bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE CONSERVATIVE TREATMENT OF CARCINOMA OF THE PROSTATE
Authors: NITCH CYRIL A. R. 
Published: November 2008

AbstractConservative treatment comprises; (1) Radio‐therapy; (2) Surgical; and (3) Surgical with Radio‐therapy.The immediate results of X‐ray treatment are often excellent but the ultimate results are disappointing.In some cases X‐rays cause rapid increase of the growth and dissemination.The best results are obtained by the five‐field maximum method of Holfelder‐Reisner, giving a total depth dose of 150 to 200 per cent. on the prostate.The intensive split‐dose method of Levitt, now under trial, seems productive of better results. At present only 6 per cent. of cures can be claimed for modern methods of X‐ray therapy.The effects of radium are better, especially when applied in large doses to the rectal, vesical and urethral surfaces of the prostate. Before treatment is commenced a thorough clinical, biochemical and radiological examination must be made and a portion of the prostate should be removed by electro‐resection for microscopical examination.When renal function tests are below normal preliminary drainage of the bladder is necessary.About 70 mgs. of radium are used thus: 14 mgs. to the posterolateral surfaces, 50 mgs. to the vesical surface and 5 mgs. to the urethral surface.Though only a few cases have been treated in this way the cure rate has been 28 per cent. up to the present. The method is therefore worth an extended trial.Conservative surgery consists of suprapubic drainage, transplantation of the ureters and electro‐resection. Transplantation of the ureters into the large intestine is preferable to suprapubic drainage but can only be performed in carefully selected cases.Electro‐resection is the best palliative measure for the relief of obstruction by growth at the neck of the bladder: it is of no value when the obstruction is due to invasion of the prostatic urethra.It is probable that in the future electro‐resection, followed by some form of radio‐therapy, will be the method of choice.
PARENCHYMAL CARCINOMA OF THE KIDNEY
Authors: Griffiths I. H. , Thackray A. C. 
Published: November 2008

Summary1. One hundred and three cases of renal parenchymal carcinoma are reviewed; nephrectomy was performed in 60 cases, 20 were found to be inoperable, and operation was not considered in the remaining cases. Post‐mortem examinations were performed on 32 cases in the series.2. The clinical features are analysed and their influence on prognosis discussed.3. The tuniours are classified into three grades of malignancy according to histological criteria.4. The spread of the tumour is described, with special reference to the sinister significance of tumour thrombosis of the renal vein.5. Radiological features are described, stressing those that assist prognosis.6. Nephrectomy is the only rational treatment in operable cases, and it is noted that the presence of a solitary metastasis is not a contraindication to surgery. The place of radiotherapy in treatment is indicated.7. The survival rate for operable cases in this series compares favourably with that from the Mayo Clinic.8. The lines on which the prognosis can be assessed are considered.
PRIMARY CARCINOMA OF THE MALE URETHRA1
Authors: Vernon H. K. , Wilkins R. D. 
Published: November 2008

SummaryAn unusual case of transitional cell carcinoma of the male urethra is presented. The commoner squamous‐cell types are discussed.The usual zetiological factors, urethral stricture, or seedlings from papillomatous tumours higher in the urinary track are considered in relation to this case and are not found pertinent.When the patient was seen originally there was no evidence of stricture, but as he was not submitted to urethroscopy the possibility that he may have had a patch of submucous infiltration cannot be excluded.The symptoms and signs are discussed; the patient presented with gangrene of the penis.Diagnosis was made by palpation of an indurated swelling which failed to resolve with penicillin. Urethroscopic confirmation was technically impossible.Treatment was by radical amputation of the penis and the construction of a perineal urethra.The patient is being kept under surveyance in order that block dissection of the inguinal glands may be undertaken should they become involved by metastatic spread.
UNCOMMON TYPES OF CONGENITAL RENAL ABNORMALITY: TWO CASES
Authors: Hanbury W. J. 
Published: November 2008

SummaryA case of crossed renal ectopia with fusion and one of solitary pelvic kidney are reported, both these conditions being rare congenital abnormalities. References are made to previous literature and available information summarised. Embryological factors in relation to aetiology are discussed.I wish to thank Dr G. J. Cunningham and Professor G. Hadfield for their helpful criticism and advice, and Mr N. K. Harrison for the photographs.
Pseudo‐ureter: a Complication of Percutaneous Nephrolithotripsy
Authors: Cronan J. J. , Dorfman G. S. , Esplin C. A. 
Published: November 2008

Summary— In 3 previously healthy patients undergoing percutaneous nephrolithotripsy complicated by perforation of the medial wall of the renal pelvis, a false channel or “pseudo‐ureter” formed around the ureteric stent catheter, starting from the renal pelvis and re‐entering the upper ureter. Recognition occurred 2 to 3 days after lithotripsy during nephrostography and the complication was treated by re‐positioning the stent into the true ureteric lumen.All patients are well 7 to 10 months after lithotripsy and there have been no long‐term complications.
A Computer‐based Program for the Follow‐up of Prostatic Cancer Patients
Authors: SIMON D. , LEVY E. , SERVADIO C. 
Published: November 2008

Summary— A computer‐based record program for the follow‐up of prostatic cancer patients is described and its practical applications discussed. The system enables the user to record personal data, medical history follow‐up (including laboratory and imaging tests), treatment and the response to it. The program can generate reports as a summary letter to the referring physician, follow‐up notes on a specific date, laboratory test results on a chronological base, etc. It has the capability to analyse statistically the medical database accumulated with the aid of SPSS (Statistical Package for Social Sciences).The program, which is designed for a micro‐computer, is conducted on the IBM Personal Computer. By providing instant access to all comprehensive information, the system is a valuable tool for the correct staging of disease and for systematic follow‐up; most of all, it is a “real‐time instrument” for the analysis of medical results.
Clinical versus Ultrasonographic Evaluation of Scrotal Disorders
Authors: Kromann‐Andersen B. , Hansen L. B. , Larsen P. N. , Lawetz K. , Lynge P. , Lysen D. , Nielsen S. Pors , Stokholm K. H. , Foged P. 
Published: November 2008

Summary— Clinical and ultrasonographic examinations of scrotal disorders were compared in 166 patients in order to determine their ability to distinguish between those diseases requiring surgery and those requiring clinical follow‐up only.Ultrasound examinations were efficient in discriminating between normal and pathological findings. Extra‐testicular lesions were readily differentiated from testicular ones. Although both clinical and ultrasonographic examinations had high sensitivity (90%) in detecting testicular cancer, the number of false positive findings was smaller after ultrasound examination. This gave a predictive value of a positive test of 53% after ultrasound examination but only 33% after clinical examination.Ultrasound examination may, therefore, reduce the number of surgical explorations in the scrotum and should be performed in patients with suspected testicular pathology based on history and palpatory findings.
The Clinical Varicocele in Infertility
Authors: Talati J. J. , Islahuddin M. 
Published: November 2008

Summary— Of 238 infertile males seen over a 47‐month period, 47 (20%) had a varicocele. Of these 51% had an abnormal sperm count (21% were azoospermic and 30%oligozoospermic) and 60% had less than a third of sperms motile; 23 patients were subjected to gonadotrophin assays. Serum follicle stimulating hormone and leutinising hormone levels were elevated in 48% and 70% of patients respectively. Serum prolactin assayed in 19 patients was raised in 10% and serum testosterone estimated in 16 patients was low in 6%. Twenty‐five patients (53%) were advised to undergo surgery but only 10 agreed. Of these, 1 showed a dramatic improvement in his spermiogram and a pregnancy ensued. The sperm count and motility of 2 others improved after treatment with prostaglandin synthetase inhibitors, and 1 after testosterone. Medical treatment improved the count and motility in 7 of 8 patients in whom surgery was not suggested as primary treatment because of abnormal hormonal results.This study has shown that infertile patients with varicocele are a heterogeneous group and that improvement in spermiograms can best be achieved by selective treatment; this may be surgery, surgery followed by medical treatment, or medical treatment alone.
Neodymium‐YAG Laser Irradiation of Stage T2 Muscle‐invasive Bladder Cancer. Long‐term Results
Authors: BEISLAND H. O. , SANDER S. 
Published: November 2008

Summary— The study group consisted of 15 patients with solitary stage T2 bladder tumours treated with transurethral resection (TUR) and subsequent neodymium‐YAG laser irradiation.Ten patients are alive without evidence of cancer 56 to 78 months (mean 67) after treatment; 1 died of cardiovascular disease 2 years after treatment and autopsy revealed no cancer. In 4 patients the treatment failed and cystectomy or external beam radiation was carried out.The long‐term results indicate the combination of TUR and laser irradiation to be beneficial in the management of T2 tumours in selected cases.
Measurement of Voiding Pressures on Ambulatory Monitoring: Comparison with Conventional Cystometry
Authors: WEBB R. J. , GRIFFITHS C. J. , RAMSDEN P. D. , NEAL D. E. 
Published: November 2008

Summary— A series of 20 patients underwent conventional medium fill cystometry (CMG) and ambulatory monitoring during natural bladder filling (AM). The measurement of voiding pressures by the 2 techniques was compared.The maximum subtracted detrusor contraction pressure recorded during CMG (50 ± 30 cm H2O) was significantly less than that recorded during AM (86 ± 35 cm H2O). Voiding pressures during natural filling are greater than those observed during conventional urodynamic studies: this finding may have important implications in the definition of bladder outflow obstruction.
Immunohistochemical Staining with Monoclonal Antibody 32–2B to Desmosomal Glycoprotein 1: Its Role in the Histological Assessment of Urothelial Carcinomas
Authors: CONN I. G. , VILELA M. J. , GARROD D. R. , CROCKER J. , WALLACE D. M. A. 
Published: November 2008

Summary— A series of transitional cell carcinomas of bladder were stained immunohistochemically with the monoclonal antibody, 32–2B, to desmosomal glycoprotein 1. All of the sections showed positive staining with the antibody. Assessment of staining intensity, by 3 independent examiners, revealed a strong negative correlation between density of desmosomal staining and degree of invasion (P=0.012). Nests of strongly staining cells were identified in several invasive tumours, possibly indicating early squamous differentiation. Invasive tumour cells in the subepithelial stroma also stained strongly with the antibody. Correlation with clinical course, however, revealed no significant association between desmosomal staining and the incidence of recurrence or progression.It is suggested that staining with this antibody may be of value in detecting both stromal invasion and early squamous differentiation of transitional cell carcinomas. Both this and previous studies emphasise the value of this antibody as an epithelial marker in neoplasia.
Epidemiological Study of Urinary Tract Stones in a Northern Italian City
Authors: BORGHI L. , FERRETTI P. P. , ELIA G. F. , AMATO F. , MELLONI E. , TRAPASSI MARIA RITA , NOVARINI A. 
Published: November 2008

Summary— An epidemiological study of stone disease in a Northern Italian city was carried out by means of a postal questionnaire mailed to 6000 individuals (2.5% of the entire population).It was found that the incidence of stone disease was comparable to that of industrialised Western Europe. There was a relationship between stone disease and gout and stone disease and a positive family history. The frequency of uric acid stones was high (26.5%). Stone‐formers showed no alimentary differences from non‐stone formers apart from the use of spices and herbs.Stone‐formers used less water from public aqueducts and more uncarbonated mineral water, but only 19% of these drank at least 2 litres a day.
Effect of Parenteral Oestrogen on the Coagulation System in Patients with Prostatic Carcinoma
Authors: HENRIKSSON P. , BLOMBÄCK M. , ERIKSSON A. , STEGE R. , CARLSTRÖM K. 
Published: November 2008

Summary— Patients with prostatic carcinoma on oral oestrogen therapy have an altered coagulation system and suffer cardiovascular side effects. Oestrogens—especially oral oestrogens—are potent inducers of liver synthesised proteins, including coagulation factors.We have assessed the effect of non‐oral oestrogen on the coagulation system in patients with prostatic carcinoma. Twelve patients were given monthly intramuscular injections of 320 mg polyoestradiol phosphate (PEP). No additional oestrogens were given. No change was found in any of the coagulation factors, including factor VII, with the exception of a significant decrease in antithrombin III. No patient, including 38 patients treated with PEP, had any cardiovascular complications after a mean follow‐up period of 12.9 ±0.7 months; 76% of the patients responded to treatment.Parenteral administration of oestrogen caused a less marked change in the coagulation system than oral administration and should be the treatment of choice for prostatic carcinoma.
Is Routine Primary Retroperitoneal Lymph Node Dissection Still Justified in Patients with Low Stage Non‐seminomatous Testicular Cancer?
Authors: AASS NINA , FOSSA SOPHIE D. , OUS S. , LIEN H. H. , STENWIG ANNA E. , PAUS ELISABETH , KAALHUS O. 
Published: November 2008

Summary— We present 8 years' experience of primary retroperitoneal lymph node dissection (RLND) in 190 patients with low stage non‐seminoma; 154 patients had clinical stage I (CSI) and 36 had clinical stage lla (CSIIa) disease. Of the 154 patients with CSI tumours, 33 had increased serum AFP and/or HCG before RLND (CSIM +)and 121 had normal tumour markers (CSIM‐).Retroperitoneal lymph node metastases (pathological stage II) (PSII) were found in 38 of 121 patients with CSIM ‐, in 19 of 33 patients with CSIIM + and in 26 of 36 patients with CSIIa. In a multivariate analysis, the presence of small vessel infiltration (demonstrated in histological sections of the primary tumour) and a prolonged tumour marker half‐life were predictive factors for PSII. These 2 factors enabled a group of non‐seminoma patients with CSI disease to be identified who had a 15% risk of retroperitoneal tumour growth (low risk group) as compared with a high risk group where 60 to 70% of patients had retroperitoneal lymph node metastases.Relapses occurred in 7 of 107 patients with PSI and in 6 of 83 patients with PSII disease; in the latter group, 5 relapses developed before the start of routine adjuvant chemotherapy; 6% of patients developed major post‐operative complications. In addition, “dry ejaculation” was the principal side effect following RLND (unilateral RLND: 20/132 patients; bilateral RLND: 50/54 patients).The comparative cost to the health service during the first year of follow‐up was estimated for low risk non‐seminoma patients with CSI subjected to RLND and for those in whom a surveillance policy was adopted. The latter approach was preferable.It was concluded that a surveillance policy should be followed in low risk non‐seminoma CSI patients provided that frequent follow‐up is possible. A more active policy is recommended in high risk patients (e.g. adjuvant chemotherapy without RLND). Nerve‐sparing RLND may be considered in patients with CSIIa disease and negative tumour markers.
Inflammatory Infiltrate in Prostatic Hyperplasia—Evidence of a Host Response to Intraprostatic Spermatozoa?
Authors: McCLINTON S. , EREMIN O. , MILLER I. D. 
Published: November 2008

Summary— The inflammatory infiltrate was characterised in 20 samples of prostatic hyperplasia using cell surface specific monoclonal antibodies. The infiltrate was composed predominantly of CD‐3 + T‐lymphocytes. The distribution of the T‐lymphocyte subsets (CD‐4 and CD‐8) between the epithelial and stromal components of the gland was significantly different, with most of the intra‐epithelial infiltrate being CD8 +, T cytotoxic/suppressor cells. This may be a necessary immunological barrier, as in the epididymis, to prevent the development of autoimmunisation to sperm antigens.Large numbers of CD4+ T helper/inducer cells and significant numbers of CD‐11c + macrophages were demonstrated in the extra‐glandular stromal tissues, suggesting a delayed type hypersensitivity reaction.Intraprostatic spermatozoa have been demonstrated recently and we have confirmed this finding on post mortem specimens. It is postulated that the presence of an intra‐epithelial cytotoxic barrier and the marked stromal infiltrate may be due, in part, to the intermittent presence of spermatozoa within the prostate.
The Use of Prostatic Stents in Patients with Urinary Retention who are Unfit for Surgery: An Interim Report
Authors: McLOUGHLIN J. , JAGER R. , ABEL P. D. , DIN A. EL , ADAM A. , WILLIAMS GORDON 
Published: November 2008

Summary— Under local anaesthesia, 19 patients (18 with acute and 1 with chronic urinary retention) underwent insertion of an expandable stainless steel tubular “stent” into their prostatic urethra under fluoroscopic control. All were considered to be at major risk from prostatic surgery. The 18 patients with acute retention voided spontaneously following the initial stent procedure, but the patient with chronic retention required a period of suprapubic catheterisation. Following the endoscopic insertion of an additional stent this patient also voided spontaneously.During a follow‐up period of 3 to 7 months (mean 4), 4 patients were lost to follow‐up. The remaining 15 patients all void spontaneously. Recurrent asymptomatic urinary tract infections were seen in all but 1 patient initially, but none of those who were followed up for over 5 months had evidence of infection.Although the follow‐up period is limited, the results to date demonstrate that the insertion of an expandable prostatic stent is a safe and reliable method of treating acute urinary retention in patients unfit for surgery. Further follow‐up is required to assess long‐term safety and to exclude late complications.
Assessment of Residual Urine in Men Following Catheterisation
Authors: PURKISS S. F. 
Published: November 2008

Summary— There is a certain volume of urine left within the bladder which cannot be drained by a catheter. A dilutional method was used to calculate this residual volume in 15 men; 10 had acute retention secondary to benign prostatic hyperplasia and 5 had permanent indwelling catheters for neurogenic urinary incontinence.The mean catheterised residual volume was 98.53 ml for patients with acute retention and 14.48 ml for patients with long‐term catheters.The explanation for higher post‐catheterisation volumes in the acute retention group is probably multifactorial; bladder sacculation and diverticula, detrusor tone and reflux may all play a role.
Cell Cycling in Bladder Carcinoma Determined by Monoclonal Antibody Ki67
Authors: MELLON K. , NEAL D. E. , ROBINSON M. C. , MARSH C. , WRIGHT C. 
Published: November 2008

Summary— Current methods of predicting prognosis in transitional cell carcinoma of the bladder fail to provide consistently reliable information about future tumour behaviour. The monoclonal antibody Ki67 recognises an antigen present in actively dividing cells and Ki67 reactivity has been shown to correlate with conventional prognostic indicators in several tumours. In this study, Ki67 antibody was used to determine the proportions of cells undergoing active division in 26 transitional cell carcinomas of the bladder.The proportion of cells stained in muscle invasive tumours (12.3 ± 5.4%) was significantly greater than in superficial tumours (4.3 ± 1.9%) and poorly differentiated tumours showed significantly greater proportions of cells staining compared with well or moderately well differentiated tumours.These results show that Ki67 reactivity correlates with high tumour stage and poor differentiation. Ki67 staining provides an easy method of determining tumour cell turnover that might provide additional prognostic information.
Serum Follicle Stimulating Hormone–Predictor of Cancer in the Remaining Testis in Patients with Unilateral Testicular Cancer
Authors: WANDERAS EVA HOFF , FOSSA SOPHIE D. , HEILO A. , STENWIG ANNA E. , NORMAN N. 
Published: November 2008

Summary— In 10 of 13 patients with unilateral testicular cancer and subsequent invasive cancer or carcinoma in situ in the remaining testis, the follicle stimulating hormone (FSH) level was elevated after the first orchiectomy and before further treatment. In only 4 of 26 comparable control patients was the FSH level raised. This may be because elevated serum FSH often reflects disturbances in spermatogenesis and fertility, the latter being a known risk factor for testicular cancer.An elevated FSH level that occurs after orchiectomy for unilateral testicular cancer and before further treatment identifies patients at high risk of developing a tumour in the remaining testis.
The Use of Internalised Ureteric Stents in Renal Transplant Recipients
Authors: THOMALLA J. V. , LEAPMAN S. B. , FILO R. S. 
Published: November 2008

Summary—Since 1982, we have used internal indwelling ureteric stents for the management and prevention of ureteric reconstruction complications in 28 renal allograft recipients.A total of 30 stents were placed in 18 patients either diagnostically or therapeutically in the management of allograft ureteric obstruction. In 16 patients internal stents were placed at the time of reconstruction for primary ureteropyelostomy (3), secondary ureteropyelostomy (8), repeat reimplant (3) and repair of ureteric or pelviureteric junction injury (2).Complications included 3 episodes of transplant pyelonephritis, proximal stent migration (1), persistent bacteriuria (1) and prolonged healing of a ureteropyelostomy (1).Internalised ureteric stenting is a safe and effective means of managing or preventing ureteric reconstruction complications in renal transplant recipients.
Effect of Bladder Outflow Obstruction on the Innervation of the Rabbit Urinary Bladder
Authors: HARRISON S. C. W. , FERGUSON D. R. , DOYLE P. T. 
Published: November 2008

Summary—The effects of bladder outflow obstruction on the innervation of the bladder were studied using a rabbit animal model. Partial occlusion of the bladder neck was obtained by the placement of a silk ligature at that level; control animals underwent a sham procedure. After a 3‐month period, the presence of outflow tract obstruction was confirmed using urodynamic studies. The animals were then killed and pharmacological assessments of the bladder innervation undertaken.Detrusor muscle strip studies provided evidence of damage to the cholinergic innervation of the detrusor. Also, muscle strips from obstructed animals showed reduced inhibitory responses to p‐adrenergic stimulation with isoprenaline. In addition to these muscle strip studies, the bladder content of the neuropeptide substance P was assayed, but no significant change was observed in response to obstruction. This finding suggests that substance P‐containing sensory nerves may be spared from the denervating effect of bladder outflow obstruction.