bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital Subtraction Angiography of the Kidney
Authors: GATTONI F. , AVOGADRO ANDREA , BALDINI U. , POZZATO C. , BONFANTI MARIA T. , GANDINI DANIELA , FRANCH L. , USLENGHI C. 
Published: November 2008

Summary— Intravenous and intra‐arterial digital subtraction angiography (DSA) was performed in 88 patients: 34 with tumours, 10 with renal trauma, 26 with suspected renovascular hypertension, 6 with vascular impression on the renal pelvis, 8 with nephrolithiasis and 4 with sonographically abnormal kidneys. Venous and arterial DSA always gave diagnostically useful images. Intravenous DSA is valuable in patients with suspected renovascular hypertension or after vascular surgery, percutaneous transluminal angioplasty and transcatheter embolisation.Arterial DSA is preferable to venous DSA in other clinical situations, particularly in the evaluation of renal tumours, and may be recommended in preference to conventional angiography.
Antenatal Diagnosis of Congenital Abnormalities in the Urinary Tract Results from the Northern Region Fetal Abnormality Survey
Authors: SCOTT J. E. S. , RENWICK M. 
Published: November 2008

Summary— One hundred and sixty‐two cases of suspected congenital abnormalities of the urinary tract notified to the Northern Region Fetal Abnormality Survey Register between the beginning of 1984 and the end of 1986 were studied. These cases represented 14.3% of total notifications, which in turn were 0.93% of total births. There were a further 25 cases notified but not due for delivery until early 1987; 10 of these were urological.Thirty‐five cases (22%) notified proved postnatally to have normal urinary tracts and 21 (13.2%) had unsuspected urinary tract abnormalities.Of the 106 cases in which a suspected urinary tract abnormality was confirmed postnatally, confirmation was obtained at perinatal death in 32 and by ultrasound, radiographic and radioisotope investigation in the remainder; 34.5% of all urological cases registered and 75% of the confirmed survivors were treated surgically.The urological abnormality most frequently missed was posterior urethral valves.Attempts to diagnose the fetal sex were seldom made but when they were the prediction was usually male and usually correct.The perinatal mortality in this group was 0.43/1000 births, a contribution of nearly 4% to overall perinatal mortality in the Northern Region.
Installation and Use of a Neodymium‐YAG Laser In a Urology Department
Authors: ARKELL D. G. , RANDALL J. 
Published: November 2008

Summary— We report our experience in setting up a urological laser unit. An operating theatre was upgraded to include the required safety features and a neodymium‐YAG laser was installed. A preliminary study using cadaver bladders was performed to establish the technique of cystoscopic laser application. We treated 55 bladder tumours in 12 patients by laser coagulation, with total destruction of 54 tumours and no serious complications; 6 patients developed recurrent tumours.Twenty‐one patients underwent surgery with the contact laser scalpel. The instrument proved slow but effective, with excellent haemostasis and almost painless wounds. Healing was delayed in 2 cases but there were no wound infections. All wounds healed with good cosmetic scars.The neodymium‐YAG laser is an effective means of destroying superficial non‐invasive bladder tumours endoscopically and can also be used in conjunction with a laser scalpel for open surgery.
Experience with the Brindley Anterior Sacral Root Stimulator
Authors: ROBINSON L. Q. , GRANT A. , WESTON P. , STEPHENSON T. P. , LUCAS M. , THOMAS D. G. 
Published: November 2008

Summary— Brindley anterior sacral root stimulators have been implanted into 22 spinal cord injured patients from the spinal injury units in Cardiff and Sheffield. The group comprised 20 men and 2 women (15 paraplegics and 7 tetraplegics); 16 patients are using the implant, of whom 11 (68%) are continent. Of the remaining 5, 4, who empty completely, are incontinent because of inability to use the implant with sufficient frequency; 6 patients are not using their implant, though 4 are continent. Of 11 patients with detrusor/sphincter dyssynergia, sphincterotomy was necessary in 3 patients before implantation and in a further 3 after implantation. Of 4 patients with abnormal upper tracts prior to implantation, 2 resolved and 2 deteriorated, in the presence of dyssynergia; 1 patient developed hydronephrosis after implantation, having previously had normal upper tracts.Although erectile function with the stimulator was clinically adequate in 6 patients, in no patient has intercourse been achieved because of concurrent lower limb spasm.
Comparative Study of the Clinical Usefulness of Prostate Specific Antigen and Prostatic Acid Phosphatase in Prostatic Disease
Authors: BUAMAH P. K. , JOHNSON P. , SKILLEN A. W. 
Published: November 2008

Summary— The clinical usefulness of prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) activity measurements has been compared in 45 patients with benign prostatic hyperplasia (BPH) and 132 patients with prostatic carcinoma (PC), 21 of whom had metastatic disease (MPC) and 111 of whom had intracapsular cancer. No BPH patient had increased PAP but 47% had increased PSA. Of the PC patients only 27% had increased PAP and 70% increased PSA. All of the MPC patients had increased PSA but only 62% had increased PAP. Increased PAP was found only in MPC but increased PSA was also found in BPH.In identifying PC, the predictive value of an increased PSA concentration is 83% and an increased PAP activity is 100%. On the other hand, the predictive value of a normal PSA concentration is 51% and of a normal PAP activity only 34%. As the PAP test is much less efficient than the PSA test, it should be discontinued.
The Value of Ultrasound Screening of the Upper Urinary Tract in Hypospadias
Authors: DAVENPORT M. , MacKINNON A. E. 
Published: November 2008

Summary— Renal tract ultrasonography was performed in 82 of 111 patients with varying degrees of hypospadias.There were 2 true positive results (2.4%) and 1 false negative (1.2%). However, 2 of these patients would have been fully investigated because of the presence of an anorectal anomaly. The third boy had a pelvic ectopic kidney with no clinical significance.It was concluded that routine ultrasonography is not justified in this condition unless it is severe or there is an associated anomaly.
Treatment of Vesicoureteric Reflux: Preliminary Report of a Prospective Study
Authors: SCHOLTMEIJER R. J. , GRIFFITHS D. J. 
Published: November 2008

Summary— Between 1982 and 1986 95 children with non‐obstructive vesicoureteric reflux were treated in a prospective study. Preliminary results are reported on 94 children with 137 refluxing ureters and a follow‐up period of at least 18 months. All children with reflux grade III or less had antibiotic treatment only. Those with reflux grade IV were randomised for antibiotic treatment alone versus surgery plus antibiotic treatment, while the primary treatment of reflux grade V was reimplantation.In 91 ureters treated by antibiotics alone, reflux disappeared in 49 cases; in 20 cases the grade of reflux was reduced. In 46 ureters treated by reimplantation, reflux was cured in 40 cases and no severe ureteric obstruction was seen. Conservative management of reflux grade IV seems to be less successful than surgery.The results of conservative, non‐surgical treatment of reflux grades I to Ill are satisfactory, but for grades IV and V reflux surgery seems to be the treatment of choice if detrusor instability can be excluded.
The Problems of Substitution Cystoplasty
Authors: NURSE D. E. , McCRAE P. , STEPHENSON T. P. , MUNDY A. R. 
Published: November 2008

Summary— Substitution cystoplasty was performed in 157 patients aged 4 to 71 years; 62% suffered no post‐operative complication. The commonest complication was sphincter‐weakness incontinence, found in 18%, mainly in patients having a cystoplasty for interstitial cystitis; it was rare for the patient to complain of this incontinence. Ten per cent suffered incontinence due to colonic overactivity and this occurred in patients with neuropathic sphincter‐weakness incontinence or an artificial sphincter; all of these patients complained of their incontinence. This was corrected by “patching” in all cases. Voiding difficulties requiring clean intermittent self‐catheterisation occurred in 15%. More worrying was the universal finding, when looked for by blood gas analysis, of a metabolic acidosis with respiratory compensation.It was concluded that in the absence of neuropathy, sphincter weakness or an artificial sphincter, an unmodified ileocaecal segment substitution cystoplasty is adequate; in the presence of neuropathy, sphincter weakness or an artificial sphincter, a “pouch” type of substitution cystoplasty should be performed. All patients should have blood gas analyses from time to time as part of their routine post‐operative follow‐up.
The Enigma of Interstitial Cystitis—an Autoimmune Disease?
Authors: ANDERSON J. B. , PARIVAR F. , LEE G. , WALLINGTON T. B. , MacIVER A. G. , BRADBROOK R. A. , GINGELL J. C. 
Published: November 2008

Summary— Interstitial cystitis (IC) is characterised by recurrent inflammation and destruction of bladder tissue without obvious cause. To determine whether this self‐perpetuating disease is the result of an autoimmune disorder, we studied 26 patients with IC of mean duration 5 years and compared the results with those of a control group of similar age and sex with other urological complaints.We performed a standard autoimmune profile and looked for specific antibodies to normal human bladder in the serum, using an indirect immunofluorescence technique. Deep bladder biopsies were examined by conventional histology and cryostat sections were studied with peroxidase‐conjugated anti‐human antibodies in a search for immunoglobulin deposition within the bladder.Seventeen of 26 patients with IC (65%) and 5 of 14 controls (36%) demonstrated non‐organ‐specific antibodies; 40% of those with IC had anti‐nuclear antibodies; 18 IC patients (75%) and 4 of 10 controls (40%) had anti‐bladder antibodies present in the serum, but 5 healthy volunteers showed no such antibody activity. There was no statistically significant difference between the two groups for either type of antibody (Fisher's exact test). Only 5 of 17 patients with IC (29%) showed immunoglobulin deposition in the bladder epithelium, a similar proportion to controls (38%); 4 of these 5 had circulating anti‐bladder antibodies present in the serum.Although IC patients demonstrated a non‐specific increase in antibody formation, this was not significantly different from a similar group of other urological patients. The lack of specificity makes this immunological response more likely to be a secondary phenomenon associated with inflammatory damage to the bladder rather than the primary cause of the disease.
Volatile N‐nitrosamines in Urinary Catheters
Authors: HEENAN M. P. , NACEY J. N. , DELAHUNT B. , FERGUSON A. F. , DICKSON S. J. 
Published: November 2008

Summary— Levels of volatile N‐nitrosamines were measured in 10 brands of latex and 2 brands of silicone catheters using high performance liquid chromatography. The cytotoxicity of catheters from identical batches was determined by measuring the inhibitory effect of catheter extracts on the uptake of 3H‐labelled thymidine into L‐929 fibroblasts in culture (IC50).The most frequently encountered nitrosamines were N‐nitrosodi‐n‐butylamine and N‐nitrosodiethylamine. Total N‐nitrosamine levels in excess of 100 ng/g were found in 6 of the 16 catheters tested. When compared with the cytotoxicity of the catheters a significant correlation was found, with increasing nitrosamine content being associated with greater cytotoxicity. In view of the reported toxic and carcinogenic effects of these compounds it is suggested that the nitrosamine content of catheters be routinely monitored and safe regulatory limits be imposed.
Metabolic Complications of Cystoplasty
Authors: NURSE D. E. , MUNDY A. R. 
Published: November 2008

Summary— A series of 48 patients with intestinal segments incorporated into the urinary tract underwent assessment of acid‐base and electrolyte balance. All patients had abnormal blood gas analyses, usually a metabolic acidosis with respiratory compensation; 33% had hyperchloraemia. Radioisotope studies using sodium, potassium and bromine showed that all were absorbed and that absorption was unaffected by renal function.The results suggest that all such patients, but particularly women and children, may be at risk of the secondary effects of chronic acidosis, especially skeletal demineralisation, unless some compensatory mechanism is working to offset the effects of the acidosis.
Blood Group Antigen Expression in Frozen Sections of Presenting Bladder Cancer: 3‐year Prospective Follow‐up of Prognostic Value
Authors: ABEL P. D. , THORPE SUSAN J. , WILLIAMS GORDON 
Published: November 2008

Summary— Blood group antigen (BGA) expression was studied on frozen sections from the initial, presenting, transitional cell bladder cancers of 73 patients. Clinical follow‐up was prospective and, after 3 years, 59 patients were available for assessment. Of 32 tumours that retained substantial BGA (BGA+ and BGA±), 11 progressed. Of 27 tumours with < 5%or undetectable BGA expression (BGA‐), 14 did not progress.Of 24 pTa tumours, 17 had substantial BGA expression and 7 were BGA‐; 5 patients progressed, 4 substantially BGA positive and 1 BGA‐, all to category pT1; 15 tumours were category pT1, 7 substantially BGA positive and 8 BGA‐; 7 patients progressed, 1 substantially BGA positive and 6 BGA‐, all of whom died from bladder cancer; 20 were pT2 or deeper, 8 substantially BGA positive and 12 BGA‐; 12 patients progressed, 6 substantially BGA positive and 6 BGA‐, all of whom died from bladder cancer.Despite improved understanding of the biochemistry and techniques of detection of BGA, these results preclude the use of BGA determination as a guide to prognosis in individual transitional cell carcinoma, whether used alone or in combination with pT category.
Proteinuria‐What Value is the Dipstick?
Authors: HARRISON N. A. , RAINFORD D. J. , WHITE G. A. , CULLEN S. A. , STRIKE P. W. 
Published: November 2008

Summary— The value of the urinary dipstick in the assessment of proteinuria was investigated in a study correlating laboratory measurements of protein and albumin against the dipstick protein in the same samples of urine; 94 patients (100 admissions) were studied at the Royal Air Force Renal Unit, each patient collecting two 24‐h urine samples. Along with each 24‐h sample, 10‐ml aliquots of urine were obtained at 3 designated times during the day for both ward dipstick testing and laboratory assay; + or more on the dipstick correlated with abnormal proteinuria (≥ 150 mg/24 h) in 88% of cases, whilst trace values straddled the level of significant proteinuria. Further differentiation of trace was possible by repeat testing during the day. The subsequent presence of a dipstick negative during that day correlated with normality in all but 5% of cases.In order to ensure detection of renal disease presenting as isolated orthostatic proteinuria, assay of the mid‐morning sample is recommended.
Lack of Effect of Cholinergic Blocking and Alpha‐adrenergic Stimulation on Nocturnal Incontinence After Ileocaecal Bladder Replacement
Authors: JAKOBSEN H. , STEVEN K. 
Published: November 2008

Summary— A controlled randomised trial was carried out in 9 patients to examine the possibility of achieving nocturnal continence after ileocaecal bladder replacement by reducing the amplitude of the peristaltic contractions and by increasing the maximum urethral pressure pharmacologically. The trial consisted of 4 treatment periods, each of 2 weeks' duration: a single‐blind placebo period was followed by 3 double‐blind periods with phenylpropanolamine hydrochloride 50 mg bd (Kontexin), oxybutynin chloride 5 mg tid (Ditropan), and combined treatment. Each patient completed a frequency/volume chart before the trial and for the last 7 days of each treatment period. Filling and storage urethrocystometry was performed before treatment and at the end of each treatment period.Treatment with phenylpropanolamine and oxybutynin failed to reduce the nocturnal urine leak of about 600 ml. Treatment did not influence the maximum urethral closure pressure, which remained unchanged at about 16 cm of water with the bladder substitute at rest and filled to its maximum cystometric capacity. At storage urethrocystometry, the treatment resulted in a decrease in the amplitude of the peristaltic contractions of about 10 cm of water to approximately 45 cm of water. Accordingly, the effect of alpha‐adrenergic stimulation and anticholinergic suppression was found to be insufficient to achieve nocturnal continence in patients with ileocaecal bladder replacement.
Comparison of Stamey and Pereyra‐Raz Bladder Neck Suspensions
Authors: SHAH P. J. R. , HOLDER P. D. 
Published: November 2008

Summary— Endoscopic bladder neck suspension has become one of the more popular methods of surgical treatment of stress incontinence. The Pereyra technique was first described in 1959 and modified by Razin 1981. Stamey first described his technique in 1973 and this has been modified in a number of ways. The reported cure rates are 54 to 94% for the Pereyra‐Raz procedure and 61 to 92% for the Stamey procedure.We present a comparative review of the technical results of treatment of 30 patients with a modified Stamey procedure and 17 patients with a modified Pereyra‐Raz technique. The age range of the 2 groups was comparable. A successful result, with either complete continence or only minor occasional leaks after surgery, was achieved in 80% with the Stamey techniques and 76% with the Pereyra technique. Those patients not helped by the procedure had nearly all undergone previous surgery for incontinence. The Pereyra technique was used more frequently in patients who had failed previous incontinence surgery (including the Stamey technique). Complications were minor; 5 buffer infections occurred (3 buffers were removed).Both techniques offer a significant improvement in continence, but previous surgery is associated with a higher failure rate.
Prostate Specific Antigen—a Screening Test for Prostatic Cancer?
Authors: POWELL C. S. , FIELDING A. M. , ROSSER K. , AMES A. C. , VAUGHTON K. C. 
Published: November 2008

Summary— A series of 287 patients referred by their family doctors with symptoms of bladder outflow obstruction were asked to attend the hospital for “pre‐clinic” screening for carcinoma of prostate (CaP). Blood samples were collected from 211 patients and analysed for serum prostate specific antigen (PSA) and prostatic acid phosphatase (PAP).Thirty‐six patients had a serum PSA > 10 μg/l and 7 had PAP levels > 5 iu/l. In no instance was the PAP elevated without an associated increase in PSA concentration. Patients with raised markers underwent further investigations which included prostatic biopsy and/or resection; 17 patients were proved to have carcinoma of the prostate, 9 of whom had distant metastases. The specificity of PSA for detecting prostate cancer in this study was 90% with a sensitivity of 89.5%, in contrast to values for PAP of 100% and 36.8%.The routine use of PAP as a marker for prostatic cancer should be abandoned. The use of PSA as a screening test in a group of patients with prostatism appears justified, but with a positive predictive value of only 47%, its use in a mass unselected screening programme is not recommended.
Does Extracorporeal Shockwave Lithotripsy Cause Hypertension?
Authors: MONTGOMERY B. S. I. , COLE R. S. , PALFREY E. L. H. , SHUTTLEWORTH K. E. D. 
Published: November 2008

Summary— Several series have suggested that the incidence of hypertension following extracorporeal Shockwave lithotripsy (ESWL) may be as high as 8%. In this study, changes in blood pressure and the incidence of hypertension have been observed in 733 patients 12 to 44 months after renal ESWL on the Dornier HM3.The incidence of hypertension following ESWL was 8.1%. In patients with a pre‐ESWL diastolic pressure < 90 mmHg, the incidence of those with a diastolic > 100 mm Hgpost‐operatively was significantly greater than that predicted by historical data. There was no overall change in the mean blood pressure of the group.The hypertensive risk of ESWL remains unclear. However, blood pressure surveillance should be performed following ESWL and a prospective study is required.
Effects of Simple Hysterectomy on Vesicourethral Func
Authors: PARYS B. T. , HAYLEN B. T. , HUTTON JANE L. , PARSONS K. F. 
Published: November 2008

Summary— Many women who present with symptoms of bladder dysfunction relate the onset to the operation of simple hysterectomy.A group of 42 women undergoing simple hysterectomy was studied prospectively. Urinary symptoms, urodynamic findings and sacral reflex latencies (SRLs) were assessed pre‐and postoperatively.After hysterectomy the incidence of urinary symptoms increased from 58.3 to 75.0%. Vesicourethral dysfunction was altered in 30.6% of patients, 72.7% of whom had evidence of pelvic neuropathy as detected by SRLs.The results show that simple hysterectomy is associated with a significant incidence of postoperative vesicourethral dysfunction and that there is an identifiable neurological abnormality incurred at operation which is pertinent to the subsequent disordered voiding.
Are Prophylactic Antibiotics Necessary during Extracorporeal Shockwave Lithotripsy?
Authors: PETTERSSON B. , TISELIUS H.‐G. 
Published: November 2008

Summary—
A randomised clinical study was carried out on patients admitted for ESWL treatment in order to establish the requirement for prophylactic treatment with antibiotics during this procedure. Patients with clinical signs of urinary tract infection, evidence of infectious stones or a positive urine culture were excluded. All other patients were consecutively randomised into 3 groups which were given either trimethoprim + sulphamethoxazole or mecillinam (Group A), methenamine hippurate (Group B), or no treatment at all (Group C). Evaluation with respect to clinical signs of infection was done immediately after the treatment and 4 weeks later. In addition, a urine culture was performed 2 weeks after ESWL, i.e. 1 week after completing treatment with antibiotics and methenamine hippurate.With respect to infectious complications there were no differences between Groups A and C, between Groups B and C or between Group A and B + C, whereas an unexplained slightly higher infectious rate was recorded for Group B compared with Group A. In all patients the occurrence of bacteriuria was low (6.7%) despite the fact that almost 30% of patients had a ureteric catheter during the ESWL procedure. Patients with ureteric catheters did not present with more infectious complications than those without. All patients had a bladder catheter during ESWL. It was concluded that prophylactic treatment with antibiotics during ESWL treatment is unnecessary in all situations where an infectious aetiology is unlikely.
Allograft Nephrectomy—a 16‐year Experience
Authors: SHARMA D. K. , PANDEY A. P. , NATHNAN V. , Gopalakrishnan G. 
Published: November 2008

Summary—
A review has been made of the indications, technical problems, complications and results of 31 allograft nephrectomies in 29 patients; 12 patients died between 15 days and 1 month after graft nephrectomy, which was undertaken within 6 months of transplantation.Gross local and general complications occurred in 7 patients who survived graft nephrectomy. The procedure is recommended when graft failure occurs within 6 months of transplatation provided it is associated with systemic signs of severe rejection or sepsis, or if it occurs in cases where continuation of immunosuppressants is life‐threatening.