bluuebunny/crossref_metadata_2025_split huggingface dataset:
Painful Bladder Syndrome—a Clinical and Immunopathological Study
Authors: WITHEROW R. O'N. , GILLESPIE L. , McMULLEN L. , GOLDIN R. D. , WALKER M. M. 
Published: November 2008

Summary—
Painful bladder syndrome is a clinical diagnosis in patients with symptoms of varying severity which always include frequency and suprapubic pain and occasionally include dysuria, nocturia and urgency persisting for more than 3 months with no loss of bladder capacity and no overt infection.Immunofluorescence studies of biopsy specimens in 38 female patients were assessed and correlated with the duration and severity of symptoms, and also with routine histology (including mast cell infiltration and integrity of the glycosaminoglycans layer), in order to assess the role of immunological mechanisms in this distressing condition.The results indicated that submucosal angiogenesis and persistence of antigen‐antibody complex in vessel walls could be responsible for this syndrome.
Estimations of the S Phase Fraction in situ in Transitional Cell Carcinoma of the Renal Pelvis and Ureter with Bromodeoxyuridine Labelling
Authors: NEMOTO R. , HATTORI K. , SASAKI A. , MIYANAGA N. , KOISO K. , HARADA M. 
Published: November 2008

Summary—
This report concerns the estimation of the S phase fraction (SPF) in situ and its value in predicting the malignant potential of transitional cell carcinoma of the renal pelvis and ureter. Eighteen patients with transitional cell carcinoma of the renal pelvis and ureter were given a 0.5 h intravenous infusion of the thymidine analogue bromodeoxyuridine (BrdU) (500 mg) at the time of surgery to label tumour cells in the DNA synthesis phase. The tumour specimens were stained by an indirect immunoperoxidase method using anti‐BrdU monoclonal antibody as the first antibody. The BrdU labelling index, S phase fraction, was determined by counting the number of bromodeoxyuridine labelled cells in the tissue sections.All grade 1 tumours had an S phase fraction lower than 10%. The average S phase fraction for non‐invasive tumour (12 cases) and invasive tumour (6 cases) were 9.7 and 20.9%, respectively. Two patients with rapid spread of ureteric tumour showed an S phase fraction of 18.4 and 22.3%. The results obtained with the S phase fraction were comparable with histological tumour grade and invasive potential. The higher S phase fraction may indicate greater biological malignancy.We believe that determination of the S phase fraction of transitional cell carcinoma of the renal pelvis and ureter offers a new objective and quantitative assay of the biological potential of individual tumours and might have practical value in their management.
Morphological change in the urothelium after electrohydraulic versus pulsed dye laser lithotripsy
Authors: WU T.T. , HSU T.H. , LI A.F. , CHEN M.T. , CHANG L.S. 
Published: November 2008

Objective To observe morphological changes in the urothelium after exposure to laser beam and electrohydraulic spark. Materials and methods The pulse dye laser lithotripter (MDL‐2, Candela Corporation, Boston, USA) and the electrohydraulic lithotripter (AEH‐2, Circon ACMI Corporation Stamford, USA) were used directly on the bladder mucosa in six pigs. Immediately (after treatment, the bladder mucosa was prepared for light microscopic and scanning electron microscopic examination. Results Both electrohydraulic spark and laser beam caused mucosal denudation, submucosal swelling and haemorrhage. There was a positive correlation between the degree of urothelial damage and the power and pulse numbers applied. Conclusion Direct contact of the urothelium in patients treated with laser beam or electrohydraulic spark should be avoided.
Treatment of ureteric stones. Comparison of laser and pneumatic lithotripsy
Authors: NAQVI S.A.A. , KHALIQ M. , ZAFAR M.N. , RIZVI S.A.H. 
Published: November 2008

Objectives To study the treatment of ureteric stones by laser lithotripsy (LL) and pneumatic lithotripsy (PL), and to evaluate the results of the two treatment modalities to assess effectiveness, complications and cost benefits. Patients and methods Between January 1993 and February 1994 200 ureteric stones in 194 patients were fragmented intracorporeally, 48 by LL and 152 by PL. The ages of the patients ranged from 31 to 40 years with a male to female ration 2:1. All procedures were performed under general/regional anaesthetic in a day‐care set‐up. Patients were followed at weekly intervals. Re‐treatment was carried out at 4 weeks where necessary. Results The majority of the stones treated (84%) were in the lower third of the ureter, 69% measured 7–12 mm in diameter, and 61% were composed of calcium oxalate. Ninety‐three per cent of the stones were fragmented in one treatment session. The overall stone‐free status at 4 weeks was 95% for PL and 84% for LL. The non‐fragmentation rate was 10% for LL and 1% for PL. Post‐treatment complications were encountered in 8% of the patients treated by LL and 7% by PL. Conclusions Our experience shows that PL and LL both provide a safe and effective means of performing intracorporeal lithotripsy for smaller ureteric stones. However, PL is more effective in fragmenting larger and harder stones. Moreover, PL is more user‐friendly and highly cost‐effective compared with LL.
Correction of vesico‐ureteric reflux by subureteric fibrin injection in dogs
Authors: TANELI C. , ÖZCAN C. , ÖZDEMIR N. , GÖKDEMIR A. 
Published: November 2008

Objective To study the histological and radiological potential of the biomaterial fibrin in the treatment of vesico‐ureteric reflux by a subureteric injection. Materials and methods For histological studies the bladders of 22 non‐refluxing adult female dogs were exposed and in 20 of these two‐component fibrin glue was injected into the right subureteric intramuscular portion of the bladder and teflon was injected into the lamina propria of the left ureter; two of them acted as controls. Two dogs were killed on alternate days over the course of 21 post‐operative days and the bladders and distal portions of the ureters were examined histologically. For radiological studies micturating cystograms were obtained from 15 female puppies. In only eight puppies was vesico‐ureteric reflux naturally present. In six of these two‐component fibrin was injected into the right and teflon into the left subureteric areas, and in two puppies fibrin was injected into the subureteric areas, while the left sides acted as controls. Micturating cystograms and intravenous urograms were obtained from all puppies 3 weeks post‐operatively. Results Histopathological studies showed persistence of increased amounts of endogenous collagen at the fibrin‐injected sites; at the Teflon‐injected sites a mass surrounded by dense granulation tissue was seen. Radiological studies revealed complete disappearance of reflux in the study group of six fibrin and Teflon‐injected puppies: in two control puppies fibrin was injected into the right subureteric area only; the left sides were left untouched to show that maturation did not play a role in abolishing the spontaneously occuring reflux. Follow‐up intravenous urography showed no evidence of vesico‐ureteric obstruction in the treated ureters. Conclusion Fibrin has the properties of a substance inducing a controlled increase in the number of endogenous collagen fibres.
Repeat testing for haematuria and underlying urological pathology
Authors: LYNCH T. H. , WAYMONT B. , DUNN J. A. , HUGHES M. A. , WALLACE D. M. A. 
Published: November 2008

Objective To assess the incidence of urological pathology in a group of patients referred for the investigation of haematuria and whose symptoms had resolved at the time of investigation. Patients and methods The results from examination of 395 patients attending for investigation of haematuria were analysed. The group comprised 198 men and 197 women with a mean age of 51 years (range 19–73). Results In 220 patients (56%) no evidence of haematuria was detected despite its diagnosis in all patients at the time of referral. One‐hundred and thirteen patients (51%) without detectable haematuria had urological pathology and 16 of these (14%) had an underlying malignancy in the urinary tract. Conclusion Repeat urine analysis to determine whether haematuria persists has been considered as a way to define a high risk group which requires urgent investigation. Our results clearly indicate that the finding of haematuria, even in one urine specimen, warrants full urological assessment.
Transrectal ultrasonography to assess local extent of prostatic cancer before radical prostatectomy
Authors: RØRVIK J. , HALVORSEN O. J. , SERVOLL E. , HAUKAAS S. 
Published: November 2008

Objective To evaluate transrectal ultrasonography (TRUS) with a 7 mHz rotating probe as a staging procedure in 33 patients with localized prostatic carcinoma.Patients and methods The ultrasound scans were compared to histopathological whole‐mount step sections of the surgical specimens. Twenty‐five of the patients had tumours with pathological stage T3 (pT3) and eight had tumours with stage pT2 giving a prevalence of extracapsular growth of 0.76.Results The overall sensitivity, specificity, positive and negative predictive values for detection of extracapsular tumour growth by TRUS of prostatic cancer were found to be 0.68, 0.63, 0.85 and 0.38, respectively. Six tumours showed solely microscopic foci of extracapsular tumour growth.Conclusion This technique gives a high percentage of both understaging (32%) and overstaging (37%) and therefore TRUS is an unreliable tool in the staging protocol prior to radical prostatectomy.
Role of penile vascular injury in erectile dysfunction after radical prostatectomy
Authors: ABOSEIF S. , SHINOHARA K. , BREZA J. , BENARD F. , NARAYAN P. 
Published: November 2008

Objective To investigate the cause of erectile dysfunction after nerve‐sparing radical prostatectomy for clinically localized adenocarcinoma of the prostate (stage A or B).Patients and methods Erectile function was evaluated in 20 patients, mean age 65 years (range 44–74), both pre‐operatively and 1 year after surgery by intracavernosal injection of a vasoactive agent (papaverine hydrochloride or prostaglandin E1) and pulsed Doppler ultrasonography. The degree of erection, the size of the cavernosal artery and penile arterial blood flow velocity were assessedResults Results revealed that the decreased response to intracavernosal injection of a vasoactive agent was associated with a significant reduction in both the diameter and velocity of blood flow within cavernosal arteries in 40% of patients after surgery. The pathological stage of the tumour did not correlate with the degree of vascular injury.Conclusion We conclude that post‐prostatectomy impotence is multifactorial but vascular injury plays a substantial role.
Xanthogranulomatous pyelonephritis in childhood: pre‐operative diagnosis is possible
Authors: HAMMADEH M.Y. , NICHOLLS G. , CALDER C.J. , BUICK R.G. , GORNALL P. , CORKERY J. J. 
Published: November 2008

Objective To diagnose xanthogranulomatous pyelonephritis (XGP) in childhood pre‐operatively.Patients and methods Eleven cases of XGP presenting to Birmingham Children's Hospital over a 10‐year‐period are reported. Nine (82%) were diagnosed pre‐operatively on the clinical and radiological findings.Results The characteristic clinical findings were urinary tract infection (9 cases), palpable renal mass (8 cases) and anaemia (8 cases). The most common radiological findings were enlarged kidney (9 cases), renal calculi (7 cases) and non‐functioning kidney (6 cases). Renal ultrasound typically demonstrated a central echoic area (6 cases) and multiple hypoechoic areas in the parenchyma (7 cases). A computed tomography (CT) scan was performed in three cases. This showed characteristic multiple, low attenuation, unenhanced areas within the parenchyma with extension of the inflammatory process into peri‐nephric fat (two cases). Ten cases (91%) were of the diffuse type. There was extension into the peri‐nephric fat in eight cases (73%). Three cases (27%) were associated with congenital urological abnormalities. Nephrectomy was performed in 10 cases and a partial nephrectomy in one.Conclusion XGP is uncommon in childhood but should always be considered in the differential diagnosis of renal masses, especially in the presence of anaemia. Nephrectomy usually results in a permanent cure.
The significance of vesicoureteric reflux on kidney development assessed by dimercaptosuccinate renal scintigraphy
Authors: WALLIN L. , BAJC M. 
Published: November 2008

Objective To study the influence of vesicoureteric reflux on kidney parenchyma and renal length, and identify typical distribution patterns by dimercaptosuccinate (DMSA) renal scintigraphy.Patients and methods DMSA renal scintigraphies in 101 children (152 renal units) with vesicoureteric reflux grade 1–5 were reviewed.Results Three main types of pathological DMSA patterns were found: (i) dysplasia; (ii) medial defect; and (ill) pole defects. In children with no history of pyelonephritis a normal distribution pattern was found in 31%, dysplasia in 23%, medial defect in 25%, pole defects in 17% and no typical pattern in 4%. In those with a history of pyelonephritis a normal distribution pattern was found in 28%, dysplasia in 24%, medial defect in 21%, pole defects in 24% and no typical pattern in 3%. A normal pattern was significantly more frequent in kidneys with reflux grade 1–2. Dysplasia was significantly more frequent in kidneys with reflux grade 4–5. In children with no history of pyelonephritis 42% of the renal units had reduced length, 8% with no other sign of pathology. The frequency of reduced kidney length at reflux grade 1–2 did not differ significantly from that at higher grades of reflux. In children with a history of pyelonephritis 52% of the renal units had reduced length, 13% with no other sign of pathology. The frequency of reduced kidney length with a normal DMSA pattern did not differ significantly from that with a pathological pattern.Conclusion The pathological DMSA distribution with vesicoureteric reflux generally conforms to one of three main patterns. Reduced kidney length is frequent even at lower grades of vesicoureteric reflux even in patients with no history of pyelonephritis, and can be the only sign of pathology.
Intravesical bacille Calmette‐Guérin in the treatment of superficial transitional cell carcinoma of the bladder
Authors: ROGERSON J.W. 
Published: November 2008

Objective To determine the efficacy of intravesical bacillus Calmette‐Guérin (BCG) in the treatment of patients with superficial transitional cell carcinoma (TCC) of the bladder, and to assess the impact of fibrin clot inhibitors.Patients and methods A retrospective review of 56 patients with superficial TCC of the bladder, treated with intravesical BCG after initial transurethral resection (TUR) of raised or papillary lesions or cold cup biopsy of areas of carcinoma in situ (CIS), was performed. Patient drug histories were reviewed for evidence of ingestion of medication known to inhibit fibrin clot formation. The impact of such medication was assessed using the Chi‐square test.Results Fifty‐six patients were treated between 1987 and 1991 of whom 52 were evaluable. Eighteen patients (35%) had a complete response with a mean follow‐up of 19 months. Six patients (60%) in the group with CIS had a complete response rate with a mean follow‐up of 28 months. Seven patients (13%) developed local progression and required cystectomy or external beam radiotherapy. Six patients (12%) died from metastatic disease. Three patients (6%) had significant complications. The adverse impact of fibrin clot inhibitors was found to be significant.Conclusion Intravesical BCG is effective in the treatment of superficial TCC, especially CIS. A careful drug history is important to identify fibrin clot inhibitors so that, if possible, they may be withdrawn prior to intravesical BCG treatment.
Transurethral resection of the prostate for benign prostatic hypertrophy: factors associated with a successful outcome at 1 year
Authors: DOLL H.A. , BLACK N.A. , McPHERSON K. 
Published: November 2008

Objective To investigate which patient and health service factors are predictive of outcome following transurethral resection for benign prostatic hypertrophy.Patients and methods A total of 388 men were assessed before and 3, 6 and 12 months following surgery. Twenty‐one patient characteristics and 12 health service factors were considered. Successful outcome was assessed in terms of avoidance of adverse effects of the operation (survival, lack of early complications and later problems) and improvement in symptoms, health status (assessed in three ways) and quality of life. An overall assessment based on all eight outcome measures was also used. Relationships between possible predictors and outcome were explored whilst controlling for three potential confounders: age, diagnostic category and co‐morbidity. A linear logistic model was employed.Results Patients who had severe pre‐operative symptoms but who otherwise enjoyed good health gained the most benefit from surgery. Generally speaking, outcome was not associated with any of the 12 health service factors studied.Conclusion The results support the policy of watchful waiting for mild or moderately symptomatic patients as even if surgery becomes necessary because of a deterioration in the condition, the benefit resulting will be greater. However, any benefits of waiting for surgery would have to be balanced against any increase in urinary tract pathology or co‐morbidity that men may suffer whilst waiting, as these will increase the likelihood of an adverse outcome of surgery. The question of whether to wait or not will only finally be resolved by means of a randomized controlled trial comparing transurethral resection of the prostate with watchful waiting.
Rapid processing in the management of prostatic cancer
Authors: MORRIS S.B. , HAMPSON S.J. , SHEARER R.J. , CORBISHLEY C.M. 
Published: November 2008

Objective To carry out rapid histological processing of prostatic biopsies for the management of patients who present with urinary retention or other urological problems, or with a suspected diagnosis of prostatic cancer.Patients and methods Biopsies were taken from each of 26 patients who presented with urinary retention or other urological problems, or with a suspected diagnosis of prostatic cancer. The biopsies were processed in a Shandon Hypercenter using a 3‐hour programme and were stained on a Shandon Linistainer automatic staining machine. The slides were reviewed both immediately and at weekly histopathology audit meetings.Results Results were available within 4 h of receipt of the specimen in the laboratory. One false negative, due to a sampling error at the time of biopsy, was identified.Conclusion We believe that this facility is of benefit to both surgeon and patient and should be more widely available.
Symptomatology of metastatic prostate cancer: prognostic significance
Authors: RANA A. , CHISHOLM G.D. , RASHWAN H.M. , SALIM A. , MERRICK M.V. , ELTON R.A. 
Published: November 2008

Objective To identify the various presenting symptoms in patients with metastatic prostate cancer, quantify the metastatic load for each symptom group and compare their case‐specific survival.Patients and methods A prospective and consecutive series of 279 men with metastatic cancer of the prostate was analysed. Based on the symptom at presentation, six different groups were identified: bladder outflow obstruction, bone pain, anaemia, weight loss, paraplegia and alteration of bowel habit.Results Significant variations were observed in their metastatic load (Kruskal‐Wallis test, P= 0.003 5) and in case‐specific survival (log‐rank test, P = 0.0038).Conclusion Bladder outflow obstruction, bone pain and anaemia not only dictate treatment selection but we provide evidence that each of these symptoms has considerable prognostic significance in patients with metastatic cancer of the prostate.
Serum level of immunosuppressive acidic protein in haemodialysis patients with or without renal cell carcinoma
Authors: SASAGAWA I. , NAKADA T. , KUBOTA Y. , SUZUKI H. , SAWAMURA T. 
Published: November 2008

Objective To assess the significance of immunosuppressive acidic protein (IAP) for detection of renal cell carcinoma in patients undergoing haemodialysis. Patients and methods The serum concentration of both IAP and creatinine was measured in 74 patients undergoing haemodialysis, 10 of whom had renal cell carcinoma and 64 of whom had no renal cell carcinoma. Control data was obtained from 13 healthy blood donors. Results The serum IAP level of patients undergoing haemodialysis was significantly elevated compared with that of the controls. The serum level of IAP inpatients with renal cell carcinoma who were undergoing haemodialysis was also considerably higher than that of patients with no renal cell carcinoma. The serum creatinine levels were not significantly different between patients with and without renal cell carcinoma but were significantly elevated when compared with the controls. Conclusion The measurement of serum IAP concentration is of value in the detection of renal cell carcinoma in patients undergoing haemodialysis.
Urinary calcium oxalate saturation in ‘stone formers' and normal subjects: an application of the EQUIL2 program
Authors: ROBERT M. , BOULARAN A. M. , COLETTE C. , AVEROUS M. , MONNIER M. 
Published: November 2008

Objective To produce an index of lithogenic risk which identifies patients at risk of stone recurrence and facilitates the monitoring of prophylactic treatments. Patients and methods The EQUIL2, program provides an evaluation of the state of urinary saturation, particularly of calcium oxalate, based on the pH and total concentrations (mmol/l) of sodium, potassium, calcium, magnesium, uric acid, chloride, ammonium, citrate, phosphate, sulphate, oxalate, pyrophosphate and carbon dioxide. The morning urinary calcium oxalate saturation coefficient was thus calculated for 30 stone‐formers (Group 1) and 30 normal control subjects (Group 2). Results Urine from the majority of individuals was saturated, with no significant difference between the two groups. There appeared to be a correlation between the state of saturation and the urinary calcium oxalate molar product in both stone‐formers (r =0.931) and controls (r=0.914). Conclusion In future studies on urinary calcium oxalate saturation, it should be possible to supplement the sophisticated coefficient determined by the EQUIL, program with the molar product, except in cases where monitoring therapies have little or no effect on urinary oxalate or urinary calcium levels.
P53 expression, ploidy and progression in pTl transitional cell carcinoma of the bladder
Authors: THOMAS D.J. , ROBINSON M.C. , CHARLTON R. , WILKINSON S. , SHENTON B.K. , NEAL D.E. 
Published: November 2008

Objective To investigate a potential role for overexpres‐sion of the p53 protein in the identification of pTl bladder tumours destined to progress. Patients and methods The protein expression of the tumour suppressor gene p53, nuclear ploidy and tumour grade were studied in 25 patients with pTl bladder tumours. Follow‐up data was available for 21 tumours over a 10 year period. p53 expression was determined by immuno‐histochemistry on paraffin embedded sections and flow cytometry was performed on cell suspensions derived from the same blocks.zResults Ten of 21 (48%) tumours progressed to muscle invasive disease. Nuclear staining for the protein was seen in 16 (64%) tumours and of these nine (56%) progressed. All tumours with abnormal DNA content and all high grade tumours demonstrated overexpression of p53. Significantly more patients with high levels of p53 expression (> 10% nuclear staining) progressed compared with tumours with less than 10% of nuclei staining (P= 0.007). However, grade was the most specific predictor of progression (100%), with all grade 3 tumours progressing and grade was also the most significant prognostic indicator in terms of survival (P= 0.025). Conclusion Tumour grade is likely to remain as the most useful aid to management decisions in pTl bladder tumours.