bluuebunny/crossref_metadata_2025 huggingface dataset:
The American Reception and Settlement of Hungarian Refugees in 1956–1957
Authors: Pastor Peter
Published: October 2016

In the wake of the Hungarian Revolution of 1956, close to two hundred thousand Hungarians crossed into Austria.  About thirty thousand of these refugees were allowed to enter the United States. Their common experience of living under totalitarian communism and participating or being a witness to the exhilarating thirteen days of the revolution and their sudden, previously unplanned, departure from the homeland gave them a collective identity that was different from the one shared by the people of previous waves of Hungarian influx to the United States. The high educational level of the refugees attained before and after their arrival made their absorption into the mainstream relatively easy. The integration process was facilitated by the shaping of a positive image of the 1956 refugees by the US government and the media.  The reestablishment of the communist system in post-1956 Hungary contributed to the perception that, for the refugees in the United States, there was no hope for return to the homeland.  This assumption strengthened the attitudes of those who wished to embrace the American melting pot model.  Many of the 1956-ers in the United Sates, however, were also comfortable with the notion of ethnic pride and believed in the shaping of a dual national identity.
Bollywood of India: Geopolitical Texts of Belonging and Difference and Narratives of Mistrust and Suspicion
Authors: Shailo Iqbal
Published: October 2016

A number of Bollywood films create meaning and geopolitical narratives through dialogue, raw images, settings, costumes and historical contexts. This study examines three contemporary Indian films —Earth (Deepa Mehta, 1998), Lagaan (Ashutosh Gowariker, 2001) and Sarfarosh (John Matthew Matthan, 1999) — that explore sub-continental history with a particular focus on insecurity, mistrust and suspicion.  It discusses how socio-cultural and regional differences are (re)produced and how geopolitical meanings of ‘we’ and ‘they’ are narrated and constructed through Bollywood. These films construct an image of identity, belonging and difference, emphasizing that Hindus and Muslims are Indians however some legacies and suffering brought on during the partition of British India are still alive in memories when discrimination and exclusion are practiced in their ancestral homelands.
What do we mean by Impact?
Authors: Perry Jill A. , Imig David G.
Published: October 2016

A history of change efforts by philanthropic agencies and government organizations directed at graduate schools of education has not produced long-term or sustained changes in their form and function. The Carnegie Project on the Education Doctorate (CPED), however, has been able to demonstrate that external change efforts can result in change in schools of education when bottom-up efforts are combined with top-down support. Such change is an important "impact" of CPED. In this short essay, the CPED Executive Director and Chairman of the Board provide an overview of CPED's impact and then challenge authors and reader to help CPED further extend the definition of impact as it related to all aspects of the Education Doctorate.
Yong Vui Kong v. Public Prosecutor (Sing. Ct. App.)
Authors: Mcdermott Yvonne
Published: October 2016

On March 4, 2015, Singapore’s Court of Appeal issued its judgment in Yong Vui Kong v. Public Prosecutor, upholding the punishment of caning imposed on the defendant as constitutional. The decision is significant because it discusses the impact of the prohibition of torture, a peremptory norm of international law, on domestic legislation. The Court of Appeal determined that, even if caning were to be considered a form of torture, the customary international law prohibition on torture did not invalidate its domestic law permitting caning as a form of punishment.
Certain Activities Carried out by Nicaragua in the Border Area (Costa Rica v. Nicaragua)/Construction of a Road in Costa Rica along The San Juan River (Nicaragua v. Costa Rica) (I.C.J.)
Authors: Miles Cameron A.
Published: October 2016

December 16, 2015, saw the International Court of Justice (ICJ or the Court) render final judgment in the joined cases of Certain Activities Carried Out by Nicaragua in the Border Area (Costa Rica v. Nicaragua) (Border Area) and Construction of a Road in Costa Rica Along the San Juan River (Nicaragua v. Costa Rica) (Road). Together, these cases represented an opportunity for the Court to advance and clarify its thinking on the role of environmental impact assessments (EIA) in general international law, as first introduced in its decision in Pulp Mills on the River Uruguay (Argentina v. Uruguay) (Pulp Mills), with both Costa Rica (in Border Area) and Nicaragua (in Road) alleging that the other had failed to carry out an EIA with respect to certain, potentially environmentally harmful, activities. They also raised some interesting questions regarding remedies for the breach of provisional measures awarded under Article 41 of the ICJ Statute.
Minamata Convention on Mercury
Authors: Coulter Margaret A.
Published: October 2016

This year, 2016, marks the sixtieth anniversary of the discovery of “Minamata Disease,” so-named for the town ravaged by the effects of methylmercury poisoning, and the namesake of the Minamata Convention on Mercury. As of April 22, 2016—Earth Day—128 nations have signed and 25 have ratified the international treaty designed to protect human health and the environment from anthropogenic releases and emission of mercury and mercury compounds.
Unpacking Digital India: A Feminist Commentary on Policy Agendas in the Digital Moment
Authors: Gurumurthy Anita , Chami Nandini , Thomas Sanjana
Published: October 2016

This article is a feminist commentary on India's national digital agenda in the current political context. The analysis pursues three main policy strands—social welfare, democracy, and economic growth, unpacking the meta-narrative of technology, gender, and development that characterizes the particular complexion of authoritarian neoliberalism reconstituting Indian democracy in digital times. The Indian case, the article submits, is reflective of the contemporary digital moment, not only marked by the evisceration of the transformative content of gender politics, but also constitutive of it. Under the circumstances, it is imperative to produce alternative feminist imaginaries of social, political, and economic discourse nationally and globally.
Unusual presentation of an obstetrical urethrovaginal fistula secondary to improper catheter placement
Authors: Cameron Anne P. , Atiemo Humphrey O.
Published: October 2016

Vesicovaginal and urethrovaginal fistulas related to obstetricalcauses are exceptionally rare in the developed world. We reporta case of 23-year-old woman with a urethrovaginal fistula, whichdeveloped after a cesarean delivery because of an inappropriatelyplaced urethral catheter. Diagnostic evaluation and surgicalapproach are discussed.
A case of indirect cauda equina syndrome from metastatic prostate cancer
Authors: Lefresne Shilo , Fairchild Alysa , Bistritz Aalo , Venner Peter , Yee Don
Published: October 2016

We report the case of a patient with metastatic hormone refractoryprostate cancer in whom “indirect” cauda equina syndromedeveloped concurrent with multilevel spinal cord compression(SCC). Three months after his first positive bone scan, a 65-yearoldotherwise healthy man presented with severe back pain, bilaterallower extremity paresthesias, leg weakness and urinary retention.Magnetic resonance imaging (MRI) showed a dural-basedmass causing SCC at the T9, T10 and T11 vertebrae, with a normalcauda equina. He received corticosteroids and palliativeexternal beam radiotherapy, resulting in good pain control andgradual improvement in his neurological symptoms. He did wellfor 8 months, at which time his residual bilateral leg weaknessabruptly worsened and he experienced numbness, paresthesias,urinary incontinence and constipation. Repeat MRI showed progressionof epidural metastatic disease compressing the spinalcord or thecal sac at 7 thoracic vertebral levels. The cauda equinawas also distorted and flattened without evidence of direct solidtumour impingement. We hypothesized that the etiology wasincreased intrathecal pressure due to disrupted cerebrospinalfluid flow resulting from multiple levels of upstream thecal saccompression. It is essential to image the entire spinal cord andcauda equina when patients with metastatic bone disease presentwith neurological symptoms to institute correct treatment andpreserve function and mobility.
Prolonged survival in a patient with choroidal metastases from urothelial bladder cancer
Authors: Wiltshire Kirsty L. , Laperriere Norman , Bristow Robert G.
Published: October 2016

Choroidal metastases secondary to urothelial carcinoma areextremely rare and are usually associated with an extremely poorprognosis. We present a case of an 88-year-old man with newlydiagnosed urothelial carcinoma of the bladder who presented withacute loss of vision before commencing definitive concurrentchemoradiotherapy to the bladder. Ophthalmological examinationdemonstrated bilateral choroidal metastases. He received palliativeradiotherapy to the orbits and completed his planned radiotherapyto the bladder. He remained disease-free at last follow-up 4 yearsafter the completion of treatment. We review the literature particularlywith regard to diagnosis and management of choroidalmetastases. Choroidal metastases should be considered in a patientwith a history of urothelial cancer presenting with new onset ofeye symptoms.
Complex mucinous cystadenoma of undetermined malignant potential of the urachus
Authors: Schell Andrew J. , Nickel Curtis J. , Isotalo Phillip A.
Published: October 2016

Urachal mucinous neoplasms are rare and include both villousadenomas and invasive adenocarcinomas. These mucinous tumoursshould be completely excised as they can demonstrate aggressiveclinical behaviour, including the development of pseudomyxomaperitonei. We describe a 70-year-old woman who presented witha lower abdominal mass and received a diagnosis of a rare, complexurachal mucinous cystadenoma of undetermined malignant potential.This tumour demonstrated extensive mucin extravasation intoperivesical soft tissue, but was not associated with pseudomyxomaperitonei or any malignancy. Rarely described in the English literature,mucinous cystadenomas of the urachus should be treatedsimilarly to their villous adenoma counterparts: with complete surgicalexcision to prevent local tumour recurrences.
Tissue engineering in urology
Authors: Matoka Derek J. , Cheng Earl Y.
Published: October 2016

Tissue engineering encompasses a multidisciplinary approach gearedtoward the development of biological substitutes designed to restoreand maintain normal function in diseased or injured tissues. Thisarticle reviews the basic technology that is used to generateimplantable tissue-engineered grafts in vitro that will exhibit characteristicsin vivo consistent with the physiology and function ofthe equivalent healthy tissue. We also examine the current trendsin tissue engineering designed to tailor scaffold construction, promoteangiogenesis and identify an optimal seeded cell source.Finally, we describe several currently applied therapeutic modalitiesthat use a tissue-engineered construct. While notable progresshas clearly been demonstrated in this emerging field, these effortshave not yet translated into widespread clinical applicability. Withcontinued development and innovation, there is optimism that thetremendous potential of this field will be realized.L’ingénierie tissulaire englobe une approche multidisciplinaireaxée sur le développement de substituts biologiques en vue derétablir et de maintenir la fonction normale de tissus lésés. L’articlequi suit passe en revue la technologie fondamentale utilisée pourgénérer des greffons implantables produits par ingénierie in vitroet possédant des caractéristiques in vivo correspondant aux tissussains équivalents sur les plans physiologique et fonctionnel.Nous examinons également les tendances actuelles en ingénierietissulaire visant à adapter des échafaudages tissulaires, à promouvoirl’angiogenèse et à dégager une source optimale de cellulesimplantables. Enfin, nous décrivons plusieurs modalités thérapeutiquesactuellement mises en application utilisant un échafaudagecréé par ingénierie tissulaire. En dépit de progrès remarquablesdans ce domaine en effervescence, les efforts déployés ne se sontpas encore traduits par une applicabilité clinique étendue. Desdéveloppements et des percées continus permettent d’être optimisteface au potentiel prodigieux de ce domaine.
Toothache as a presenting symptom of metastatic renal cell cancer
Authors: Hallock Abhirami , Rodrigues George
Published: October 2016

A 53-year-old man with a 14-year history of renal cell carcinoma(RCC) presented with a 2-month history of right-sided upper jawpain and severe bleeding during tooth extraction. Pathology reviewof a lower maxillary sinus/upper gingival mass revealed metastaticRCC. The presentation, differential diagnosis and literature reviewof this uncommon presentation of metastatic kidney cancer arediscussed in this report.
Renal cell carcinoma with caval thrombus extending to the right atrium in a horseshoe kidney: a unique surgical challenge
Authors: Greene Graham F. , Bissada Nabil K. , Madi Rabii
Published: October 2016

The surgical anatomy of a horseshoe kidney (HK) is unique inmany ways, ranging from its anomalous circulation, shared renalparenchyma between the right and left renal moieties, and its anteriorrenal pelvis, to the fact that it obscures access to the vena cavaand aorta. While renal cell carcinomas (RCCs) are known to occurin HKs, the surgical approach to an RCC with tumour thrombusextending to the right atrium has not been reported in the literature.We report an unusual presentation of RCC and the technicalaspects of our successful experience with managing RCC of a HKextending to the inferior vena cava and right atrium.
Paraneoplastic production of heparin-like anticoagulant in a patient with metastatic transitional cell carcinoma
Authors: Fahl Kelly N. , Poon Stephen A. , Badani Ketan K. , Benson Mitchell C.
Published: October 2016

It has been reported that patients with bladder cancer have widelyvarying paraneoplastic consequences, including metabolic, dermatologic,myopathic and neurologic disturbances. We report a case of a52-year-old man with advanced transitional cell carcinoma and livermetastases, who developed a severe coagulopathy following roboticradical cystoprostatectomy due to circulating heparin-like substancesprior to onset of liver failure. Heparin-like anticoagulant production isa rare paraneoplastic effect documented in concert with transitionalcell carcinoma, breast carcinoma and hematological malignancies.
Hormone use after radiotherapy failure: a survey of Canadian uro-oncology specialists
Authors: Loblaw D. Andrew , Pickles Tom , Cheung Patrick C. , Lukka Himu , Faria Sergio , Klotz Laurence
Published: October 2016

Introduction: A survey of Canadian uro-oncology specialists wasperformed to assess practice patterns of patients with recurrentprostate cancer postradiotherapy and to assess the feasibility ofconducting a trial in this setting.Methods: There were 14 survey questions and 1 demographic question.Responses were reported by frequency.Results: There were 96 respondents. Most respondents use bothprostate-specific antigen doubling time (PSAdt) and PSA levelwhen deciding to start androgen deprivation therapy (ADT) inasymptomatic patients. About half of respondents start ADT whenPSA is greater than 10 ng/mL or when the PSAdt is less than6 months. Eighty-six percent felt that the timing of ADT was animportant research question. Over 1500 patients per year wereestimated as being available for such a trial.Conclusion: After radiotherapy failure, respondents initiated ADTabout half of the time when PSA is less than 10 ng/mL and/orPSAdt is less than 6 months. A clinical trial examining the timingof ADT has strong support and appears to be feasible.Introduction : Un sondage mené auprès d’uro-oncologues cana diensa été mené afin d’évaluer les tendances concernant le traitement depatients atteints de cancer récurrent de la prostate après une radiothérapieet d’évaluer la faisabilité d’une étude dans ce contexte.Méthodologie : Le sondage comportait 14 questions portant sur lestraitements et 1 question de type démographique. Les réponsesétaient groupées par fréquence.Résultats : Quatre-vingt-seize médecins ont participé au sondage.La majorité des répondants se basent sur le temps de doublementde l’APS et les taux d’APS pour décider du moment optimal pouramorcer un traitement antiandrogène chez les patients asymptomatiques.Environ la moitié des répondants entreprennent un traitementantiandrogène lorsque le taux d’APS dépasse 10 ng/mL oulorsque le temps de doublement de l’APS est inférieur à 6 mois.Quatre-vingt-six pour cent des répondants ont indiqué que le momentoptimal pour l’amorce du traitement antiandrogène représentaitune importante question de recherche. On estime que plus de1500 patients par année seraient admissibles à une telle étude.Conclusion : Après l’échec d’une radiothérapie, les répondants entreprennentun traitement antiandrogène dans environ la moitié descas lorsque l’APS est inférieur à 10 ng/mL et/ou lorsque le tempsde doublement de l’APS est inférieur à 6 mois. Un essai cliniqueportant sur la détermination du moment optimal pour l’amorce dutraitement antiandrogène est fortement souhaité et semble faisable.
Endoscopic ablation of Hunner’s lesions in interstitial cystitis patients
Authors: Payne Ryan A. , O’Connor R. Corey , Kressin Margarita , Guralnick Michael L.
Published: October 2016

Introduction: We report our experience with endoscopic ablationof Hunner’s lesions in women with interstitial cystitis (IC).Methods: A chart review was performed on 14 patients with ICsymptoms who were identified to have bladder lesions and underwentendoscopic ablation. A Hunner’s lesion was identified asan area of erythema that reproduced the patients’ pain when touchedby the cystoscope. Pathology reports were reviewed and improvementin pain was used as the main outcome measure.Results: Of the 14 patients, 12 had more than 50% symptomaticimprovement and 8 patients reported 100% improvement. Meanimprovement was 76%. In all patients who improved, the biopsyspecimen showed inflammatory cystitis, often with epithelialdenudation. Four patients had symptomatic recurrence, but allhad improvement after repeat ablation.Conclusion: Endoscopic ablation of Hunner’s lesions improves symptomsin IC patients. Recurrence of symptoms should prompt repeatcystoscopy to identify recurrent lesions, as repeat ablation offerssymptomatic improvement.Introduction : L’article fait état de notre expérience concernantl’ablation endoscopique d’ulcères de Hunner chez des femmesatteintes de cystite interstitielle (CI).Méthodologie : On a mené un examen des dossiers de 14 patientesprésentant des symptômes de CI chez qui des lésions vésicalesavaient été observées et traitées par ablation endoscopique. Unulcère de Hunner était défini comme une zone d’érythème reproduisantla douleur décrite par la patiente lorsque cette zone étaittouchée à l’aide du cystoscope. Les rapports de pathologie ontété examinés et la réduction de la douleur a été utilisée commeprincipal critère d’évaluation.Résultats : Sur les 14 patientes, 12 ont présenté une réduction supérieureà 50 % des symptômes et 8 ont signalé une réduction de 100 %. Letaux moyen de réduction était de 76 %. Chez toutes les patientesayant signalé une réduction des symptômes, l’échantillon de tissuprélevé par biopsie montrait la présence de cystite inflammatoire,souvent accompagnée de dénudation épithéliale. Quatre patientesont signalé une réapparition des symptômes, mais une nouvelle ablationa permis de réduire encore une fois les symptômes.Conclusion : L’ablation endoscopique des ulcères de Hunner entraîneune réduction des symptômes en présence de CI. La réapparitiondes symptômes devrait être prise en charge par une nouvelle cystoscopieafin de repérer les nouvelles lésions; une nouvelle ablationpermet de soulager les symptômes.
Symptomatic cystic seminal vesicle: a laparoscopic approach for effective treatment
Authors: Nassir Anmar
Published: October 2016

This case report highlights a symptomatic cystic seminal vesiclelesion, treated laparoscopically. A young adult male known tohave congenital right renal agenesis presented with a history ofrecurrent right iliac fossa pain, as well as deep pelvic discomfort.The preoperative evaluation revealed a 7 x 4.5 x 4 cm cystic seminalvesicle mass. After discovery of the mass, the patient underwenta transperitoneal laparoscopic excision of the lesion. Thepatient was discharged on the third postoperative day and hadan uneventful recovery. There were no complications noted duringa routine follow-up. The laparoscopic approach was shownto be effective in the management of this rare condition.
Bilobed testicle in children: diagnosis and management
Authors: De Carli Claudio , Guerra Luis , Leonard Michael
Published: October 2016

Bilobed testicle is an extremely rare testicular malformation inchildren. It may be presumed that this condition could be an incompleteexpression of polyorchidism; however, the etiology of bothentities remains unknown. In this report, a 3-year-old boy presentedwith a right bilobed testicle mimicking a testicular tumour. Sincethere are insufficient data in the pediatric literature presenting theideal management of bilobed testicles, we believe it is importantto report this case to provide more information about this condition.Although rare, bilobed testis should be considered in the differentialdiagnosis of a testicular mass. Surgical treatment is notmandatory, and conservative follow-up may play a role.
Malignant giant pheochromocytoma: a case report and review of the literature
Authors: Torres Arcos Cristina , Ruiz Luque Virgilio , Aguilar Luque José , Martínez García Pablo , Brox Jiménez Antonia , Márquez Muñoz Macarena
Published: October 2016

Malignant pheochromocytoma is a rare disease and surgical resectionis the only curative treatment. There are no definitive histologicalor cytological criteria of malignancy, as it is impossible todetermine this condition in the absence of advanced locoregionaldisease or metastases. We report a case of a patient with a giantretroperitoneal tumour, the second largest to be published, whichwas diagnosed as a malignant pheochromocytoma; it was treatedwith surgery. The literature is reviewed to evaluate tumour featuresand criteria to distinguish between benign and malignantpheochromocytomas.
Mantle cell lymphoma of the prostate
Authors: Abdussalam Abuhjar , Gerridzen Ronald G.
Published: October 2016

Lymphoma of the prostate, either primary or secondary, is veryrare. We report the case of an 82-year-old man with symptoms ofbladder outlet obstruction presumably due to benign prostatehyperplasia (BPH). He underwent an uneventful transurethral resectionof the prostate. Pathological review of the resected tissuedemonstrated substantial infiltration by an atypical lymphoid infiltratepositive for CD20, BCL2, CD5, k light chain and cycline D1.Histology and immunoprofile were consistent with mantle celllymphoma.
Chemoprevention in bladder cancer: What’s new?
Authors: Lattouf Jean-Baptiste
Published: October 2016

Bladder cancer is the sixth most common tumour in Canada andranks eighth in terms of cancer mortality. Up to now, managementof this condition relied mostly on surgical and intravesicaltreatments once the disease is established. Chemoprevention is anattractive option to prevent the disease in high-risk populationsand may well reduce the costs related to its treatment. This reviewexamines the available data on chemoprevention strategies in bladdercancer, with special emphasis on randomized controlled trialswhen available.
The optimal management of T1 high-grade bladder cancer
Authors: Nepple Kenneth G. , O’Donnell Michael A.
Published: October 2016

Stage T1Hg bladder cancer should be considered an aggressive andpotentially lethal disease. The importance of initial re-resection toidentify unrecognized muscle-invasive disease is significant. Mostpatients with high-risk disease are candidates for initial bladder salvagewith intravesical bacillus Calmette-Guerin vaccine forimmunotherapy, a procedure with a high survival rate; however,failure of the procedure may result in a guarded prognosis. Evenafter apparent success, patients should be informed of the risks ofthe disease progressing to muscle-invasive or metastatic diseaseand the need for vigilant monitoring. Despite optimal management,a significant number of patients relapse or progress to invasive diseaserequiring cystectomy. This review provides insight into theoptimal management of T1 high-grade bladder cancer.
Isolated renal hydatid disease in a non-endemic country: a single centre experience
Authors: Mokhtar Alaa A. , Al Sayyah Ahmed , Al-Hindi Hindi , Seyam Raouf M. , Al Khudair Waleed
Published: October 2016

Objective: Isolated renal hydatid disease (HD) is rare in nonendemic countries. Clinical and radiological suspicion warrants appropriate serological tests, preoperative treatment and intra-operative precautions. We present a tertiary care centre experience of isolated renal HD in a non-endemic country.Methods: We reviewed the medical records of patients with HD treated in the past 20 years. We identified patients with the definitive diagnosis of isolated renal HD and described their management.Results: Of the 119 cases with HD, 6 were found to have isolated renal involvement (5%). Their median age was 46.5 (28-70) years. Five patients presented with flank pain and 1 had an incidentally discovered renal mass. Radiologic investigations raised the suspicionof possible HD in 4 cases, while 2 cases were diagnosed as renal tumours. Computerized tomography showed complex renal cyst in 4, solid renal mass with heterogonous enhancement in 2 and calcification in 5. Eosinophilia and indirect hemagglutinationtest (IHA) were positive in 3 of the 4 suspected cases. Three cases were treated as renal tumours, while 3 were managed as HD. Four cases had total nephrectomy and 2 had partial nephrectomy. Histopathology revealed that all cases had renal HD. Patients were followed for a median of 7.3 (0.4-11.3) years with no evidence of recurrence.Conclusions: Isolated renal HD is a challenging preoperative diagnosis in non-endemic countries. The definitive diagnosis is only possible by histopathology. Retrospectively, HD mimicked renal tumours in half the cases and should be considered in the differential diagnosis of renal space occupying lesions.
Management of metastatic urothelial cancer: the role of surgery as an adjunct to chemotherapy
Authors: Svatek Robert S. , Siefker-Radtke Arlene , Dinney Colin P.
Published: October 2016

Metastatic or unresectable disease is identified in approximately20% of patients presenting with invasive urothelial cancer. Inaddition, up to 50% of patients will develop metastases followingradical cystectomy for clinically localized disease. Multiagentcisplatin-based chemotherapy is considered standard first-linetreatment for these patients. Although urothelial cancer is considereda chemosensitive tumour, metastatic disease is associatedwith poor prognosis and short-term survival. Here, we review therole of a multidisciplinary approach to treating patients with metastaticurothelial cancer.
Diagnosis and prognosis of malignant mesothelioma of the tunica vaginalis testis
Authors: Hai Bo , Yang Yu , Xiao Yajun , Li Bing , Chen Chaohui
Published: October 2016

Objectives: The objective of this study is to evaluate the diagnosis and prognosis of malignant mesothelioma of the tunica vaginalis testis through an additional 6 patients with urogenital mesothelioma.Methods: Six patients with urogenital mesothelioma who underwent adequate surgical procedures and histopathologic analysis from 1990 to 2009 were identified and retrospectively reviewed.Results: Six patients between the ages of 26 and 78 years with urogenital mesothelioma, 5 of which originated in the scrotum and 1 in the spermatic cord. Histopathologic analysis showed that CK5/6 and calretinin were positive in all cases, 5 cases were positive for vimentin, and 1 case showed focal weak positive reaction with MOC3, but none of the cases stained for CEA or CD15. The overall recurrence rate of urogenital mesothelioma after surgery was 5/6, including local recurrences and fatalities due to tumour.Conclusions: In cases of mesothelioma of the tunica vaginalis testis, the histopathologic markers we chose helped conﬁrm the histopathological diagnosis; adequate surgical procedures are typically not curative, and this tumour is often fatal.
Early immune outcome of retroperitoneal laparoscopic radical nephrectomy for localized renal cell carcinoma: a prospective, randomized study
Authors: Lu Yang , Tianyong Fan , Qiang Wei , Xiaobo Cu , Siyuan Bu , Ping Han
Published: October 2016

Objectives: We evaluated differences in cytokine responses and T-lymphocyte subsets following retroperitoneal laparoscopic andconventional open radical nephrectomies for localized renal cellcarcinoma (RCC).Methods: A total of 62 patients with T1N0M0 staged RCC were randomized to either retro-laparoscopic (n = 31) or open (n = 31) radical nephrectomy. Plasma levels of interleukin-1β (IL-1β), IL-6, andtumour necrosis factor-alpha (TNF-α) were measured separately by enzyme linked immunosorbent assay (ELISA) preoperatively and on postoperative days 1 and 5. Levels of CD3+, CD4+ and CD8+ as well as the CD4+:CD8+ ratio were acquired by flow cytometry at the same time points.Results: Levels of IL-1β, IL-6 and TNF-α increased significantly compared to preoperative values in both groups (p < 0.05) on postoperative day 1, and all the parameters in the open group were significantly higher than those in the retro-laparoscopy group (p < 0.05). On postoperative day 1, the levels of CD3+ and CD4+ and the CD4+:CD8+ ratio decreased markedly compared to preoperative values for both groups (p < 0.05). Elevations of the CD4+:CD8+ ratio in the retro-laparoscopy group (p < 0.05) and the CD8+ level in the open group (p < 0.05) were observed when compared with the other group. On postoperative day 5, the levels of CD3+ and CD4+ and the CD4+:CD8+ ratio in the retro-laparoscopy group, as well as the level of CD8+ in the open group, returned to about preoperative levels (p < 0.05). Follow-up ranged from 4 to14 months postoperatively in all 62 patients with a 100% cancer specific survival rate in both groups.Conclusions: Retroperitoneal laparoscopic radical nephrectomy is associated with the milder cytokine responses caused by trauma and inflammation and the better preserved distribution ofT-lymphocytes.
FROM PODIUM TO PRESS: THE 10-YEAR PUBLICATION RATE OF ABSTRACTS PRESENTED AT THE ANNUAL MEETINGS OF THE QUEBEC UROLOGICAL ASSOCIATION (QUA)
Authors: Al-Qaoud Talal M , Yafi Faysal A , Aprikian Armen G
Published: October 2016

Introduction: To determine the proportion of publications arising from abstracts presented at the Quebec Urological Association (QUA), to analyze differences in publication rates according to certain parameters, and to examine the quality of publications using journal impact factors. Methods: All abstracts presented at the annual meetings of the QUA between 2000 and 2010 were obtained from the QUA archives and searched using the PubMed database. Variables included: Institute, number of abstracts presented, year of presentation and publication, impact factor of publishing journal (according to 2010 Thomson Reuters report), time to publication (months), research type, presenter, and location of research. Kaplan Meier methods were used for analysis. Results: By May 2012, 248 out of 439 abstracts (QUA 2000 to 2010) were published in peer-reviewed journals resulting in a publication rate of 56%. There were significant differences in publication rate according to institute, research type, and location of research. Non-Quebec institutions were twice as likely to publish compared to Quebec institutions (Cox HR 2.13, CI 1.20 – 3.76, p-value <0.01). Discussion: The QUA publication rate was considerably higher than previously studied by the American Urological Association (37.8%) and British Association of Urological Surgeons (≈42%); however length of follow up and presentation types differed. Research conducted outside Quebec was more likely to be published, reflecting the multi-institution robust study designs and higher level of evidence. Factors influencing publication deserve further attention, and clinicians are encouraged to conduct research with intent to publish.
Should peritoneal dialysis catheters be removed at the time of kidney transplantation?
Authors: Warren Jeff , Jones Emily , Sener Alp , Drage Martin , Taqi Ali , Griffin Sian , Watson Christopher , Luke Patrick P. W.
Published: October 2016

Background: Delayed graft function (DGF) following transplantationnecessitates support in the form of hemodialyis (HD) orperitoneal dialysis (PD). However, post-transplant PD-related complicationand failure rates are unknown.Methods: We studies patients who were on PD at the time of kidneytransplantation over a 4-year period at two separate institutions.Results: Of the 137 PD patients, 19 had their catheters removedat the time of transplant. Of the remaining 118 patients, 89% hadimmediate graft function. PD-related complications in this groupincluded peritonitis (n=5), catheter-related infections (n=2) andemergency laparotomy (n=1). Of the 15 patients requiring posttransplantPD, 33% developed peritonitis and 20% had fluid-leaksnecessitating HD. Overall, leaving a PD catheter in situ post- transplantationis associated with 7% rate of peritonitis versus 0% ifremoved (p < 0.05).Conclusions: PD catheter removal should be considered at thetime of renal transplantation, as postoperative PD-related failure/complication rates are high.
How do you define success in stress urinary incontinence treatment?
Authors: Zimmern Philippe E.
Published: October 2016

At present, there is no consensus on the best way to define treatment success in the context of stress urinary incontinence (SUI). There is, however, a recognition that it is important to include patient-reported outcomes among the core assessments. Going forward, there is a need to unite outcome reporting tools to be able to compare data across studies and perform meaningful meta analyses.
Stress urinary incontinence: A case-based discussion
Authors: Carr Lesley , Corcos Jacques
Published: October 2016

At the conclusion of the sessions on stress urinary incontinence (SUI) in women, participants at the 2012 Canadian Urology Forum (academic and clinical urologists from across Canada) engaged in a discussion of optimal SUI evaluation and management. The discussion was led by Dr. Lesley Carr and co-facilitated by the other members of the Forum’s steering committee and was based on a patient case. This review provides a summary of the case and the discussion it generated.
Pre-treatment risk stratification of prostate cancer patients:A critical review
Authors: Rodrigues George , Warde Padraig , Pickles Tom , Crook Juanita , Brundage Michael , Souhami Luis , Lukka Himu
Published: October 2016

Introduction:  The use of accepted prostate cancer risk stratification groups based on prostate-specific antigen, T stage and Gleason score assists in therapeutic treatment decision-making, clinical trial design and outcome reporting. The utility of integrating novel prognostic factors into an updated risk stratification schema is an area of current debate. The purpose of this work is to critically review the available literature on novel pre-treatment prognostic factors and alternative prostate cancer risk stratification schema to assess the feasibility and need for changes to existing risk stratification systems. Methods:  A systematic literature search was conducted to identify original research publications and review articles on prognostic factors and risk stratification in prostate cancer. Search terms included risk stratification, risk assessment, prostate cancer or neoplasms, and prognostic factors. Abstracted information was assessed to draw conclusions regarding the potential utility of changes to existing risk stratification schema. Results:  The critical review identified three specific clinically relevant potential changes to the most commonly used three-group risk stratification system: (1) the creation of a very-low risk category; (2) the splitting of intermediate-risk into a low- and highintermediate risk groups; and (3) the clarification of the interface between intermediate- and high-risk disease. Novel pathological factors regarding high-grade cancer, subtypes of Gleason score 7 and percentage biopsy cores positive were also identified as potentially important risk-stratification factors. Conclusions:  Multiple studies of prognostic factors have been performed to create currently utilized prostate cancer risk stratification systems. We propose potential changes to existing systems.
Large minimally symptomatic iatrogenic urinoma presenting three years after abdominal aortic aneurysm repair
Authors: Spurrell Mark , Pike John , Duffy Gavin
Published: October 2016

We describe a case of a large, minimally symptomatic, urinoma presenting 3 years after emergent repair of a ruptured abdominal aortic aneurysm. We discuss the symptoms and signs, as well as the imaging, treatment and prevention options, for this rare complication. Because of the high mortality associated with delayed diagnosis of ureteral injury, a high index of suspicion should be maintained in patients who had surgery adjacent to the ureters.
Urothelial carcinoma involving the distal penis
Authors: Dason Shawn , Sheikh Adeel , Wang Jing Gennie , Tauqir Syeda , Davies Timothy O. , Shayegan Bobby
Published: October 2016

Urothelial carcinoma (UC) rarely metastasizes to the penis and skin. We report the case of a 73-year-old man with UC metastases to the corpus spongiosum and dermis of the distal penis. We also review the clinicopathologic characteristics and management options for UC metastasizing to the penis. The patient presented with priapism and edema of the genital region. This follows a 5-year history of urothelial carcinoma in situ that progressed to invasive cancer despite intravesical immunotherapy. Seventeen months prior to presentation, the patient underwent a radical cystectomy with adjuvant chemotherapy. The cystectomy specimen demonstrated a pT4a N2 M0 G3 UC and margins were positive for carcinoma in situ. Follow-up had been negative for recurrence until his presentation with priapism. Incisional biopsy of the glans revealed UC and radical penectomy was performed with negative margins. The penile specimen demonstrated extensive involvement of the corpus spongiosum by UC with lymphovascular invasion and subepidermal involvement. Three months after penectomy, the patient presented with inguinal nodal recurrence. Palliative radiotherapy was administered and the patient passed away eight months after surgery.
“Just what the doctor ordered”: Factors associated with oncology patients’ decision to bank sperm
Authors: Yee Samantha , Fuller-Thomson Esme , Dwyer Catherine , Greenblatt Ellen , Shapiro Heather
Published: October 2016

Introduction: The purpose of this cross-sectional study was toexplore factors associated with oncology patients’ decision to banksperm prior to cancer treatment.Materials andMethods: Patients who were referred to the oncologysperm banking program between January 2009 and March 2010 were invited to complete an 18-item questionnaire during one oftheir sperm banking visits.Results: Of the 157 cancer patients referred to the Mount Sinai Oncology Sperm and Tissue Bank for sperm banking during the15-month period, 79 questionnaires were returned (50% response rate). Of the respondents, 89% were informed about sperm bankingby their physician. Future family planning was cited as the mainreason to bank. Cost was not a barrier for the vast majority ofrespondents. Forty percent of respondents banked sperm within 4days prior to initiating cancer treatment. Most respondents reliedon their physician for verbal information on sperm banking. Eighty-one percent were unaware of any patient organizations that have educational materials on oncology fertility preservation.Conclusion: Sperm banking prior to cancer treatment is the only proven method of preserving fertility for cancer patients. The two main determinants associated with deciding whether to bank sperm were: the physician’s recommendation and the patient’s desirefor future fatherhood. Physicians play a key role in influencing patients’ decisions. The recommendation to bank sperm is a persuasive message if patients are clearly informed about their potential risk of infertility post-cancer treatment, and that sperm banking is an effective way of preserving fertility. Providing patients with education materials might enhance compliance in sperm banking.
Wunderlich syndrome as the first manifestation of an extraskeletal Ewing sarcoma
Authors: Kim Jong Wook , Chae Ji Yun , Yoon Cheol Yong , Oh Mi Mi , Park Hong Seok , Moon Du Geon
Published: October 2016

We recently encountered an extremely rare case of spontaneous perirenal hemorrhage in a 34-year-old man. He initially had undergone radical nephrectomy owing to suspicion of renal cell carcinoma. The final diagnosis was extraskeletal Ewing sarcoma.
Acute urinary retention due to cystic echinococcosis: A case report
Authors: Izol Volkan , Eken Alper , Aridogan Atilla , Koltas Soner , Tansug, Zuhtu
Published: October 2016

Urinary hydatidosis is very rare and represents 2% to 4% of all cases of cystic echinococcosis. We present a case of a 21-yearold man with symptoms of frequency, urinary retention and reduced force in urinary stream due to cystic echinococcosis. Anti- Echinococcus granulosus antibodies were determined by echinococcosis western blotting, and pelvic computed tomography revealed a 11 × 14 × 10-cm retrovesical homogeneous cystic mass. The patient underwent surgical intervention; the cystic mass and retrovesical cavity were removed. After a 3-year follow-up period, there was no episode of lower urinary tract symptoms. This case illustrates that cystic echinococcosis should be considered in every case of cystic mass, especially in endemic countries, such as Turkey
Essential role of using virtual pyeloscopy in the diagnosis of small satellite renal pelvic tumour in solitary kidney patient
Authors: Bata Pal , Tarnoki David Laszlo , Tarnoki Adam Domonkos , Domjan Zsolt , Buzogany Istvan , Berczi Viktor
Published: October 2016

Virtual pyeloscopy (VP) plays an important role in the organ-sparing nephroscopic tumour resection and traditional pole resection, especially when a fibreoptic ureteroscopic examination cannot be performed. A 67-year-old man developed macroscopic hematuria. Abdominal computed tomography (CT) and cystoscopy revealed a lower calix renal stone and a 20-mm lower pyelon mass suggesting transitional cell cancer. An additional small satellite lesion in the pelvico-ureteral junction was supposedly present. Three-phase MultiDetector CT with VP showed a solitary 3 to 4-mm renal pelvic lesion beyond the known calix stone and lower pole mass. In our case, VP played an important role in the organ-sparing nephroscopic tumour resection and traditional pole resection.
Mechanism of action of sacral nerve stimulation using a transdermal
Authors: Elkelini Mohamed S. Elkelini S , Pravidivyi Igor , Hassouna Magdy M.
Published: October 2016

Introduction: Sacral neuromodulation (SNM) is an effective treatmentmodality for several urological problems, including neurogenicbladder. However, the invasiveness of this technique makesit unsuitable for many patients. We present a novel transdermalamplitude-modulated signal (TAMS) that may provide a non-invasivealternative to implantable SNM to treat neurogenic detrusoroveractivity (NDO).Methods: In this study, we investigated the mechanism of action of non-invasive SNM using TAMS on our established spinal cordinjury (SCI) animal model. We demonstrated that spinally transectedrats develop urinary bladder hyper-reflexia after 3 weeks of SCI,indicated by the presence of uninhibited contractions, increasedresting pressure, increased threshold pressure and increased maximum voiding pressure.Results: Short-term neurostimulation affected urodynamics parameters by significantly reducing the threshold pressure (p = 0.02). Spinal transection also increased calcitonin gene-related protein(CGRP) concentration in the L6 dorsal root ganglia; whereas,neurostimulation significantly reduced CGRP concentration in L6(p = 0.03).Conclusion: TAMS caused a reduction in NDO by inhibitingC-fibre activity.
Laparoscopic partial nephrectomy: The McMaster University
Authors: Touma Naji J. , Matsumoto Edward D. , Kapoor Anil
Published: October 2016

Introduction: Laparoscopic partial nephrectomy (LPN) remains one of the more challenging procedures in urology. Minimizing warm ischemia time (WIT) and bleeding requires efficient intracorporeal suturing. In addition, achieving negative surgical margins requires complete excision of the tumour. We report a large Canadian series of laparoscopic partial nephrectomy with intermediate follow-up.Methods: Between September 2000 and August 2008, 152 consecutive laparoscopic partial nephrectomies were performed at our centre. Demographic, pathological and clinical data were collected through a retrospective review of the charts.Results: The average tumour size was 2.68 cm (Range: 0.5-8.8.The vast majority of tumours were malignant (80%). All marginswere negative, except for 2 patients who underwent an immediate re-resection. There were no local recurrences or distant metastasis during the follow-up period of 44.3 months. Most procedures required hilar clamping (93.4%) with a mean WIT of 34 minutes, with a clear trend for declining WIT with increasing experience. Live procedures were converted to laparoscopic radical nephrectomy, 10 converted to a hand-assisted procedure, and 1 was converted to an open partial nephrectomy. The average blood loss was 162 cc. Complications related to the procedure were classified according to the Clavien grading system. The average drop in the glomerular filtration rate was calculated by the Modification of Dietin Renal Disease (MDRD) Study equation between preoperativeand 2.5 months postoperative was 8.6 mL/min/1.73 m2.Conclusions: LPN is a challenging procedure that requires advanced laparoscopic skills. LPN is feasible with excellent oncological outcomes, and an acceptable complication profile. The short-term impact on overall renal function is minimal. The most common postoperative complication was pseudo-aneurysm requiring embolization, which reinforces the intra-operative need for meticulous and a quick suture-ligation of blood vessels during LPN.