bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Treatment of Peyronie's Disease with Tamoxifen
Authors: RALPH D. J. , BROOKS M. D. , BOTTAZZO G. F. , PRYOR J. P. 
Published: November 2008

Summary This is a preliminary study of the treatment of 36 patients with Peyronie's disease who received tamoxifen 20 mg twice daily for 3 months.An improvement occurred in 16 of 20 patients with penile pain, in 11 of 31 patients with an erectile deformity and 12 of 35 patients had a plaque shrinkage of at least 1 cm. Some improvement occurred in 6 of the 8 patients with a histologically confirmed inflammatory infiltrate of the plaque but not in any of the 4 patients without an infiltrate. The inflammatory infiltrate was found in patients in whom the duration of the disease was less than 4 months.
Instillation of Silver Nitrate in the Treatment of Chyluria
Authors: SABNIS R. B. , PUNEKAR S. V. , DESAI R. M. , BRADOO A. M. , BAPAT S. D. 
Published: November 2008

SummaryA series of 62 patients with chyluria received instillations of 1% silver nitrate in the renal pelvis over an 8‐year period; 51 patients responded well but 11 showed no response to treatment. Follow‐up ranged from 2 to 7 years.The treatment was found to be safe, effective and minimally invasive.
Placebo‐controlled Study of Terazosin in the Treatment of Benign Prostatic Hyperplasia with 2‐Year Follow‐up
Authors: FABRICIUS P. GERHARD , HANNAFORD J. MAC 
Published: November 2008

Summary— This randomised, placebo‐controlled, double‐blind study was performed to evaluate the efficacy and safety of once‐a‐day terazosin (10 mg/d) in ambulatory patients (n = 57) with benign prostatic hyperplasia (BPH). After a 4‐week placebo lead‐in and a 24‐week treatment period with terazosin (with both phases being single‐blind), 30 patients who responded to terazosin were randomly assigned to either the terazosin or placebo treatment group for 12 weeks. During the single‐blind treatment period, the peak urine flow rate increased 54% from a baseline average of 7.76 ml/s to 11.92 ml/s after terazosin administration; the mean flow rate increased 55% from a baseline of 4.90 ml/s to 7.59 ml/s; and the residual volume decreased 56% from 93. 1 ml to 40.7 ml. The mean obstructive symptom score, irritative symptom score and physician global assessment score improved by 68%, 34% and 27%, respectively. All these changes were significant when compared with baseline values.During the double‐blind period, the improvement in all the variables was sustained in the terazosin group but not in the placebo group. Peak and mean urinary flow rates, and physician assessment showed significant differences at the end of the double‐blind period. Adverse events occurred only during the single‐blind period. The most frequently experienced events were headache (n = 6), asthenia (n = 3) and hypotension (n = 3).A follow‐up study that initially included 12 patients showed no significant loss of improvement in symptoms and no change in urodynamic parameters with the 5 mg terazosin dose at 1 year. At 2 years, the 9 remaining patients showed sustained improvement and no signs of tachyphylaxis.
Electromyographic Abnormalities in the Urethral and Anal Sphincters of Women with Idiopathic Retention of Urine
Authors: WEBB R. J. , FAWCETT P. R. W. , NEAL D. E. 
Published: November 2008

Summary— Previous concentric needle studies of the urethral sphincter in women with idiopathic urinary retention have found evidence of denervation and reinnervation as well as abnormal patterns of muscle fibre discharge—complex repetitive discharges (CRDs). In order to test the hypothesis that these abnormalities represented a more widespread disease process of pelvic floor function, we carried out an electromyographic (EMG) study of both anal and urethral sphincters in 18 women with idiopathic urinary retention.The urethral sphincter EMG was abnormal in 15 patients. These abnormalities included polyphasic and long duration potentials. Complex repetitive discharges were identified in 8 women. However, abnormalities of the anal sphincter were found in 14 of the 15 patients with abnormal urethral sphincter EMGs, polyphasic and abnormally long duration potentials being found in the anal sphincters of all 14 patients. In addition, 7 of the 8 women who had complex repetitive discharges in the urethral sphincters had similar complex repetitive discharges in their anal sphincters. Women with complex repetitive discharges had a significantly greater proportion of abnormal potentials than women with no such repetitive discharges.These results support the previous findings of electromyographic urethral sphincter abnormalities in women with idiopathic urinary retention, but also suggest that these abnormalities reflect a widespread disease process involving the pelvic floor in such patients.
Ultrastructural Observations on Cystitis Cystica in Human Bladder Urothelium
Authors: JOST S. P. , DIXON J. S. , GOSLING J. A. 
Published: November 2008

Summary Cystitis cystica, a common urothelial pathology whose aetiology, morphology and clinical significance are poorly understood, affects the human urinary bladder and trigone in both sexes. We have studied the fine structure of urothelial cysts in 11 patients diagnosed cystoscopically as suffering from cystitis cystica. Several abnormal features were observed in the adjacent urothelium, including large intracellular vacuoles (4 patients), Brunn's nest (5), lymphocyte infiltration (10) and generally disorganised urothelial architecture (10). Squamous metaplasia was observed in one case.The wall of each cyst consisted of a 2–3 layered epithelium with either tall columnar or flattened cells lining the fluid‐filled lumen. Both types of lining cell possessed short microvilli, while the columnar type also contained numerous membrane‐bound, electron dense secretory granules in the apical cytoplasm. Rough endoplasmic reticulum, mitochondria and Golgi membranes were plentiful in the surface cells. Junctional complexes joined adjacent lining cells. The deeper cells contained relatively fewer organelles, while a basal lamina separated the cyst wall from the underlying connective tissue.
Bladder Neck Mobility Evaluated by Vaginal Ultrasonography
Authors: MOURITSEN L. , RASMUSSEN ANNLISE 
Published: November 2008

Summary— Factors involved in monitoring bladder neck mobility were studied by means of vaginal ultrasonography. Thirty‐three continent, 28 incontinent and 39 patients who had undergone surgery for incontinence were examined in the supine and sitting positions during rest, the Valsalva manoeuvre and withholding urine.Bladder neck mobility can be described as a semicircular movement with the tip of the symphysis pubis as the centre and a line from the tip to the bladder neck as the radius (BS). Movement can be measured by 2 independent factors: BS distance and size of the angle between the BS line and the midline of the symphysis, at rest, during the Valsalva manoeuvre and withholding urine.The continent controls were characterised by a 90° angle at rest, a long BS (2.4 cm) and a fixed bladder neck. The incontinent patients had a shorter BS (2.1 cm), angles at rest of approximately 100°—the angle increased with the grade of incontinence—and a mobile bladder neck.If 2 of the 3 criteria (angle at rest ≥ 95°, BS ≤ 2.3 cm and mobility ≥ 20°) are regarded as diagnostic of incontinence, diagnostic sensitivity was 84% and specificity 82%.In the surgical group, patients who failed to respond to treatment had a shorter BS, larger angles and greater bladder neck mobility than their successfully treated counterparts.
Patient‐perceived Health Status before and up to 12 Months after Transurethral Resection of the Prostate for Benign Prostatic Hypertrophy
Authors: DOLL HELEN A. , BLACK N. A. , FLOOD ANN B. , McPHERSON K. 
Published: November 2008

Summary— As part of a prospective cohort study of 388 men undergoing transurethral resection of the prostate (TURP) for benign prostatic hypertrophy, the perceived physical, social and emotional health before and 3,6 and 12 months after surgery was assessed using the Nottingham Health Profile. Before surgery, 88% of patients reported one or more specific health problems, most commonly concerning sleep (75%). The areas of daily life considered by the patients to be most affected by their health status were employment (by 33% of those currently in work), sex life (31%), social life (29%) and holidays (29%). Comparisons with other patient groups are described.Three months after surgery the proportion of patients reporting at least one health problem had fallen to 66%. Significant improvements occurred in all aspects of health, particularly sleeping problems. The improvements persisted for all aspects during the year following surgery with the exception of physical mobility, which deteriorated. These improvements were reflected in a significant reduction in perceived limitations in the patients' daily lives, with a tendency for the patients to perceive fewer limitations 1 year after surgery than at the 3‐month assessment.
Prevalence of Bilateral Testicular Germ Cell Tumours and Early Detection Based on Contralateral Testicular Intra‐epithelial Neoplasia
Authors: DIECKMANN K.‐P. , LOY V. , BÜTTNER PETRA 
Published: November 2008

Summary— The prevalence of bilateral tumours was found to be 4% in a retrospective analysis of 531 consecutive patients with testicular germ cell tumours. Patients with bilateral tumours were younger when their first tumour was diagnosed than those who had only 1 testicular tumour. Bilateral undescended testis was more frequent in 21 patients with bilateral tumours than in the total population of patients examined (2 of 21 versus 10 of 452, i.e., 9.5% versus 2.2%). Histology and unilateral undescended testis were not helpful in identifying patients at risk of developing a second tumour.In a separate study, 76 consecutive patients with unilateral testicular cancer underwent contralateral testicular biopsy at the time of orchiectomy. Five patients had testicular intra‐epithelial neoplasia (TIN, so‐called carcinoma in situ) in the contralateral testis; 1 of these patients had a history of bilateral undescended testis and 4 had an increased level of serum follicle stimulating hormone post‐operatively. None of the other 71 patients had developed a second tumour after a median observation time of 30 months. Testicular biopsy and a search for TIN appear to be a safe method for the early identification of the patients at risk of developing a contralateral testicular tumour.
Collecting Duct Carcinoma of the Kidney
Authors: DIMOPOULOS M. A. , LOGOTHETIS C. J. , MARKOWITZ A. , SELLA A. , AMATO R. , RO J. 
Published: November 2008

Summary— Collecting duct carcinoma (CDC) is a recently recognised histological variety of renal carcinoma (RC) considered to arise from the epithelium of the collecting ducts. Diagnosis of this entity depends on well defined gross and microscopic criteria and is supported by a characteristic immunostaining pattern. The clinical features of these patients, the natural course of the disease and its response to treatment have not been clearly established.Between 1980 and 1990 we treated 12 patients (median age 43 years, range 16–62) with collecting duct carcinoma of the kidney. In addition to being relatively young, each patient had a strong family history of associated malignancies. Survival was short (median 22 months) and 11 patients presented with locally advanced or metastatic disease.
Surgical. Correction of Bilharzial Ureteric Stricture by Boari Flap Technique
Authors: RAVI G. , MOTALIB M. A. 
Published: November 2008

Summary— Extensive ureteric strictures due to bilharziasis can be managed satisfactorily by reimplantation of the ureters using a Boari flap technique. A series of 150 patients with extensive ureteric strictures underwent ureteric reimplantation using this technique.Contrary to the conventional belief that patients with bilharziasis have a contracted bladder, our patients maintained a good capacity and sufficient supple tissue was available to replace even very extensive ureteric strictures.
Treatment Preferences of Urologists in Great Britain and Ireland in the Management of Prostate Cancer
Authors: WAYMONT B. , LYNCH T. H. , DUNN J. , BATHERS S. , WALLACE D. M. A. 
Published: November 2008

Summary— A questionnaire was sent to all full‐time British and Irish urologists (n=278) on the management of prostate cancer and was answered by 229 (82%). The questions included 3 specific clinical situations, namely the management of incidental disease, the timing of treatment for metastatic disease and the mode of hormonal manipulation used for advanced disease.It was found that 79% of urologists preferred a deferred treatment policy for incidental disease in the over‐75 age group. Radical prostatectomy was advocated by 10% of those questioned for patients in the under‐60 age group. Radiotherapy was the mainstay of treatment for incidental disease in the poorer prognosis groups of incidental disease, namely younger patients with more aggressive tumours.Most urologists treated patients with asymptomatic metastatic disease at the time of diagnosis, with 18% entering patients into the Medical Research Council trial comparing immediate with deferred therapy.Orchiectomy was advocated by 57% of urologists as their first‐line treatment for patients where hormonal manipulation was indicated. Consequently orchiectomy should remain the “gold standard” in comparative phase III trials in advanced prostate cancer.
Extracorporeal Shock Wave Lithotripsy Induces the Release of Prostaglandins which Increase Ureteric Peristalsis
Authors: HORGAN P. G. , HANLEY D. , BURKE J. , COUSE N. F. , FITZPATRICK J. M. 
Published: November 2008

Summary—The aim of this study was to identify the changes in secretion of prostaglandins into the urinary tract as a result of treatment by extracorporeal shock wave lithotripsy (ESWL) and to determine their effects on ureteric motility.Sixteen patients with renal or upper ureteric calculi were studied. A peripheral blood and urine sample was collected immediately before and after ESWL, with further samples taken 24 h later. The following variables were assessed by radioimmunoassay: prostaglandin E2(PGE2), prostaglandin F1α (PGF1α), and thromboxane B2(TXB2). Anin vitrocanine study was then designed to study the activity of TXB2, PGF1α and PGE2on an isolated intact canine ureter model.Significant elevations of TXB2were found immediately after ESWL in both serum and urine, which fell almost to pre‐treatment levels by 24 h. PGF1α levels showed significant elevations at 24 h but no immediate increase as seen with TXB2. In contrast, PGE2levels were unchanged in the urine but significantly decreased in the serum.In vitrostudies showed that both TXB2and PGF1α repeatedly produced an increased frequency of ureteric contraction.ESWL results in the release of prostaglandins from the urinary tract which are shown to cause increased ureteric peristalsis.
Extracorporeal Shock Wave Lithotripsy for Bladder Stones
Authors: HOTIANA M. Z. , KHAN L. A. , TALATI J. 
Published: November 2008

Summary— Between December 1989 and July 1991, 29 patients with bladder stones were treated on the MPL 9000 extracorporeal shock wave lithotriptor using ultrasound for localisation. The mean stone dimensions were 22.65 × 15.17 mm (<400 mm2 in 20 patients); 75% of patients required only 1 ESWL session but the largest stone (2025 mm2) required 3. Whilst larger stones tended to require more shock waves, linear regression analysis showed a poor fit and factors other than size (operator experience and stone hardness) may determine the number of shock waves required. Satisfactory fragmentation was obtained in all patients.All were treated under intravenous analgesia without anaesthesia. Three patients also had outflow obstruction and were treated by transurethral resection of the prostate (TURP) on the day after completing ESWL. ESWL prior to TURP reduces the morbidity and operating time associated with endoscopic therapy of bladder stones. Macroscopic fragments remaining after ESWL can be washed out at TURP.
Changes in Serum Immunosuppressive Acidic Protein following Surgery in Patients with Renal Carcinoma
Authors: UEDA T. , YASUMASU T. , UOZUMI J. , NAITO S. 
Published: November 2008

SummarySerum immunosuppressive acidic protein (IAP) was measured serially in 69 patients with renal carcinoma who were treated surgically and followed up for more than 6 months after surgery. Elevated IAP levels > 600 µg/ml were seen in 8 of 52 patients without evidence of recurrence and in 5 of 10 patients prior to clinical evidence of recurrence but in whom recurrence did eventually develop. The positive rate of IAP levels > 600 µg/ml in recurrent cases was significantly higher than in non‐recurrent ones. In 7 patients with distant metastases, IAP levels rose to > 500 µg/ml in 3 of 5 patients whose disease progressed despite therapy; levels fell to < 600 µg/ml in 2 patients who responded to therapy. The data suggest that recurrence should be suspected in patients with IAP levels > 600 µg/ml, as these changes appear to correlate with the response of metastases to therapy.
Development of a Catheterised Bladder Model to Evaluate Urinary Drainage Equipment
Authors: MULHALL ANNE , GARNHAM A. , ORAEDU A. 
Published: November 2008

SummaryA catheterised bladder model was developed to examine the design features of urinary drainage bags. The drainage bag of 4 commonly used products was inoculated with either Escherichia coli or Proteus mirabilis. The speed of retrograde contamination towards the “bladder” was determined over 96 h. The effect of lifting the drainage bag above the level of the “bladder” was examined also. Within 4 days micro‐organisms were detected in the backflow valves/drip chambers of all products, but contamination had not progressed as far as the catheter. Ps. mirabilis appeared to migrate more rapidly than Esch. coli. Lifting the drainage bag had no effect on the migration of either organism. The implications of these results for clinical practice are discussed.
Uraemia with Concomitant Urothelial Cancer
Authors: JIAAN BANG‐PING , YU CHIA‐CHENG , LEE YING‐HUEI , HUANG JONG‐KHING 
Published: November 2008

SummaryWe report our experience with 3 uraemic patients who were found to have transitional cell carcinoma of the renal pelvis, ureter and urinary bladder after undergoing haemodialysis for an average of 18 months (range 11–28). The underlying causes of renal failure were chronic glomerulonephritis or pyelonephritis. Bloody urethral discharge was the cardinal symptom. Because of anuria, it was often discovered at a late stage. In spite of their poor general condition and advanced stage, palliative surgical intervention was still performed. After a mean follow‐up of 9 months, progression of disease was noted in 1 patient. The importance of regular follow‐up in patients with end‐stage renal disease for early detection of concomitant cancer cannot be overemphasised. Uraemic patients with urothelial cancer should be treated in the same way as non‐uraemic patients, since aggressive surgical intervention may improve their quality of life and prolong their survival.
Audit and its Impact in the Management of Advanced Prostatic Cancer
Authors: RANA A. , CHISHOLM G. D. , CHRISTODOULOU S. , MclNTYRE MARGARET , ELTON R. A. 
Published: November 2008

SummaryFrom a prospective database of 614 consecutive men with newly diagnosed prostatic cancer an audit of outcome was studied in 169 men who presented with bone metastases and subsequently received hormonal manipulation in the form of monotherapy. The cohort was divided into 2 groups according to serum alkaline and acid phosphatase enzyme levels. Men with normal alkaline phosphatase levels (41.5%) had a better prognosis (median survival 38 months) than those with elevated levels at presentation (58.5%) (median survival 19 months). This difference was highly significant. A similar stratification on prostatic acid phosphatase levels did not yield any prognostic significance. With regard to cause‐specific survival, serum alkaline phosphatase was an even more powerful prognosticator, with a median survival of 45 and 21 months for patients with normal and elevated levels respectively. Thus monotherapy is recommended for metastatic prostate cancer patients with normal serum alkaline phosphatase, but for those with elevated alkaline phosphatase the alternative avenues of treatment must be explored.
Re‐evaluation of the Need for Pelvic Lymphadenectomy in Low Grade Prostate Cancer
Authors: FOURNIER G. R. , NARAYAN P. 
Published: November 2008

SummaryIn a series of 166 patients undergoing radical prostatectomy and bilateral pelvic lymph node dissection for clinical stage A and B prostate cancer we found that 83% of patients with lymph node metastases had a final tumour Gleason score 7. Gleason scoring of the pre‐operative biopsy demonstrated 3 groups of patients with biopsy scores 5, 6, and 7, and a prevalence of lymph node metastases of 2, 13 and 23% respectively. The pre‐operative serum prostate specific antigen (PSA) was of marginal value in predicting either the presence of lymph node metastases or the presence of cancer, since 15% of patients with nodal metastases had normal pre‐operative PSA levels, as did 54% of patients with tumour Gleason scores 5. It was concluded that the need for pelvic lymph node dissection in patients with low grade tumours is questionable because of the low prevalence of lymph node metastases, and that the pre‐operative biopsy can identify those patients who are at low risk for lymph node metastases.
Bladder Contractility and Idiopathic Detrusor Instability in the Female
Authors: CUCCHI A. 
Published: November 2008

Summary Twenty females with pure stress urinary incontinence (Group A) were studied clinically and urodynamically together with 20 stress incontinent women with idiopathic detrusor instability (Group B) and 20 controls (Group C). Forty females with the idiopathic urge syndrome, 20 with detrusor instability (motor urgency. Group D) and 20 with stable bladders (sensory urgency, Group E) were also investigated. Detrusor contractility, assessed on the basis of strength and velocity parameters derived from pressure flow data, was increased in the unstable groups. In particular, the maximum mechanical power (per unit of bladder wall surface area) generated by the contracting detrusor during voiding was higher in the unstable patients, this was also the case when estimating maximum bladder contraction velocity.No significant difference in these parameters was found in the patients with sensory urgency when compared with the controls and with the women with stress urinary incontinence, nor was there any significant difference between patients with motor urgency and the stress incontinent patients with detrusor instability.The enhanced contractile capability could be explained in the unstable stress incontinent group by a reduced threshold of stretch receptors in the urethral walls. If this were the case, urine running through the urethra at the beginning of voiding would be able to activate a urethrovesical reflex which may augment micturition contractions.In the group with the idiopathic urge syndrome one could speculate that sensory and motor urgency are due to the same neurological disorder (i.e. possibly a reduction in a tonic inhibitory or modulatory device) that would affect detrusor mechanics at different levels of the nervous system, resulting in different contractile capabilities.
Is Abnormal Electrosensitivity in the Lower Urinary Tract a Sign of Neuropathy?
Authors: WYNDAELE J.J. 
Published: November 2008

Summary The threshold of sensitivity to electrical stimulation was determined in several parts of the lower urinary tract in 436 consecutive patients.In the groups with different patterns of disturbed sensation a higher incidence of neuropathy was found than in the group with a normal sensation. Further neurological investigation revealed abnormal innervation in 29% of patients who lacked electrosensitivity in one or more parts of the lower urinary tract but who had shown no previous evidence of neuropathy.