bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carcinoma in situ in boys with cryptorchidism: when can it be detected?
Authors: PARKINSON M. C. , SWERDLOW A. J. , PIKE M. C. 
Published: November 2008

Objective To investigate the possibility of a pre‐invasive phase of adult germ cell tumours being detectable in childhood. Patients and methods Seventy testicular biopsies were examined which had been taken at orchidopexies from 57 patients aged 1 to 16 years during the period 1951–1973, and for whom follow‐up data on cancers and deaths up to 1989 were available. Results Malignant germ cell tumours had developed in three testes from which biopsies were available: a right‐sided teratoma and left‐sided mixed germ cell tumour in one patient and a left‐sided teratoma in a second patient. Carcinoma in situ was seen in only one of the 70 biopsies. This biopsy was taken from a patient aged 16 years and preceded the appearance of a teratoma by 4 years. Carcinoma in situ was not seen in a biopsy of this testis carried out 11 years before tumour diagnosis. Carcinoma in situ was also not seen in a biopsy of the contralateral testis in this patient carried out 22 years before tumour diagnosis in the testis, nor was it observed in a biopsy 17 years before the development of malignancy in the second patient. Conclusion These findings bring into question the extent to which the appearance of testicular biopsies taken during childhood orchidopexy can exclude the development of a tumour in adult life. No evidence has been found in this study for histological pre‐malignant changes occurring before the onset of puberty.
Epidermoid cyst of the testis: a review of clinical and histogenetic considerations
Authors: DIECKMANN K.‐P. , LOY V. 
Published: November 2008

Objective To review the records of patients with epidermoid cysts and those with germ cell tumours to determine the most appropriate method of treatment.Patients and methods The records of the patients treated for epidermoid cysts and testicular germ‐cell tumours in a period covering 22 years were analysed retrospectively. Nine specimens with an epidermoid cyst were examined by immunohistology for the presence of testicular intraepithelial neoplasia (TIN) (or carcinoma in situ of the testis). Results Ten patients with a simple epidermoid cyst and 481 patients with testicular germ‐cell tumour were treated during the observation period. The relative incidence of epidermoid cysts in relation to the number of patients with testicular germ‐cell tumours was 2.1% (95% confidence interval 0.8‐3.35%). The mean age of the 10 patients with an epidermoid cyst was 24.1 years. The right testis was affected in seven patients and the left in three. Six of these patients received conservative surgery with excellent cosmetic results. No relapse had occurred after a median observation period of 30 months. Immunohistological staining for placental alkaline phosphatase disclosed the absence of TIN in the parenchyma surrounding the cysts. Conclusion The absence of TIN calls into question the common assumption that an epidermoid cyst constitutes a monodermal teratoma. Two distinct entities of epidermoid cyst are proposed ‐ one occurring in conjunction with a teratoma or a germ cell tumour (a ‘complex’ or ‘mixed’ epidermoid cyst) and the other a ‘simple’ epidermoid cyst without TIN in the adjacent tissue and thus representing a benign neoplasm that is not a teratoma. The absence of TIN near a simple epidermoid cyst justifies testis‐sparing surgery.
Dopamine D1and D2receptors in the human ureter and urinary bladder: a radioligand binding and autoradiographic study
Authors: ESCAF S. , CAVALLOTTI C. , RICCI A. , VEGA J.A. , AMENTA F. 
Published: November 2008

ObjectiveTo analyse the pharmacological profile and the anatomical localization of the dopamine D, and D, receptors in sections of the pelvic part of the ureter and of the fundus of the urinary bladder.Patients, materials and methodsSamples of the pelvic part of the ureter and of the fundus of the urinary bladder were taken in men (age range 61k4 years) who were undergoing lower urinary tract surgery. Biochemical characterization and autoradiographical techniques were used on frozen sections of the ureter or the urinary bladder. [3H]‐SCH 23390 was used as a ligand of dopamine D, receptors and [3H]‐spiroperido1 as a ligand of dopamine D2 receptors.Results[3H]‐SCH 2 3 390 and [3H]‐spiroperidol were bound by specific sections of the ureter and of the urinary bladder. The pharmacological profile of the binding was consistent with the labelling of D, and D, receptors respectively. Light microscope analysis of the localization of D1 and D2 receptors revealed the accumulation of the two radioligands in the tunica muscularis of the ureter or of the urinary bladder. Conclusion A possible role of the dopaminergic system in the control of urine flow and of some dysfunctions of the lower urinary tract is suggested.
The scope and place of ultrasound‐monitored extracorporeal shock wave lithotripsy in a multimodality setting and the effects of experiential, audit‐evoked changes on the management of ureteric calculi
Authors: TALATI J. , KHAN L.A. , NOORDZIJ J.W. , MOHAMMAD N. , MEMON A. , HOTIANA M.Z. 
Published: November 2008

Objective To assess the results from ultrasound‐monitored extracorporeal shock wave lithotripsy (ESWL) for ureteric stones, to compare the results with other treatment modalities and to evaluate experiential audit‐evoked gains. Patients and methods A review of the records of 109 patients with ureteric stones who were treated during 1990 (Group I) and 69 patients treated by ESWL during the first 10 months of 1991 (Group II), was carried out. All patients with a steinstrasse or fragments secondary to ESWL were excluded from the study. Results Of the 109 patients in Group I, 63 were treated with ESWL, nine underwent ureteroscopic push‐up of the stone and 11 underwent catheter push‐up prior to ESWL, 28 underwent ureteroscopic extraction/fragmentation, five underwent post‐ESWL ureteros‐copy and 29 underwent open ureterolithotomy (nine after failed ureteroscopy). Ureteroscopy was successful in fragmentation/extraction of 19 of 28 (68%) stones and 95% of patients were stone‐free at 3 months. All patients who underwent ureterolithotomy and 84% who underwent ESWL (and post‐ESWL ancillary procedures) were stone‐free at 3 months. All patients who underwent ureterolithotomy, 51% of those who underwent ureteroscopy and 56% of patients who underwent ESWL needed only one treatment. The mean stone burdens of patients in Groups I and II were comparable but more patients presented with larger stones (< 15 mm length, > 100 mm2 surface area) in Group II. The stone‐free rates for ESWL monotherapy with ESWL increased from 84% in 1990 to 92% in 1991. A higher proportion of stones were treated in situ in 1991 and a stent was used less frequently in obstructed ureters. Post‐ESWL procedures fell from 8% in 1990 to 6% in 1991 and the proportion of patients who required more than one treatment fell from 44% in 1990 to 14% in 1991. Conclusions The choice of treatment for patients with ureteric stones is critical but will vary depending on the individual's circumstances, the availability of equipment, costs and time required to perform the procedure. The results obtained using ESWL for ureteric stones improved considerably over the course of the study as a result of experience and refinement of the technique. Stones located in more difficult systems such as in kidneys with a thin cortex and those located above the ischial spine were no longer subjected to ESWL. Audit of the results obtained following treatment allows identification of problem areas, alerts physicians to alternative methods of treatment and gives an objective quantification of experience, assisting rational decision making with consequent improved success.
In situ echoguided extracorporeal shock wave lithotripsy of ureteric stones with the Dornier MPL 9000: a multicentric study group
Authors: FRABBONI R. , SANTI V. , RONCHI M. , GAIANI S. , COSTANZA N. , FERRARI G. , FERRARI P. , CORRADO G. , CONCETTI S. , FORNAROLA V. 
Published: November 2008

Objective To study the efficacy of the Dornier MPL 9000 lithotripter with a real time ultrasound transducer in the localization and treatment of upper and prevesical ureteric stones. Patients and methods Two‐hundred and eighty‐five patients with pre‐vesical ureteric stones and 247 patients with upper ureteric stones underwent extracorporeal shock wave lithotripsy (ESWL) using ultrasound targeting, under no regional or general anaesthesia. Results At follow‐up after 3 months 9 7% of patients with pre‐vesical stones and 96% with upper ureteric stones were stone free. Ninety‐nine patients were treated more than once. The average number of sessions of ESWL for all patients was 1.19 (1.17 for patients with prevesical stones and 1.22 for those with upper ureteric stones). Ureteric stenting was employed in 6% of cases. The infrequent use of ureteric stenting did not reduce ESWL efficacy, nor increase either the complication or the retreatment rates. In many cases upper urinary tract dilatation was provoked by administering intravenous fluid and a diuretic. Conclusion
In situ echoguided ESWL is a simple, safe and effective technique for treating ureteric stones which can be detected on ultrasound
Pressure, volume and infusion speed criteria for the ice‐water test
Authors: GEIRSSON G. , LINDSTRÖM S. , FALL M. 
Published: November 2008

Objective To define pressure, volume and infusion speed criteria for the ice‐water test (IWT). Patients and methods In this prospective clinical study, cystometry and IWTs were performed in 115 patients. Results The critical response for a positive IWT was found to be a peak detrusor pressure above 30 cm H2O, with or without fluid leakage. Neither the infusion speed nor the infused volume was critical for the outcome of the test provided that the bladder wall was sufficiently cooled. Conclusion The IWT is a rapid, simple and robust test, whose results are easy to interpret. The test increases the precision of urodynamic diagnosis, especially in patients with an overactive detrusor dysfunction, at a small cost.
Abnormalities in p53 and DNA content in transitional cell carcinoma of the bladder
Authors: MELLON K. , WILKINSON S. , VICKERS J. , ROBINSON M.C. , SHENTON B.K. , NEAL D.E. 
Published: November 2008

Objective To determine if transitional cell tumours of the bladder which contain mutations in the p53 gene have alterations in their DNA content. Materials and methods In 33 transitional cell tumours of the bladder, DNA content was determined by flow cytometry and compared with expression of mutant p53 as assessed by immuno‐histochemistry. Results Abnormal DNA content was associated with increased staining for p53 (P < 0.05), high tumour stage (P < 0.001) and increased histological grade (P < 0.01). Although positive staining for p53 was frequently associated with abnormal DNA content, a significant number of non‐diploid tumours stained negatively for mutant p53. Conclusion These data demonstrate that increased staining for p53 is associated with abnormalities in DNA content suggesting that mutation of the p53 gene is associated with an increased rate of chromosomal abnormalities and an increased rate of cell proliferation.
Microsurgical arterio‐arterial and arterio‐venous penile revascularization in patients with pure arteriogenic impotence
Authors: JANSSEN Th. , SARRAMON J.P. , RISCHMANN P. , BENNIS S. , MALAVAUD B. 
Published: November 2008

Objective To restore physiological erection by performing microsurgical penile revascularization. Patients and methods The records of 21 patients with pure arteriogenic impotence were reviewed. Thirteen patients with localized obstruction of the internal pudendal or common penile artery underwent a Michal II arterio‐arterial penile revascularization. Eight patients with a more distal arterial obstruction underwent a penile deep dorsal vein arterialization (DDVA). The mean follow‐up period was 22 months. Surgery was considered successful when the patients had a permeable anastomosis and were able to achieve satisfactory erections resulting in normal intercourse. Results Potency was restored in eight of the 13 patients who had a Michal II procedure and in five of the eight patients who had a DDVA. Under antithrombotic therapy graft occlusion occurred in four patients. Conclusion Microsurgical penile revascularization restored erectile function in two‐thirds of patients in this study. However, further research must be performed to reach a greater understanding of the revascularization process.
The distribution of elastic fibrous elements within the human penis
Authors: HSU G.‐L. , BROCK G. , HEYDEN B. VON , NUNES L. , LUE T.F. , TANAGHO E.A. 
Published: November 2008

Objective To determine the distribution of elastic fibres in the tunica albuginea and the erectile tissue of the penis. Materials and methods Samples of tunica albuginea or penile erectile tissue were taken from seven cadavers and five patients undergoing surgery. Light and electron microscopy were performed. Results There were two anatomical regions in which elastic fibres were seen rarely: the proximal crus and the distal tunica. In the rest of the corpora cavernosa where the tunica was more compliant, the elastic fibres were in relative abundance. In the corpus spongiosum, abundant irregularly oriented elastic fibres were present; the densest elastic network was found in the glans penis and was composed of coarse elastic fibres. A perisinusoidal fibroelastic shell was seen in the glans, which was probably an extension of Buck's fascia. The elastic components within the sinusoids (cavernosal, spongiosal, and glanular) were similar but finer than the elastic lamellae in the penile arterial wall. Conclusion The elastic fibres were unevenly distributed, often forming an irregular network on which the collagen component rested. Elastic fibres were more abundant in the corpus spongiosum, around the blood vessels and surrounding the sinusoid of the corpus cavernosum.
Salvage radical prostatectomy in the management of locally recurrent prostate cancer after 125I implantation
Authors: Brenner P.C. , Russo P. , Wood D.P. , Morse M.J. , Donat S.M. , Fair W.R. 
Published: November 2008

Objective To define the role of salvage prostatectomy in patients who have locally recurrent prostate cancer following pelvic lymph node dissection and 125 implantation. Patients and methods Over 1000 patients underwent 125I implantation for localized prostate cancer at the Memorial Sloan Kettering Cancer Center between 1970 and 1986. Salvage radical prostatectomy was performed in a highly selected group of 10 patients with locally recurrent disease. Results Three of the 10 patients had organ‐confined residual prostate cancer following salvage radical prostatectomy. The remaining seven patients had extra‐prostatic disease including four patients with positive surgical margins. Two patients with organ‐confined disease and one with extracapsular tumour had no evidence of locally recurrent or metastatic disease and continue to have undetectable prostate‐specific antigen (PSA) levels at 50, 44, and 31 months following salvage radical prostatectomy. After a mean follow‐up of 30 months, the remaining seven patients had a rising PSA level consistent with locally persistent and/or metastatic disease (median 5 ng/mL; range 1.0–144). This PSA elevation occurred within 20 months of salvage radical prostatectomy (median 6 months). Two of these patients developed clinically evident bone metastases. Conclusion Salvage radical prostatectomy, although technically feasible in highly selected patients, should not be widely advocated as an effective treatment option for patients with locally recurrent prostate cancer after 125 implantation.
Quality of life 12 months after radical prostatectomy
Authors: Braslis K.G. , Santa‐Cruz C. , Brickman A.L. , Soloway M.S. 
Published: November 2008

Objective To evaluate the impact of radical prostatectomy (RP) upon quality of life (QOL) in patients with prostate cancer. Patients and methods Seventy‐nine patients with prostate cancer were recruited to evaluate the impact of RP upon QOL. The patients comprised two groups: the first group (n= 51) was evaluated 12 months or longer after RP; and the second group (n= 28) was evaluated 1 month prior to RP. All patients completed two previously reported QOL measures: the Functional Living Index Cancer (FLIC) and Profile of Mood States (POMS), and a series of questions which evaluated bladder, bowel and sexual function. Results Comparison of patients before RP with those after RP at 12 month follow‐up revealed significant (P<0.05) deterioration in sexual function, continence and hardship scores following RP while tension scores improved significantly. Although 10 other subscale parameters were analysed, no other differences were observed. Of the 51 post‐RP patients, 46 (90%) stated that given a choice they would have their surgery again. Conclusion The Results reported show that RP has minimal overall impact upon patient QOL. Although minimal voiding and bowel dysfunction was reported, many patients were dissatisfied with post‐operative sexual function.
Emphysematous pyelonephritis in diabetic patients
Authors: Pontin A.R. , Barnes R.D. , Joffe J. , Kahn D. 
Published: November 2008

Objective To determine the clinico‐pathological profile of patients with emphysematous pyelonephritis (EPN). Patients and methods The records of 22 diabetic patients who presented with EPN were reviewed. Results EPN occurred predominantly in female diabetic patients without evidence of ureteric obstruction. The ages of the patients and the duration of the diabetes were variable. EPN occurred in insulin‐dependent as well as non‐insulin‐dependent patients. The patients presented following a prodromal illness of urinary sepsis, with an acute severe illness with symptoms and signs on the affected side. Dehydration and keto‐acidosis were common. The diagnosis was made by recognizing gas in the kidney on an X‐ray or ultrasound. Eighteen patients were subjected to emergency nephrectomy. Conclusions EPN is an uncommon, life‐threatening condition characterized by the production of intraparen‐chymal gas. We believe that vigorous resuscitation and emergency nephrectomy is the treatment of choice.
Distal penile hypospadias repair in children, with complete mobilization of pendulous urethra and triangular glandular flap
Authors: Dindar H. , Çakmak M. , Yucesan S. , Barlas M. 
Published: November 2008

Objective To present a technique for repair of distal hypospadias. Patients and methods Sixteen children (average age 6.6 years) were treated between January 1985 and January 1991. The procedure is described. Results One child developed a mild meatal stenosis and another had a small urethral fistula; both responded to treatment. Results were excellent in the remaining 14 patients. Conclusion This simple operative procedure was successful in the majority of patients and there were only two minor complications.
Ploidy and Tn‐antigen expression in the detection of transitional cell neoplasia in non‐tumour‐bearing patients
Authors: Pinnock C.B. , Roxby D.J. , Ross J.M. , Pozza C.H. , Marshall V.R. 
Published: November 2008

Objective To study the effectiveness of combining DNA ploidy and the blood‐group related membrane antigen Tn as bladder tumour markers which have been individually associated with high tumour grade and poor prognosis. In particular to (i) determine whether use of these two markers would improve tumour detection compared with either alone, particularly of high grade disease and (ii) determine whether intermediate rates of marker expression would occur in bladder cancer patients with no current tumour compared with those with a tumour and a control group with benign prostatic hypertrophy. Patients and methods A total of 102 patients undergoing cystoscopic monitoring for either benign prostatic hyperplasia (BPH) or for transitional cell carcinoma (TCC) at the Repatriation Hospital and Flinders Medical Centre were included in the study. The patients comprised three study groups, those with BPH (n= 37), with TCC but no tumour present (n=38) and those with TCC and a tumour present at cystoscopy (n= 27). Exfoliated cells obtained from bladder washings at cystoscopy were double‐labelled using a monoclonal antibody to the Tn antigen and a DNA stain, pro‐pidium iodide and examined by flow cytometry. Results Rates of marker expression in 2 7 patients with tumours were 30% for Tn antigen, 30% for aneuploidy and 48% for either marker. Marker expression was strongly associated with tumour grade, with no expression at grade 1, 38% (3/8) tumours at grade 2 and 90% (9/10) at grade 3. In patients with a history of bladder tumours but no current tumour, rates were intermediate (30%) compared with patients with current transitional cell carcinoma (42%) and control patients (19%). Conclusion The use of Tn antigen combined with DNA flow cytometry can increase tumour detection, particularly of high grade, aggressive disease. Gradation of expression of these markers across patient groups at increasing risk of a tumour, with intermediate expression in patients with no current tumour, suggests that marker expression may be detecting a pre‐neoplastic stage of the disease, which is not possible with cytology. Given two parallel disease processes for superficial papillary and for high grade disease with invasive potential, the expression of high grade tumour markers in cells from cystoscopically normal bladders may represent a pre‐clinical stage of aggressive disease. The identification of patients at risk of invasive disease using combinations of tumour markers may offer advantages in clinical management, particularly when no tumour is present and therefore no histopatholog‐ical assessment is made.
Kinetic analysis of prostatic volume in patients with stage D prostatic cancer treated with LHRH analogues in relation to prognosis
Authors: Kojima M. , Ohe H. , Watanabe H. 
Published: November 2008

Objective To evaluate the clinical usefulness of the kinetic analysis of prostatic volume in the prognosis of patients with Stage D prostatic cancer treated using Iuteinizing hormone‐releasing hormone (LHRH) analogues. Patients and methods The reduction of prostatic volume was monitored in 12 patients with Stage D prostatic cancer using transrectal ultrasonography (TRUS) after treatment with LHRH analogues. Data obtained from the kinetic analysis of prostatic volume were compared with the prognosis. Results All the patients having a reduction time, τ (derived from the kinetic analysis of prostatic volume change with time), of less than 41 days had neither clinical progression within 15 months nor death caused by prostatic Cancer during the 5‐year followup, while the disease‐specific 5‐year survival rate in patients having a τ of greater than 42 days was as low as 17%. The difference in both the progression and disease‐specific survival between these groups was statistically significant (P<0.05) despite the limited number of patients. In contrast, conventional prognostic parameters showed no significant predictability for prognosis with the exception of prostatic acid phospha‐tase, which correlated strongly with the occurrence of progression within 15 months. Conclusion The kinetic analysis of the change of prostatic volume using TRUS shows promise in the prognosis of the patients with Stage D prostatic cancer.