bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vasectomy reversal — microsurgery for best results
Authors: FOX M. 
Published: November 2008

Objective To determine whether microsurgery achieves a better result in vasectomy reversal than other macroscopic techniques. Patients and methods A series of 103 consecutive patients with a median age of 36 years (range 26–58) who underwent microsurgical vasovasostomy was studied. The method employed was a modification of a two‐layer anastomotic technique. In the first 49 patients 8/0 Vicryl was used to create a two‐layer anastomosis whereas in 54 patients 10/0 Ethilon was used. Results Sperm were present in the ejaculate in 85% of patients who underwent bilateral vasovasostomy. The rate increased to 94% in those in whom 1010 Ethilon had been used as the suture material but the difference was not statistically significant. In half of the patients sperm concentration, quality and motility improved over the 12 months following reversal. The fertility rate, measured between 8 months and 5 years after vasovasostomy, was 64% if the vasectomy had been performed within 10 years and fell to 39% if 10 years or more had elapsed. In the 10 patients who had undergone a failed reversal attempt elsewhere four had sperm in the ejaculate and two of these patients became fertile. Conclusion The additional time and effort required for microsurgical approach to vasovasostomy were worth‐while to obtain patency and fertility rates which were superior to those of other techniques.
Frequency of H‐ras mutations in human bladder cancer detected by direct sequencing
Authors: BURCHILL S. A. , NEAL D. E. , LUNEC J. 
Published: November 2008

Objective To determine the frequency of mutations of the H‐ras gene in transitional cell carcinomas of the human urinary bladder using direct DNA sequencing based on the polymerase chain reaction (PCR) method and to compare the results with those of other methods. In addition, the relationship of the mutation frequency to tumour stage and grade was examined. Patients and methods Bladder tumour samples, taken by cystoscopic resection from 50 patients with newly diagnosed transitional cell carcinoma of the urinary bladder, were analysed by PCR‐based direct DNA sequencing for point mutations in the H‐ras gene at codon 12. Results Point mutations were found in 9 of 50 tumours examined (18%). The most frequent mutation (8/9) was a G to T transversion converting GGC to GTC, which would result in a glycine to valine substitution. The remaining mutation was a G to A transition altering GGC to GAC, producing a glycine to aspartic acid substitution, which has not previously been reported in bladder cancer. In all tumour samples examined the wild‐type allele (GGC) was also evident. Variation in the proportion of wild‐type to mutated sequence was found within tumour samples. No relationship between mutations and tumour grade and stage was apparent. Conclusion The frequency of H‐ras mutations detected in this first large scale study using the highly sensitive and rapid PCR‐based sequencing method was comparable to that reported by earlier studies with the nude mouse tumorigenesis variation of the 3T 3 transfection assay. H‐ras mutations can be early events in the development and progression of a significant proportion of human bladder cancer cases.
DNA ploidy, serum prostate specific antigen, histological grade and immunohistochemistry as predictive parameters of lymph node metastases in T1‐T3/M0 prostatic adenocarcinoma
Authors: Berner A. , Waere H. , Nesland J.M. , Paus E. , Danielsen H.E. , Fosså S.D. 
Published: November 2008

Objective To evaluate whether DNA ploidy and immunohistochemistry performed in primary prostatic carcinoma specimens give predictive information on regional lymph node metastasis in addition to T category, histological grade and serum prostate specific antigen (PSA). Patients and methods Pre‐treatment TURP specimens from 80 patients with prostatic carcinoma T0‐T3/M0 disease were retrospectively evaluated by means of DNA ploidy and histological grade, and immuno‐staining for PSA, prostatic acid phosphatase (PAP), neuron‐specific enolase (NSE) and p53 protein. Pelvic lymph node dissection was performed in all patients. Serum PSA was determined in 76 of the 80 patients before pelvic staging lymphadenectomy. Thirty‐two (40%) of the 80 patients had pN+ disease. Results Thirty‐six patients (46%) had serum PSA values below the upper reference limit (≤ 10 μg/L). By univariate analysis the pN category correlated with the serum PSA level (P<0.001), histological grade (P<0.001), tissue PSA (P<0.001), tissue PAP (P<0.04), T category (P<0.005) and DNA ploidy (P<0.02). Multivariate analysis revealed that the serum PSA level was the most powerful independent prognosticator, followed by the T category, tissue PAP and tissue PSA. Histological grade and DNA ploidy did not reach the level of significance in the multivariate analysis. Conclusion These data suggest that tissue PAP and tissue PSA predict the pN status in patients with T0‐T3/M0 prostate carcinoma, in addition to serum PSA and T category. Neuroendocrine differentiation and p53 protein seem to have no predictive ability.
Treatment of catheter‐associated Candiduria with fluconazole irrigation
Authors: Simşek Ü. , Akinci H. , Oktay B. , Kavrama I. , Özyurt M. 
Published: November 2008

Objective To examine the safety and efficacy of fluconazole in patients with a permanent nephrostomy or suprapubic catheter in the prevention of candiduria. Patients and methods Twenty patients with a nephrostomy or suprapubic catheter who had at least two positive urine cultures with a minimum of 15 000 col/mL Candida counts were studied. The catheters were irrigated with fluconazole solution prepared as 1 mg/mL with normal saline. Repeated urine cultures were obtained. Results In 17 patients Candida was eradicated from the urine by the third to sixth day of irrigation. No side‐effects were noted. Conclusion Fluconazole as an irrigant is effective and safe in the treatment of catheter‐associated candiduria, which can be eliminated without changing the catheter.
Surgery of lung metastases in renal cell carcinoma
Authors: Cozzoli A. , Milano S. , Cancarini G. , Zanotelli T. , Cunico S. Cosciani 
Published: November 2008

Objective To examine the impact on survival of pulmonary resection in the treatment of renal cell carcinoma that has metastasized to the lung. Patients and methods From June 1986 to July 1991, 19 patients were submitted to synchronous or asynchronous lung metastasectomy. Histological examination confirmed the presence of lung metastases from renal cell carcinoma in 16 cases (six synchronous and 10 asynchronous with a mean disease‐free interval of 23 months). In the other three cases, histological examination revealed tuberculomas, chondroid ham‐artoma and foci of anthracosis. Results To date, among the six patients with synchronous lung métastases, three have died, two are progressing and one has no evident disease after a mean survival of 24 months. Among the 10 patients who underwent surgical resection of metachronous lung metastases, one has died, three are progressing and six have no evident disease (mean survival time, 43 months). Conclusion While the presence of synchronous lung metastases is an unfavourable prognostic factor even after surgical removal (five out of six patients died or are in progression shortly after metastasectomy), the results after surgery of asynchronous lung metastases are encouraging, although the real efficacy of this treatment is still to be confirmed.
Analysis of early failures after intravesical instillation therapy with bacille Calmette‐Guerin for carcinoma in situ of the bladder
Authors: Merz V.W. , Marth D. , Kraft R. , Ackermann D.K. , Zingg E.J. , Studer U.E. 
Published: November 2008

Objective To analyse the clinical and therapeutic consequences of early treatment failure after bacille Calmette‐Guérin (BCG) instillation therapy for carcinoma in situ of the bladder. Patients and methods A total of 115 patients with carcinoma in situ (Tis) of the bladder were treated by intravesical instillation of living BCG vaccine (Immun BCG Pasteur F). Twenty five patients had primary Tis and 90 had secondary Tis with synchronous or prior superficial papillary tumours. All papillary tumours were resected before instillation of BCG. All patients completed one series of 6 weekly instillations of 120 mg BCG. Results Twenty‐two of 25 patients (88%) with primary Tis responded completely, with negative cytology and cystoscopy findings within a median follow‐up period of 44 months. Three of the 25 (12%) had cytological evidence of disease within 9 months of therapy and were considered to be early treatment failures. One patient had muscle‐invasive bladder cancer, one had Tis and invasive cancer of the prostatic urethra, and the last, in whom a second BCG course also failed, had Tis of both ureters. Seventy of 90 patients (78%) with secondary Tis had a complete response after treatment with BCG, with repeated negative cytology and cystoscopy examinations within a median follow‐up time of 40 months. Twenty of the 90 (22%) with secondary Tis had positive cytology within 9 months after BCG therapy and were considered early treatment failures. Five of these 20 had a cystectomy, three for persistent Tis of the bladder and two for a solid urothelial carcinoma of the prostate. The remaining 15 early failures received a second course of BCG. Four of these 15 patients responded and the remaining 11 failed the second course. The 11 failures included two patients with multifocal T1 G3 bladder cancers, four with invasive bladder cancer, two with solid urothelial carcinomas of the prostatic urethra, and three with Tis of the upper urinary tract. Conclusions According to these data, early treatment failure after 6 weekly instillations of 120 mg Immun BCG Pasteur F is an alarming signal which requires immediate re‐assessment of the patient to exclude a muscle‐invasive bladder cancer or an extravesical carcinoma in situ, either in the upper urinary tract or in the prostatic urethra.
Persistent polyuria after posterior urethral valves
Authors: Dinneen M.D. , Duffy P.G. , Barratt T.M. , Ransley P.G. 
Published: November 2008

Objective To assess urinary concentrating ability, urine production and glomerular filtration rates in a cohort of boys with previously treated posterior urethral valves. Patients and methods Urinary concentrating capacity was assessed in 51 boys aged 5.4–9.9 years with previously treated posterior urethral valves. They all completed urinary frequency/volume charts, permitting calculation of 24 h urine volumes. The osmolal‐ity of an overnight urine collection was measured and, if <800 mOsm/kg (n= 40), an intramuscular injection of desaniino‐cys‐l‐8‐d‐arginine vasopressin was given to determine the maximum concentrating ability. The glomerular filtration rate (GFR) was estimated from the plasma clearance of 51Crethylenediamine tetra‐acetic acid following a single intravenous injection. Results The mean 24 h urine volume was 1025+448 (sd) mL. The mean overnight urine flow rate was 28.4±17.9 mL/h. Urinary concentrating capacity was impaired (<800 mOsm/kg) in 30 (59%) of the boys and <300 mOsm/kg in eight (16%). The mean GFR was 81+38 mL/min/1.73 m2 SA. Significant correlations were noted between the GFR, the maximum urine concentration and the 24 h urine volume. Conclusion Persistent polyuria after valve ablation occurs in boys with posterior urethral valves. This has implications both in terms of urinary continence and on‐going renal impairment.
Blood coagulation proteins and urolithiasis are linked: crystal matrix protein is the Fl activation peptide of human prothrombin
Authors: Stapleton A.M.F. , Ryall U.L. 
Published: November 2008

Objectives To determine the relationship between prothrombin and crystal matrix protein (CMP). CMP is the predominant protein found in the organic matrix of calcium oxalate (CaOx) crystals generated from human urine and is a 31 kDa glycoprotein, whose N‐terminal amino acid sequence shares homology with human prothrombin. Materials and methods CaOx crystallization was induced in ultraflltered (UF) human urine containing either plasma or serum derived from the same healthy donor, by the addition of sodium oxalate. The crystals were demineralized and the resulting protein extracts analysed by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS‐PAGE) and Western blotting, using antibodies raised against human prothrombin and the C‐terminus of prothrombin fragment 1 + 2 (Fl+2). Results Prothrombin was detected in extracts of crystals precipitated from the UF urine in the presence of plasma, while CMP was completely absent. Crystals precipitated from UF urine supplemented with serum contained relatively large amounts of Fl+2 and a protein with the same electrophoretic mobility as CMP. Analysis of a standard preparation of Fl + 2 which also contained prothrombin fragment 1 (Fl) as a minor contaminant, showed a protein with electrophoretic and staining properties comparable to CMP. Conclusion CMP is a urinary form of Fl, a degradation product of prothrombin possessing the domain rich in y‐carboxyglutamic acid, which may have undergone some molecular modification either before or after its release into the urine.
Are neuroendocrine cells of practical value as an independent prognostic parameter in prostate cancer?
Authors: Allen F.J. , Velden D.J.J. Van , Heyns C.F. 
Published: November 2008

Objective To assess whether the presence of neuroendocrine (NE) cells is of value as an independent indicator of poor prognosis in patients with prostate carcinoma. Patients and methods A series of 160 consecutive patients with prostate carcinoma was studied retrospectively. In 120 there was sufficient tissue for review and to perform immunoperoxidase stains for neuron specific enolase (NSE) and chromogranin A (CGA). All patients had a potential follow‐up of at least 5 years. Results Five‐year survival was poorer for patients with a high tumour grade and stage at presentation compared to those with a lower grade and stage. NE cells were more common in higher grade and stage disease, but 5‐year survival did not differ significantly between patients with NE cell positive and negative tumours. Conclusion NE cells are of no practical value as an independent prognostic indicator in patients with pros‐tatic adenocarcinoma.
Zonal biochemical and morphological characteristics in BPH
Authors: Feneley M.R. , Puddefoot J.R. , Xia S. , Sowter C. , Slaving G. , Kirby R.S. , Vinson G.P. 
Published: November 2008

Objective To compare androgen, oestrogen, progesterone and epidermal growth factor receptor concentrations in the transition zone and peripheral zone of the prostate in benign prostatic hyperplasia (BPH), and to relate these findings to epithelial and stromal composition.Patients and methods Tissue from both the transition and peripheral zone of the prostate was obtained from 26 patients undergoing transurethral prostatectomy for benign prostatic obstruction and used for both receptor binding studies and morphometric analysis. Androgen receptor (AR), oestrogen receptor (ER), progesterone receptor (PR) and epidermal growth factor receptor (EGFR) concentrations were assayed by saturation binding with a competitive inhibitor. The epithelial, stromal and luminal composition of the tissue was determined using a Zeiss AxioHOME microscope workstation.Results The epithelial content was significantly greater in the transition zone than in the peripheral zone. No overall zonal difference in AR concentration was detected; however, when values were expressed relative to the epithelial component, the AR content was significantly higher in the peripheral zone. Conversely, overall EGFR concentrations were significantly greater in the transition zone, although not when expressed per unit epithelium. Higher concentrations of oestrogen receptor were measured in the transition zone per unit stroma. No zonal difference in PR was detected. However, there was a significant correlation between AR and PR in the peripheral zone and between EGFR and AR in the transition zone.Conclusion These data demonstrate that receptor concentrations should be related to tissue composition. Concentrations of AR were higher in the peripheral zone epithelium than in transition zone epithelium, suggesting greater androgen dependence. This may be important in determining its greater propensity for malignancy. Although EGFR concentrations were greater in the transition zone, there was no zonal difference after correction for the amount of epithelium. Finally, higher concentrations of ER were detected in the transition zone stroma which may reflect important zonal differences in regulating growth and provides further evidence of a role for oestrogens in BPH.
Periurethral collagen injections for genuine stress incontinence: a 2‐year follow‐up
Authors: MONGA A.K. , ROBINSON D. , STANTON S.L. 
Published: November 2008

Objective To assess the short‐and medium‐term efficacy of periurethral collagen injection in women with urethral sphincter incompetence and to determine if urodynamic variables can elucidate the mechanism of action.Patients and methods Sixty women (mean age 64 years, range 20–90) with genuine stress incontinence received periurethral collagen injections under local anaesthesia; 55 had undergone previous continence surgery. A total of three injection sessions were allowed. Subjective and urodynamic assessments were obtained at 1, 3, 6, 12 and 24 months after injection to evaluate success and long‐term effects of collagen.Results Subjective success rates were 86% at 3 months, 77% at 12 months and 68% at 24 months. Objective cure rates were 61% at 3 months, 54% at 12 months and 48% at 24 months. Low urethral pressures and decreased bladder neck mobility did not affect the outcome. Collagen injections significantly increased stress maximum urethral closure pressures and functional urethral length; increase in the latter and clinical assessment of bulking at the time of injection appeared to predict medium‐term success. There were some minor early complications and none in the medium‐term.Conclusions Periurethral collagen injections continued to be effective at the 2‐year follow‐up, although there was a time‐dependent decline. In comparison with more complicated procedures used in patients with previous failed continence surgery, periurethral collagen injection is a simple, acceptable, day case procedure which improves the quality of life in physically fit or frail patients, with few complications.
Diabetes mellitus increases nitric oxide synthase in penises but not in major pelvic ganglia of rats
Authors: ELABBADY A.A. , GAGNON C. , HASSOUNA M.M. , BEGIN L.R. , ELHILALI M.M. 
Published: November 2008

Objective To determine the effect of diabetes mellitus (DM) on erectile function and evaluate the levels of nitric oxide synthetase (NOS) activity in streptozotocin‐induced diabetic rats.Materials and methods Rats were studied at 9 weeks and 14 weeks after the induction of DM by streptozoto‐cin and compared with untreated control rats. Erectile potency was assessed physiologically by testing and recording mating behaviour. NOS activity was assayed in penile tissues and major pelvic ganglia (MPG) by conversion of [3H] L‐arginine to [3H] citrulline. Histological, ultrastructural and immunohisto‐chemical studies of penile tissues were performed in similar groups of rats.Results Diabetes mellitus adversely and significantly degraded all parameters of mating behaviour, thusindicating defective erectile potency. However, NOS activities in penile tissues from both groups of diabetic rats were significantly higher than those in controls (P<0.01). In MPG, NOS activities were not significantly different between diabetic and control rats (P>0.05). Histological, ultrastructural and immu‐nohistochemical studies of penile tissues revealed no significant differences between control and diabetic rats, indicating an intact effector organ (smooth muscles) in rats with up. to 14 weeks of DM.Conclusion The impotence frequently observed in diabetic subjects would suggest that despite the increase in NOS activity in the penis, the pharmacological action of nitric oxide is impaired.
Interferon‐alpha and survival in renal cell cancer
Authors: FOSSA S. , JONES M. , JOHNSON P. , JOFFE J. , HOLDENER E. , ELSON P. , RITCHIE A. , SELBY P. 
Published: November 2008

Objective To establish whether the use of interferonalpha might result in improved survival, using two large series of patients with advanced renal cell cancer treated during studies of chemotherapy and biological therapy, respectively.Patients and methods Patients treated either in the Eastern Cooperative Oncology Group (ECOG) chemotherapy protocols (327 patients) or in protocols employing interferon as part of a European randomized study or phase II studies at the Norwegian Radium Hospital (231 patients) were retrospectively analysed. Groups for comparison were matched by exclusion of those with an ECOG performance status >2, no prior nephrectomy, brain metastases or prior chemotherapy. Univariate analysis of prognostic factors for survival was performed by the log rank method and multivariate analysis by Cox regression.Results Univariate analysis of the whole population showed that performance status, time from diagnosis to treatment, sites of metastases and the use of interferon carried the greatest prognostic significance. In multivariate analysis, the use of interferon remained a significant predictor of survival (P < 0.001). Subgroup analysis suggested that the impact of interferon treatment was greatest in those patients with two of the following characteristics; good performance status, an interval of < 2 years from diagnosis to treatment and no more than one site of metastasis.Conclusion Although a prospective randomized trial is needed to establish definite benefit from the use of interferon in advanced renal cell cancer, this analysis supports the rationale for performing such a trial, particularly in patients with relatively good prognostic features. Patients should be entered into the Medical Research Council study comparing interferon with medroxyprogesterone acetate.
In situ piezoelectric extracorporeal shock wave lithotripsy of ureteric stones
Authors: ROBERT M. , DELBOS O. , GUITER J. , GRASSET D. 
Published: November 2008

Objective To evaluate the efficacy of the EDAP LT 02 lithotripter for the in situ treatment of ureteric calculi.Patients and methods One hundred consecutive patients presenting with ureteric calculi were treated with in situ piezoelectric extracorporeal shock wave lithotripsy (ESWL) using the EDAP LT 02 lithotripter. There were 49 patients with upper, nine with mid and 42 with lower ureteric stones. The largest diameter of the stones varied from 7 to 21 mm (mean 9.6 mm). Mild or severe hydronephrosis was present in 53 cases. Mid and lower ureteric stones were treated with the patients in the prone position, with no anaesthesia or pre‐medication, and upper ureteric stones in the supine position, with intravenous sedation in 44 cases.Results Localization of the stones was easy in 81 cases and more difficult in 19, but an intravenous pyelogram was only necessary in three cases. The number of sessions per patient varied from 1 to 3 (mean 1.17). Complete success rate was achieved in 75% of patients and partial success (residual stones ≤ 3 mm) in 6%. The stone‐free rate was statistically affected by stone size but was independent of stone localization or the degree of obstruction. The rate of infective and obstructive complications was 14% and auxiliary treatments were necessary in 5% of patients.Conclusion In situ piezoelectric ESWL with the EDAP LT 02 device is a convenient and efficient method for the treatment of ureteric stones.