.artery ,medicine ,Retroperitoneal space ,Humans ,Robotic surgery ,Retroperitoneal Space ,Laparoscopy ,Testicular cancer ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Neoplasms, Germ Cell and Embryonal ,medicine.disease ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Operative time ,Feasibility Studies ,Lymph Node Excision ,business - Abstract
There have been no previous reports of post-chemotherapy robotic bilateral retroperitoneal lymph node dissection (RPLND) using a single-dock technique. One deterrent of robotic RPLND is that accessing bilateral retroperitoneal spaces requires patient reposition and surgical robot redocking, therefore increasing operative time. Herein we provide the first step-by-step description of a single-dock technique for robotic bilateral RPLND in the post-chemotherapy setting. We describe port placement and technique for robot positioning to optimize access to bilateral retroperitoneal spaces with a single dock. We also demonstrate the feasibility of sparing the inferior mesenteric artery when utilizing this approach. This single-dock approach was used on two patients at our institution who had residual paracaval masses following chemotherapy for metastatic testicular cancer. Mean operative time was 6 h, and neither patient had significant blood loss or suffered from any peri-operative complications.
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- 2016
16. MP91-18 LITIGATION INVOLVING SPERM BANKING IN THE UNITED STATES
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Amin S. Herati, Dolores J. Lamb, Larry I. Lipshultz, Peter Cook, Andrew Allison, and Thomas E. Stout
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Gynecology ,medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Accounting ,business ,Sperm bank - Published
- 2016
17. Suppression subtractive hybridization identifies novel transcripts in regenerating Hydra littoralis
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Binoy Appukuttan, Thomas E. Stout, and Trevor J. McFarland
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Genetics ,Expressed Sequence Tags ,Expressed sequence tag ,DNA, Complementary ,Hydra ,Regeneration (biology) ,Nucleic Acid Hybridization ,Shotgun ,General Medicine ,Biology ,Biochemistry ,Polymerase Chain Reaction ,Nucleic acid thermodynamics ,Suppression subtractive hybridization ,GenBank ,Animals ,Regeneration ,Lernaean Hydra ,RNA, Messenger ,Molecular Biology ,Gene - Abstract
Despite considerable interest in the biologic processes of regeneration and stem cell activation, little is known about the genes involved in these transformative events. In a Hydra littoralis model of regeneration, we employed a rapid shotgun suppression subtractive hybridization strategy to identify genes that are uniquely expressed in regenerating tissue. With an adaptor-PCR based technique, 16 candidate transcripts were identified, 15 were confirmed unique to mRNA isolated from hydra undergoing regeneration. Of these, 6 were undescribed in GenBank and allied expressed sequence tag (EST) databases (GenBank + EMBL + DDBJ + PDB and the Hydra EST database). BLAST analysis of these sequences identified remarkably similar sequences in anonymous ESTs found in a wide variety of animal species.
- Published
- 2007
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