bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is beta‐Human Chorionic Gonadotrophin Production by Transitional Cell Carcinoma of the Bladder a Marker of Aggressive Disease and Resistance to Radiotherapy?
Authors: MOUTZOURIS G. , YANNOPOULOS D. , BARBATIS C. , ZAHAROF A. , THEODOROU CH. 
Published: November 2008

Summary The biopsies from 75 patients with transitional cell carcinoma of the bladder (25 Ta‐T1; 45 T2‐T4, 5M) were studied immunohistochemically for the expression of beta‐human chorionic gonadotrophin (β‐HCG).Only 5 Ta‐T1 tumours contained a small number of β‐HCG positive cells but 24 invasive tumours and all patients with metastases showed increased numbers of positive cells.A significant correlation was found between β‐HCG immunoreactivity and tumour category.In 30 patients with muscle‐invasive disease (T2‐T4, N0, M0) who were treated with radical radiotherapy a significant correlation was observed between response to treatment and β‐HCG expression; β‐HCG positive tumours did not respond to treatment.A difference in survival was found between patients with tumours negative for β‐HCG compared with patients with positive tumours, all treated with radical radiotherapy. The results indicate that β‐HCG expression increases with tumour invasiveness and the use of immunohistochemistry may prove a useful means of identifying radioresistant and aggressive forms of bladder cancer.
Antitumour effect of a synthetic analogue of fumagillin on murine renal carcinoma
Authors: MORITA T. , SHINOHARA N. , TOKUE A. 
Published: November 2008

Objective To evaluate the antitumour effect of an angio‐inhibitory drug, a synthetic analogue of fumagillin (TNP‐470), on murine renal carcinoma (Renca) in vivo and in vitro.Materials and methods The effect of TNP‐470 on the growth of Renca cells in vitro was measured by angio‐genesis assay and cell counting with dye exclusion. In the angiogenesis assay, Renca cells were injected intra‐dermally and the number of blood vessels orientated towards the tumours was counted 3 days after tumour inoculation. To examine the effect of TNP‐470 on the subcutaneous tumour growth and lung metastasis of Renca, Renca cells were injected subcutaneously or intravenously in BALB/c mice and they were treated with a subcutaneous injection every 3 days.Results Dose‐dependent growth inhibition in vitro was observed with 50% inhibition occurring at 600 ng/ml. Angiogenesis assay revealed that administration of TNP‐470 inhibited the angiogenesis induced by Renca in a dose‐dependent manner. In the subcutaneous experiment, TNP‐470 decreased the growth rate of established subcutaneous tumours rather than reduced the size of the tumour. The administration of TNP‐470 in mice with lung metastasis inhibited the development of metastasis of Renca without weight loss or diarrhoea.Conclusion The present study demonstrated that TNP‐470 had an inhibitory effect on tumour‐induced angiogenesis and a significant anti‐tumour effect on Renca. This suggests that TNP‐470 could be useful in the treatment of renal cell carcinoma. Further studies are needed to clarify whether TNP‐470 is more effective when combined with other drugs such as interferons.
Beta haemolytic group A streptococci causing urinary tract infection
Authors: PALOCAREN T. , MATHAI E. , BRAHMADATHAN K.N. , JOHN T.J. , BALASUBRAMANIAM N. , NATH V. 
Published: November 2008

Objective To describe the clinical and laboratory findings in patients with Group A streptococci (GAS) bacteriuria.Patients Patients with GAS bacteriuria seen in a tertiary care hospital in southern India between 1988 and 1993 were identified. Data were collected from the hospital records.Result GAS were isolated from 15 women and 11 men. Clinical data were available for 24 of these. The condition presented as asymptomatic bacteriuria (nine patients), dysuria or frequency (12), and fever without localizing signs (three). All infections occurred in individuals with systemic or local conditions predisposing to urinary tract infection. All patients responded well to antimicrobial therapy.Conclusion GAS bacteriuria is rare and occurs only in individuals with other predisposing conditions. Patients with this infection respond well to therapy.
Evaluation of augmentation cystoplasty in childhood with reference to vesico‐ureteric reflux and urinary infection
Authors: KRISHNA A. , GOUGH D.C.S. 
Published: November 2008

Objectives To assess the non‐operative treatment of vesico‐ureteric reflux in patients with abnormal bladder compliance, to determine whether reduction in storage pressure by augmentation leads to cessation of reflux and whether symptomatic urinary tract infection worsens or renal function deteriorates if reflux continues after augmentation and clean intermittent catheterization (CIC).Patients and methods Thirty‐nine children (17 boys, 22 girls) who underwent clam ileocystoplasty over a 5‐year‐period were evaluated. The mean age at operation was 9.7 years (range 1.5–17.5). Pre‐operative assessment included renal imaging and slow fill video‐cystometry. Vesico‐ureteric reflux, if present, was graded I‐V. The frequency and severity of symptomatic urinary tract infections were recorded. Cystometry was performed 6 months after reconstruction. Storage pressures below 20 cm saline were regarded as safe. The mean follow‐up was 3.3 years (range 10 months‐6.1 years).Results Of the 17 renal units assessed for the outcome of reflux, 11 stopped reflux and one showed a lower grade. No patient showed worsening of upper tract dilatation or progressive renal scarring. Thirty‐seven patients (95%) had symptomatic urinary tract infection pre‐operatively. Following bladder augmentation, clean intermittent catheterization and trimethoprim prophylaxis, seven continued to have symptomatic infection.Conclusions Augmentation cystoplasty is effective in resolving reflux in a majority of the patients. This is achieved by reducing storage pressures to below 20 cm saline and emptying the bladder regularly by CIC. There is also a reduction in the incidence and severity of symptomatic urinary tract infections. Even when reflux persists there is no evidence of deterioration of the upper tracts or progressive renal scarring.
Urodynamic and clinical follow‐up of 28 children after gastrocystoplasty
Authors: BOGAERT G.A. , MEVORACH R.A. , KOGAN B.A. 
Published: November 2008

Objectives To determine the efficacy of gastrocystoplasty in creating a large and compliant urinary reservoir.Patients and methods Twenty‐eight children (14 boys, 14 girls), with a median age of 9 years (range 4–17), were evaluated before and for a median of 2 years and 5 months after gastrocystoplasty. Evaluation included urodynamic and renal function studies and a survey of their post‐operative complications and their sense of well‐being. Renal function was assessed by ultrasound and serum creatinine, and electrolytes were measured.Results After gastrocystoplasty bladder size increased, compliance improved, hydronephrosis decreased or was stable, and renal function remained stable. There were minimal complications and the children's subjective impression of their well‐being was markedly improved.Conclusion Gastrocystoplasty, using our surgical technique, is a reliable method of creating a large and compliant urinary reservoir. Advantages include the absence of clinical urinary tract infections, the absence of mucus and the preservation of renal function. Complications, such as haematuria, dysuria and hypochloraemic alkalosis, might be avoided by excluding the antrum from the gastrocystoplasty, maintaining the child on a normal salt‐containing diet, employing catheterization or buffering the urine in children with normal urethral sensation.
Written consent about sexual function in men undergoing transurethral prostatectomy
Authors: THORPE A.C. , CLEARY R. , COLES J. , REYNOLDS J. , VERNON S. , NEAL D.E. 
Published: November 2008

Objective To review the written recording of consent about possible sexual dysfunction after transurethral resection of the prostate (TURP), and the incidence of sexual dysfunction in sexually active men after TURP. from a large scale audit of transurethral prostatectomy held in 12 hospital sites in the Northern Region.Patients and methods Over an 8‐month period data were collected from 12 separate hospital sites within the Northern Region by two independent nurse co‐ordinators who travelled to each of the sites. Information was gathered from medical records, operation lists and theatre books using a standard pro‐forma. The Nottingham Health Profile (NHP) was used as a quality of life instrument in a subgroup of patients who were asked about sexual function before and after operation.Results Advice about retrograde ejaculation was recorded infrequently, with only 30% of case notes including a statement about this (inter‐site variations 0–78%). The mean age of patients in whom a written record was made was lower (70 [0.44 SEM] years) than those in whom there was no recording (72 [0.25] years; P<0.001), but marital status did not appear to be a significant factor. No significant differences in NHP were found comparing men who did or who did not have written evidence about consent regarding retrograde ejaculation. In addition, in a subset of men who had been asked pre‐operatively about sexual function, no significant differences were found in overall NHP measurements in those who did or who did not develop retrograde ejaculation. In men who were sexually active before operation, the incidence of major sexual problems, impotence and retrograde ejaculation were 12%, 11% and 24% respectively.Conclusion The incidence of sexual dysfunction following TURP in this audit concurred with previously reported studies (4–40%), but despite this most urologists in our audit were not recording that they had advised their patients about this possible outcome.
Preliminary report – combined surgical and radiological penile vein occlusion for the management of impotence caused by venous‐sinusoidal incompetence
Authors: FOWLIS G.A. , SIDHU P.S. , JAGER H.R. , AGARWAL S. , JACKSON J.E. , ZAFAR F. , WILLIAMS G. 
Published: November 2008

Objectives To combine surgical and radiological penile vein occlusion therapy in the treatment of patients with venogenic impotence, to try to improve on the results of either treatment used separately.Patients and methods Fourteen patients, with a mean age of 46 years (range 25–71), with pure venous‐sinusoidal impotence were treated by surgical ligation of accessible veins and embolization of surgically inaccessible veins. The preliminary results over a follow‐up period of at least 8 months are reported for each patient.Results Venous embolization was considered complete in 11 patients. Overall, 13 had improved erectile function. Post‐operatively, eight patients developed spontaneous erections and four (aged <40 years) have maintained this for 8–24 months.Conclusion Combined surgery and radiology treats the end result of the failure of the sinusoidal smooth muscle to relax. Although some patients, the majority of whom are young (aged <40 years), will achieve short‐term benefit, all individuals need to be fully counselled with regard to the likelihood of long‐term benefit before undergoing this invasive method of treatment.
Biochemical analysis of tunica vaginalis fluid in patients with or without idiopathic hydroceles
Authors: MADLALA T.S.L. , RENCKEN R.K. , BORNMAN M.S. , REIF S. , JOUBERT H.F. , VAN DER MERWE C.A. 
Published: November 2008

Objective To establish the differences, if any, between the biochemical composition of idiopathic hydrocele fluid and the fluid normally present in the tunica vaginalis.Patients and methods Aspiration and sclerotherapy of 37 idiopathic hydroceles from patients who presented to this urology clinic were performed. The biochemical content of the fluid was compared with that of the tunica vaginalis fluid from a small group of controls (n = 8), taken from patients undergoing orchidectomy for carcinoma of the prostate.Results Differences in several measurements were recorded; in particular, there were significantly higher concentrations of calcium, albumin, total protein and creatine‐kinase in the hydrocele group. The levels of potassium, aspartate transaminase, alanine transaminase and alkaline phosphatase were significantly lower in the hydrocele group.Conclusion Whether these differences have a role in the causation of an idiopathic hydrocele is, at this stage, speculative. A similar study on a larger scale would probably be more conclusive.
Detection of microscopic extracapsular extension prior to radical prostatectomy for clinically localized prostate cancer
Authors: OHORI M. , EGAWA S. , SHINOHARA K. , WHEELER T.M. , SCARDINO P.T. 
Published: November 2008

Objective To assess better techniques of clinical staging to identify the presence and location of extracapsular extension (ECE) and assist the surgeon in the selection of candidates for resection or preservation of neurovascular bundles during radical prostatectomy.Patients and methods In a retrospective review of the records of 117 patients with clinically localized (31 T1 and 86 T2) prostate cancer treated with radical prostatectomy the results of digital rectal examination (DRE). real‐time transrectal ultrasound (TRUS) and a retrospective review of static films were compared to assess their accuracy in the detection of ECE. The ultrasonic criterion for ECE was bulging or irregularity of the boundary echo adjacent to a hypoechoic lesion. On DRE, the criterion for ECE was palpable bulging of a nodule beyond the normal contour of the prostate. The reference standard was the presence and location of ECE in the whole‐mount, serially sectioned radical prostatectomy specimens.Results Microscopic ECE was present in 64 of the specimens (55%). There was no significant difference between DRE, prospective TRUS and retrospective TRUS in the overall accuracy of detection of ECE. However, when the results of DRE and TRUS were combined (if either was positive the result was considered positive), the positive predictive value (PPV) was 79% and the sensitivity (91%), with the overall accuracy increased significantly (P<0.05).Conclusion The presence and precise location of microscopic ECE can be determined pre‐operatively with reasonable accuracy using real‐time ultrasound combined with the results of DRE.
Ultrasound in the evaluation of urethral stricture disease: a prospective study in 175 patients
Authors: HEIDENREICH A. , DERSCHUM W. , BONFIG R. , WILBERT D.M. 
Published: November 2008

Objective To investigate the characteristic ultrasonic appearance of urethral stricture disease in men.Patients and methods Between 1990 and 1992 a prospective study in 175 men with the suspicion of urethral stricture was performed using urethral ultrasound as the first diagnostic procedure, followed by retrograde urethrography, voiding cystourethrography or urethroscopy.Results The sensitivity and specificity in detecting urethral strictures were 98% and 96% respectively. UItrasound offers a three‐dimensional study in the evaluation of the urethra without exposing the gonads to ionizing radiation. The exact length and depth of the stricture, the severity of the strictured segment as well as the anatomy of the periurethral scars were diagnosed accurately.Conclusion Ultrasound is a simple, inexpensive and rapid investigation of the urethra which requires no exposure of the patient to ionizing radiation and should be the preferred diagnostic procedure in the evaluation of strictures in the anterior urethra in men.
Laparoscopic ureterolithotomy: the results of an initial series, and an evaluation of its role in the management of ureteric calculi*
Authors: HAREWOOD L.M. , WEBB D.R. , POPE A.J. 
Published: November 2008

Objective To evaluate the place of laparoscopic ureterolithotomy in the management of ureteric calculi for which extracorporeal shockwave lithotripsy (ESWL) and endourological techniques are unsuitable.Patients and methods Laparoscopic ureterolithotomy was attempted in nine patients (eight men, one woman) with an age range of 26–81 years (mean 55.5) who had large, long standing and impacted calculi in the upper and mid ureter. The stone size ranged from 5 to 28mm (mean 13.2) and stone duration ranged from one to 24 months (mean 8.2). The transperitoneal route was used in six patients and the extraperitoneal route in three but was converted to a transperitoneal approach in two.Results The stone was successfully removed in all nine patients. The operative time ranged from 80 to 260 minutes (mean 158). No intra‐operative complication was encountered and no patient required a blood transfusion. Post‐operative complications included urinary leak and fever. The post‐operative stay ranged from 2 to 13 days (mean 5.2).Conclusions Laparoscopic ureterolithotomy has definite advantages over open ureterolithotomy. Furthermore, the more difficult a stone is for treatment by ESWL and endourological techniques, the more suitable it is for laparoscopic removal. For large, hard, longstanding and impacted ureteric calculi, one laparoscopic ureterolithotomy as initial therapy may be preferable to multiple endourological and ESWL procedures.
Bacteriuria in patients with a continent ileal reservoir for urinary diversion does not regularly require antibiotic treatment
Authors: ÅKERLUND S. , CAMPANELLO M. , KAIJSER B. , JONSSON O. 
Published: November 2008

Objective To eluciadate the importance of bacteriuria in patients with a continent urinary diversion.Patients and methods Eighteen asymptomatic patients (16 women and two men, with a meanage of 53 years [range 22–73]) with ileal reservoirs coupled to the skin for urinary diversion were studied. Consecutive urine cultures were performed over 5 months. Concomitant measurements of antibody titres against Escherichia coli and Proteus, and C‐reactive protein (CRP) values were made.Results The results ofthe urine cultures varied considerably between samples. Increased titres of antibodies against E. coil were seen in several patients but the weak (sensitivity 33% specificity 56%). Increased titres of antibodies against Proteus were rarely seen and in no patient correlated with bacteriuria caused by Proteus. Increased levels of CRP were seen in three patients.Conclusions The present results indicate that asymptomatic bacteriuria in patients with a continent ileal reservoir for urinary diversion is generally of no antibiotics. This conclusion is based on the observations that the bacterial strains growing in the reservoir changed spontaneously indicating colonization rather than infection. Raised titres of antibodies against E. coli correlated weakly with bacterial growth. The observed elevations in antibody titres were usually just above the normal upperlimit.
Similarity of the American Urological Association Symptom Index among men with benign prostate hyperplasia (BPH), urethral obstruction not due to BPH and detrusor hyperreflexia without outlet obstruction
Authors: CHANCELLOR M. B. , RIVAS D. A. , KEELEY F. X. , LOTFI M. A. , GOMELLA L. G. 
Published: November 2008

Objective To compare the specificity of the American Urological Association (AUA) Symptom Index for benign prostatic hyperplasia (BPH) versus other urodynamically verified micturitional dysfunction in men.Patients and methods Fifty‐seven consecutive men who had been referred for video‐urodynamic evaluation of voiding symptoms were evaluated. The patients were divided into three groups: (i) BPH group (n = 24): (ii) non‐BPH obstructed group (n = 20; nine bladder neck obstruction, 11 bulbous urethral stricture); and (iii) detrusor hyper‐reflexia group: detrusor hyperreflexia without outlet obstruction (n = 13).Results The mean AUA symptom score for the BPH group was 18.9 (range 7–28). The mean score for the 20 non‐BPH obstructed group was 17.6 (range 4–28) and the mean score for the 13 men with detrusor hyper‐reflexia was 20.5 (range 12–27). There was no statistical difference in the AUA symptom score among the three groups.Conclusion The AUA Symptom Index does not specifically identify BPH or bladder outlet obstruction. The index cannot differentiate the site of obstruction as noted by the similar scores among men with BPH from those with bladder neck obstruction and urethral strictures. Moreover, The AUA Symptom Index scores are similar between men with voiding symptoms secondary to bladder dysfunction and bladder outlet obstruction.
Prognostic value of c‐erbB‐2 and epidermal growth factor receptor in stage A1 (Tla) prostatic adenocarcinoma
Authors: FOX S.B. , PERSAD R.A. , COLEMAN N. , DAY C.A. , SILCOCKS P.B. , COLLINsT C.C. 
Published: November 2008

Objective To determine whether the presence or absence of the oncoproteins epidermal growth factor receptor (EGFR) and c‐erbB‐2 could predict tumour behaviour.Patients and methods Tissue from 45 stage A1 (Tla) prostatic adenocarcinomas from patients with a mean age of 65 years were immunostained for EGFR (12E) and c‐erbB‐2 (NCL‐CB11). Their expression in the tumour and surrounding benign hyperplastic epithelium was correlated with each other and with survival.Results Forty per cent (18 of 45) and 36% (16 of 45) of patients respectively were EGFR and c‐erbB‐2 positive in the tumour. Expression of these tyrosine kinase oncogenes was not confined to the tumour and the surrounding hyperplastic prostate was also positive for EGFR in 76% (34145) of patients and for c‐erbB‐2 in 16% (11 of 45). EGFR and c‐erbB‐2 expression was weakly associated in both benign and malignant epithelium. Statistical analysis of survival showed that tumour c‐erbB‐2 expression was associated with significantly worse prognosis (exact two tailed P= 0.03 16), whereas no significant association was observed between EGFR expression and survival (P = 0.7 3 7).Conclusion As c‐erbB‐2 expression increases the rate of dying by 4.2 times, recording its expression by thcse tumours may be useful in selecting patients who would benefit from treatment in stage A1 (Tla) disease.
The long‐term outcome of patients who relapse after chemotherapy for non‐seminomatous germ cell tumours
Authors: LEDERMANN J.A. , HOLDEN L. , NEWLANDS E.S. , BEGENT R.H.J. , RUSTIN G.J.S. , BAGSHAWE K.D. , BRAMPTON M. 
Published: November 2008

Objective To examine the long‐term survival of a group of patients with non‐seminomatous germ cell tumours, who relapse after chemotherapy and are retreated with a cisplatin and etoposide‐based regimen.Patients and methods At the Charing Cross Hospital between 1979 and 1988 38 patients in relapse were seen. The median interval after primary therapy was 8 months. They were treated with an intensive cisplatin and etoposide‐based regimen with cycles repeated at 7–10 day intervals, and with surgery in 22 patients.Results Forty‐seven per cent of patients entered a second complete remission and 88% of these remain disease free. The overall survival was 46% with a median follow‐up of more than 4.3 years. Surgery was performed in 14 of 18 patients who entered a second complete remission. Adverse risk factors before initial chemotherapy and the time to relapse did not predict outcome but patients with unresectable radiological masses after relapse therapy had a poor outcome despite normalization of serum tumour markers. The tumours of 68% of patients initially treated with cisplatin‐based regimens and 62% of patients who also received etoposide remained responsive to conventional doses of these drugs at relapse.Conclusions This study demonstrates that there is a group of patients with relapsed teratoma who can be cured without the need for very high dose chemotherapy and autologous bone marrow rescue.