bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of letrozole on urinary bladder function in the female rabbit
Authors: Lin Wei‐Yu , Rehfuss Alexandra , Whitbeck Catherine , Juan Yung‐Shun , Chichester Paul , Mannikarottu Anita , Levin Robert M. 
Published: September 2007

OBJECTIVETo investigate the effect of letrozole (a potent aromatase inhibitor that effectively inhibit the synthesis of oestrogen) on bladder contraction with changes in morphology and biochemistry.MATERIALS AND METHODSSixteen female New Zealand white rabbits were separated into four equal groups; groups 1–3 were given oral letrozole for 1, 2 and 3 weeks, and group 4 was given saline and served as the control group. At the end of the medication period each rabbit was anaesthetized and the bladder muscle strips were used for contractile, histological and biochemical studies.RESULTSThe concentration of serum oestrogen was significantly lower and testosterone was significantly higher in letrozole‐treated rabbits than in the control group. The rabbits treated for 1 week with letrozole showed significant decreases in the contractile responses to electrical field stimulation, ATP and carbachol, but not to KCl. Contractility returned to normal in the rabbits treated for 2 and 3 weeks. Letrozole resulted in an increased volume percentage of collagens and decreased bladder compliance. The volume percentage of the smooth muscle component also changed, with a significant decrease at 1 week and then a gradual increase at 2 and 3 weeks. Contractile dysfunction was absent at 2 and 3 weeks, which was consistent with no change in sarcoplasmic reticulum Ca2+‐ATPase content or mitochondrial function.CONCLUSIONSThe bladder contractility decline in the first week and was restored at 2 and 3 weeks. The present study unexpectedly showed the possibility that testosterone might be as important as oestrogen in the contractile function of the female bladder.
A validated mouse model for orthotopic bladder cancer using transurethral tumour inoculation and bioluminescence imaging
Authors: Hadaschik Boris A. , Black Peter C. , Sea Jason C. , Metwalli Adam R. , Fazli Ladan , Dinney Colin P. , Gleave Martin E. , So Alan I. 
Published: September 2007

OBJECTIVESTo describe a technique for transurethral tumour inoculation, bioluminescence imaging (BLI) and validation of this approach using ex vivo magnetic resonance imaging (MRI), as a reproducible and quantifiable model of orthotopic bladder cancer is required to enable preclinical pharmacological studies of intravesically administered anticancer agents and the use of BLI provides a sensitive method to monitor tumour growth over time.MATERIALS AND METHODSHuman KU‐7 bladder tumour cells were transduced with a lentiviral construct to stably express the firefly luciferase gene. These cells were then inoculated in female nude mice by intravesical instillation. BLI was performed weekly and the mice were killed after 4 weeks. Ex vivo MRI and whole‐mount step‐sections were obtained to assess bladder tumour volume.RESULTSKU‐7 tumour cells were highly tumorigenic and were successfully inoculated in 96% of mice. After 4 weeks, all tumours were confined to the mucosa and submucosa (≤pT1). There was an excellent correlation between tumour volume and BLI for both ex vivo bladder MRI (R2 = 0.929) and end‐point histological measurements (R2 = 0.836).CONCLUSIONSWe have established and validated a reliable model of orthotopic bladder cancer that can be used to evaluate various methods of intravesical therapy. BLI allows excellent longitudinal surveillance and quantification of tumour burden.
A 10‐year retrospective audit of penile cancer management in the UK
Authors: Mistry Tina , Jones Rob W.A. , Dannatt Erica , Prasad Krishna K. , Stockdale Andrew D. 
Published: September 2007

OBJECTIVETo audit the penile cancer workload, management and outcome within a regional cancer network serving a population of ≈ 1 million in the West Midlands (UK), comparing these data to that published by the British Association of Urological Surgeons National Cancer Registry, the UK National Institute of Clinical Excellence and the European Associations of Urology guidelines.PATIENTS AND METHODSPatients diagnosed with or treated for penile cancer within the Arden Cancer Network over a 10‐year period were identified retrospectively, and data relating to histology, local treatment, lymph node management, outcome and survival were recorded.RESULTSData were obtained for 65 patients; 61 (94%) had histologically confirmed squamous cell carcinoma (SCC) of the penis, equating to ≈ 0.6 cases per 100 000 population per year. Their mean age at diagnosis was 63 years. Of SCCs, 86% were located on the glans and/or foreskin. Thirty‐six patients had conservative primary local therapy, mostly for T0 or T1 disease. The 5‐year relapse‐free survival after radiotherapy was 63%, although survival after salvage penectomy was 75% at 4 years. Forty‐seven patients had lymph node surveillance; 11 developed lymph node disease and had lymph node dissection (LND) with or with no radiotherapy, but survival was poor. Primary inguinal LND with or without radiotherapy was used in eight patients, and was associated with a good survival, although three were found to have negative histology after LND. Survival was strongly influenced by T and N stage at presentation and the 5‐year survival for the whole group was 71%.CONCLUSIONThe workload, incidence and overall mortality from penile cancer within the Arden Cancer Network are in line with those in the rest of the UK. Rates of conservative therapy were good in this group and associated with good survival. Survival could be improved by identifying and aggressively treating those patients at high risk of lymph node disease.
The outcome with ureteric stents for managing non‐urological malignant ureteric obstruction
Authors: Jeong In Gab , Han Kyung Seok , Joung Jae Young , Seo Ho Kyung , Chung Jinsoo 
Published: September 2007

OBJECTIVETo investigate the clinical outcome using ureteric stents to manage ureteric obstruction in advanced non‐urological malignancies.PATIENTS AND METHODSWe retrospectively reviewed the use of ureteric stents (Endo‐sof, Cook Urological, Spencer, IN, USA) placed for malignant ureteric obstruction from June 2001 to September 2006. The clinical and radiological variables for predicting the failure of stent insertion, functional stent failure and death were analysed.RESULTSIn all, 86 patients with a non‐urological malignant ureteric obstruction were treated by ureteric stenting; 13 (15%) had failure of retrograde stent insertion, and of the remaining 73, 12 (16%) had stent failures during the subsequent follow‐up. The risk of failure for stent insertion significantly increased with male gender (hazard ratio 6.45, P = 0.028) and the presence of bladder invasion (hazard ratio 27.04, P < 0.001). There was no independent predictor of stent failure in univariate analysis. Of the 86 patients, 54 (63%) died with a mean survival time of 8.6 months after an initial attempt to place a stent, and 41 (48%) died within 1 year. Multivariate analysis showed that low performance status, upper ureteric obstruction and no chemotherapy after stenting were independently associated with a poor prognosis (P = 0.03, 0.004 and 0.003, respectively).CONCLUSIONThe method of diversion for a malignant ureteric obstruction should be carefully discussed with male patients or if there is bladder invasion. Patients with a low performance status, upper ureteric obstruction and no scheduled chemotherapy after stenting had a poor survival time.
Lack of prognostic significance of prostate biopsies in metastatic androgen independent prostate cancer
Authors: Aragon‐Ching Jeanny B. , Gillespie John , Price Douglas K. , Chuaqui Rodrigo , Rodriguez‐Canales Jaime , Steinberg Seth M. , Dahut William L. , Figg William D. 
Published: September 2007

OBJECTIVETo assess the significance of viable tumour in the prostate of patients with metastatic androgen‐independent prostate cancer (AIPC).PATIENTS AND METHODSWe evaluated the clinicopathological features, including follow‐up, of 40 men with metastatic AIPC who had a transrectal biopsy of the prostate.RESULTSProstate biopsies (median three cores per biopsy) showed viable tumour in 19 of 40 patients (48%). Of the 18 patients who had received radiotherapy (RT), nine had negative on‐study biopsy results. A previous history of RT was not associated with overall survival in patients with biopsy‐positive tumours (P = 0.84). Also, there was no statistically significant association between positive or negative biopsy status and overall survival (OS) in these 40 patients (P = 0.39), with a similar median OS of 19.6 months for biopsy‐negative and 19.8 months for biopsy‐positive patients, respectively.CONCLUSIONSTaking prostate biopsies at the time of documented metastatic AIPC yielded tumour in about half the patients. A previous history of RT was not associated with a negative prostate biopsy; the latter appears to have no influence on the prognosis.
The influence of prostate volume on prostate cancer detection using a combined approach of contrast‐enhanced ultrasonography‐targeted and systematic grey‐scale biopsy
Authors: Colleselli Daniela , Bektic Jasmin , Schaefer Georg , Frauscher Ferdinand , Mitterberger Michael , Brunner Andrea , Schwentner Christian , Bartsch Georg , Horninger Wolfgang , Pelzer Alexandre E. 
Published: September 2007

OBJECTIVETo evaluate the influence of prostate volume (PV) on the detection of prostate cancer using a combined approach of contrast‐enhanced ultrasonography (CEUS) and grey‐scale US‐guided systematic biopsy (SB).PATIENTS AND METHODSWe evaluated 345 patients with prostate cancer and a total prostate‐specific antigen (PSA) level of ≥ 1.32 ng/mL (1.32–35.3, mean 6.6). Biopsies were taken by two independent examiners; one took five CEUS (Doppler) targeted biopsies of hypervascular regions in the peripheral zone, and subsequently the other took 10 systematic prostate biopsies. We assessed the cancer detection rates for the five different subgroups of prostate volumes, i.e. <20, 20–30, 30–40, 40–50 and > 50 mL.RESULTSEach technique, SB and CEUS, detected 73.4% and 77.1% of all detected cancers, respectively, but there were statistically significant differences in detection rate only in small glands. Only 69.0% and 70.4% of all cancers were detected by SB in glands of <20 and 20–30 mL, respectively, whereas 88.1% and 80.8% were detected by CEUS.CONCLUSIONThe prostate cancer detection rate for CEUS was significantly higher in prostates of <30 mL (48.1% of the study population) than for SB. Therefore the combined approach of CEUS and SB allows improved cancer detection in patients with small glands and low total PSA values.
Prostate‐specific antigen velocity in untreated, localized prostate cancer
Authors: Venkitaraman Ramachandran , Norman Andrew , Woode‐Amissah Ruth , Dearnaley David , Horwich Alan , Huddart Robert , Parker Chris 
Published: September 2007

OBJECTIVETo report the results of a prospective study of active surveillance of untreated prostate cancer, with a focus on baseline predictors of prostate‐specific antigen (PSA) velocity, as PSA velocity before treatment is an important predictor of prostate cancer mortality, and patients on active surveillance are monitored for several years to estimate the PSA velocity and thus select patients for radical treatment.PATIENTS AND METHODSA prospective study of active surveillance for localized prostate cancer opened at the Royal Marsden Hospital in 2002. Eligible patients had clinical stage T1/T2a, N0/Nx, M0/Mx adenocarcinoma of the prostate with a serum PSA level of <15 ng/mL, a Gleason score of ≤7 with primary grade ≤3, and less than half the biopsy cores positive. The PSA velocity before treatment was analysed in relation to baseline clinical characteristics.RESULTSIn all, 237 patients on surveillance were followed for a median of 24 months (median age 67 years; median initial PSA level 6.5 ng/mL; median pretreatment PSA velocity 0.44 ng/mL per year). On multivariate analysis, PSA density (i.e. serum PSA level/prostate volume) was the only significant determinant of PSA velocity (P < 0.001). Patients with a PSA density above or below the median (0.185 ng/mL/mL) had a median (interquartile range) PSA velocity of 0.92 (0.34–1.77) ng/mL per year and 0.35 (− 0.06, 0.80) ng/mL per year, respectively.CONCLUSIONSPSA density, which is readily available at the time of diagnosis, is an independent determinant of PSA velocity in untreated, localized prostate cancer. If this is confirmed, PSA density could be used to inform the often difficult choice between active surveillance and immediate radical treatment.
Intermediate‐term prospective results of radiofrequency‐assisted laparoscopic partial nephrectomy: a non‐ischaemic coagulative technique
Authors: Zeltser Ilia S. , Moonat Saurabh , Park Sangtae , Anderson J. Kyle , Cadeddu Jeffrey A. 
Published: September 2007

OBJECTIVETo report the first intermediate‐term oncological outcomes of laparoscopic radiofrequency coagulation followed by laparoscopic partial nephrectomy (RF‐LPN) to treat small renal masses, as LPN is limited by the technical difficulty of efficient tumour resection and parenchymal repair during warm ischaemia of the kidney.PATIENTS AND METHODSA prospective database was searched to identify patients treated with RF‐LPN; in each case the tumour was first RF coagulated with a margin of normal parenchyma, and then excised. Only fibrin glue was applied to the haemostatic resection site to prevent urinary leaks. In all, 32 tumours were treated with this approach, and a radiographic follow‐up was completed yearly.RESULTSAll PNs were accomplished with no hilar clamping, with a mean blood loss of 80 mL; 72% of masses were renal cell carcinoma. There was a positive margin in four masses (13%); 29 tumours (mean size 1.9 cm) were eligible for analysis of oncological outcomes, with a mean follow‐up of 31 months. There were no tumour recurrences at the last follow‐up, giving a cancer‐specific survival rate of 100%.CONCLUSIONSRF‐LPN with no hilar clamping simplifies the surgical technique and appears to have excellent cancer control in the intermediate term. In the few patients with a positive surgical margin, it is possible that coagulation beyond the tumour margin kills any residual microscopic tumour, minimizing or obviating the risk of tumour recurrence. Nevertheless, vigilance during tumour excision and margin identification is mandatory.
Anandamide improves the impaired nitric oxide‐mediated neurogenic relaxation of the corpus cavernosum in diabetic rats: involvement of cannabinoid CB1 and vanilloid VR1 receptors
Authors: Ghasemi Mehdi , Sadeghipour Hamed , Dehpour Ahmad R. 
Published: September 2007

OBJECTIVETo investigate the ability of acute administration of the endogenous cannabinoid, anandamide, in vitro to alter the nonadrenegic noncholinergic (NANC)‐mediated relaxation of corpus cavernosum (CC) in diabetic rats and the possible role of nitric oxide (NO), as it is well known that erectile dysfunction (ED) affects 35–75% of men with diabetes mellitus and several studies have been conducted to find appropriate strategies for treating diabetes‐induced ED.MATERIALS AND METHODSDiabetes was induced in rats by streptozotocin administration and was maintained for 8 weeks. The CC were removed and isolated in organ baths for pharmacological studies. Agonist‐evoked or electrical‐field stimulation (EFS)‐evoked smooth muscle tensions in CC strips from control and diabetic rats were measured.RESULTSThe neurogenic relaxation of phenylephrine (7.5 µm)‐precontracted isolated CC strips was impaired in diabetic rats. Anandamide (0.3, 1 and 3 µm) enhanced the relaxant responses to EFS in diabetic CC strips in a dose‐dependent manner. This effect was antagonized by the selective cannabinoid CB1 receptor antagonist AM251 (1 µm) and the selective vanilloid receptor antagonist capsazepine (3 µm). Concurrent administration of partially effective doses of l‐arginine (10 µm) and anandamide (0.3 µm) exerted a synergistic improvement in EFS‐induced relaxation of diabetic CC strips (P < 0.001). The relaxant responses to the NO donor, sodium nitroprusside, were similar between diabetic and control groups.CONCLUSIONFor the first time, we show that acute administration of anandamide, an endogenous cannabinoid, alone or combined with l‐arginine can improve nitrergic nerve‐mediated relaxation of the CC in diabetic rats. This effect was mediated by cannabinoid CB1 and vanilloid VR1 receptors within the CC.
Surveillance of patients with bladder carcinoma using fluorescent in‐situ hybridization on bladder washings
Authors: Bergman Jonathan , Reznichek Richard C. , Rajfer Jacob 
Published: September 2007

OBJECTIVESTo compare the sensitivity and specificity of the UroVysionTM (Abbott Laboratories Inc., Downers Grove, IL, USA) fluorescent in‐situ hybridization (FISH) assay to that of urinary cytology obtained from bladder irrigation during cystoscopic surveillance in patients with bladder carcinoma.PATIENTS AND METHODSThe medical records were retrospectively reviewed for 41 consecutive patients screened at the authors’ institution between August 2000 and December 2006 for recurrence of pathologically confirmed bladder cancer. All 162 cytology examinations and 141 FISH assay results obtained from bladder washing were included. Recurrence was determined by cystoscopy, bladder biopsy and upper‐tract imaging. Sensitivity, specificity, positive predictive and negative predictive values were assessed using a chi‐square distribution with one degree of freedom.RESULTSThere were 24 men and 17 women (male to female ratio 0.59), the mean (range) age was 56 (33–73) years and the mean follow‐up 30 (2–57) months. At the initial diagnosis, 35 of the 41 patients (85%) had superficial tumours (stage ≤ T1), while six (15%) had muscle‐invasive tumours (stage ≥T2). Twenty‐six (63%) had low‐grade and 15 (37%) had high‐grade tumours. In 16 of 141 (11%) of the FISH assays and 16 of 162 (10%) of the cytological samples that were collected from bladder irrigations, there were too few cells for an adequate analysis. The FISH assay correctly correlated with subsequent cystoscopy, bladder biopsy or upper‐tract imaging in 110/125 (88%) cases but not in 15/125 (12%). Cytology correctly correlated with the subsequent evaluation in 112/146 (77%) cases but did not in 34/146 (23%). When the FISH was compared with cytology in this setting, the sensitivity was 77% (30/39) vs 74% (37/50; P > 0.1), the specificity was 93% (80/86) vs 78% (75/96; P < 0.01), the positive predictive value was 83% (30/36) vs 64% (37/58; P < 0.05), and the negative predictive value was 90% (80/89) vs 85% (75/88; P > 0.1), respectively.CONCLUSIONThe UroVysion FISH assay obtained from bladder washings during cystoscopic surveillance of patients with a history of bladder cancer provides a similar specificity but greater sensitivity than that of cytology for detecting bladder cancer recurrences. Given the better specificity and similar sensitivity of UroVysion compared with urine cytology obtained from bladder washings, a reasonable approach might be to use the UroVysion assay as the primary marker for recurrence, with urine cytology used as a complementary examination.
Frozen section‐guided wide local excision in the treatment of penoscrotal extramammary Paget’s disease
Authors: Zhu Yao , Ye Ding W. , Chen Zhong W. , Zhang Shi L. , Qin Xiao J. 
Published: September 2007

OBJECTIVETo analyse the clinicopathological characteristics of penoscrotal extramammary Paget’s disease (EMPD) and to discuss the outcomes after frozen section‐guided wide local excision.PATIENTS AND METHODSFrom 1990 to 2005, at our institution, 38 patients with penoscrotal EMPD received wide local excision with intraoperative frozen‐section analysis. Their medical records were reviewed for patient demographics, lesion characteristics, surgical margin status, and clinical outcome.RESULTSNo patients had EMPD secondary to a non‐cutaneous malignancy; 23 patients had intraepithelial EMPD, 12 had invasive EMPD and three had EMPD with underlying adnexal adenocarcinoma. The median (range) largest diameter of the lesion was 6 (1–20) cm. Of 38 patients, 12 (32%) had positive frozen‐section results and had extended surgical excision until a negative margin was obtained. Additional margin examination of the gross specimen and final examination of the frozen sections showed that five patients had false‐negative results. There was a microscopic positive margin in 15 of 38 (40%) patients when a conventional 2 cm clinical tumour‐free border was maintained. Skin erythematous patches were significantly correlated with the spread of disease (P = 0.03). After a median (range) follow‐up of 33.5 (3–140) months, six of 38 (16%) patients had recurrent disease, of whom only two had recurrent skin lesions, while four had systemic progression.CONCLUSIONFrozen section‐guided wide local excision gave an acceptable recurrence rate in the treatment of penoscrotal EMPD. Primary EMPD with dermal invasion should be actively monitored for possible aggressive behaviour.
The maximum tumour length in biopsy cores as a predictor of outcome after radical prostatectomy
Authors: Hayashi Norihiro , Urashima Mitsuyoshi , Kuruma Hidetoshi , Arai Yoichi , Kuwao Sadahito , Iwamura Masatsugu , Egawa Shin 
Published: September 2007

OBJECTIVESTo evaluate maximum tumour length (MTL) in biopsy cores as a predictor of prostate‐specific antigen (PSA)‐failure, systemic failure, and death from prostate cancer after radical prostatectomy (RP).PATIENTS AND METHODSWe assessed 209 men with clinically localized prostate cancer treated with RP; preoperative variables were correlated with unfavourable pathological characteristics in the RP specimens and with outcome after surgery, using univariate and multivariate analysis.RESULTSThe median (range) MTL was 4 (0.2–19) mm and correlated with adverse pathological findings, including specimen Gleason score (P = 0.003), pT3 (P < 0.001), seminal vesicle invasion (P < 0.001) and lymph node involvement (P = 0.019) in multivariate analysis. Preoperative PSA (P < 0.001), biopsy Gleason score (P = 0.002), and MTL (P = 0.045) were independent predictors of PSA failure, whereas only MTL remained a predictor of systemic‐failure (P < 0.001) and death from prostate cancer (P = 0.004). The median (range) follow‐up after surgery was 90 (17–152) months, during which 83 patients had PSA failure, 20 developed systemic failure and 15 died from prostate cancer.CONCLUSIONSThe MTL correlates well with adverse pathological findings and appears to be an independent predictor of outcome after RP. Patients with a greater MTL might have cancer with an aggressive phenotype and therefore be candidates for more aggressive therapies.