bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of polyclonal serum prostate specific antigen levels in screening for prostate cancer: a comparison with corresponding monoclonal values
Authors: TERMS M. K. , STAMEY T. A. 
Published: November 2008

Objectives Prostate specific antigen (PSA) measurement has become increasingly popular as a screening test for prostatic adenocarcinoma. Although this is a sensitive, organ‐specific assay, use as a screening tool is hampered by the lack of a clearly defined normal range in older men, frequent elevation of PSA levels by benign processes, and the availability of two different assays, one polyclonal and the other monoclonal, which produce very different values. This study was designed to evaluate the distribution of PSA levels by the Yang and corresponding Hybritech values in patients from the general population.Subjects and methods A total of 478 volunteers over 40 years of age underwent serum PSA determination by the Yang polyclonal radioimmunoassay and digital rectal examination. The PSA levels were stratified and the patient distribution analysed.Results In 69% of patients, PSA levels were ≤ 2.5 ng/ml (proposed normal range for the Yang polyclonal assay). In 89% of patients, PSA levels were ≤ 7.3 ng/ml by the polyclonal assay which corresponds approximately to the proposed normal range of 0–4.0 ng/ml by the Hybritech monoclonal assay. Nine per cent of patients fell between 7.4 and 18.4 ng/ml by the polyclonal assay (4.1–10 ng/ml by the monoclonal assay) and 2% had polyclonal PSA levels > 18.4 ng/ml (> 10 ng/ml by the monoclonal assay). Cancer detection rates (influenced by the percentage of patients undergoing biopsy) were 0.3% in patients with polyclonal PSA levels ≤ 2.5 ng/ml, 1.2% in patients ≤ 7.3 ng/ml, 20.9% between 7.4 and 18.4 ng/ml, and 50% of those > 18.4 ng/ml; the overall cancer detection rate was 3.8%.Conclusions These data support the use of higher PSA levels as a criterion for further evaluation in screening for prostate cancer and establish the frequency distribution of PSA in a screening population when the Yang assay is used.
Congenital urethral obstruction: Cobb's collar or prolapsed congenital obstructive posterior urethral membrane (COPUM)
Authors: DEWAN P. A. , KEENAN R. J. , MORRIS L. L. , QUESNE G. W. LE 
Published: November 2008

Objective To determine whether there are two distinct types of congenital obstruction of the proximal urethra.Patients and methods Three boys with a congenital bulbar urethral narrowing (Cobb's collar) were examined. Recent papers on congenital obstructive posterior urethral membrane (COPUM) were reviewed.Results The more proximal lesion is a membranous obstruction which is able to prolapse as far as the bulbar urethra, but has paramedian folds that attach along the posterior wall of the urethra to the verumon‐tanum, and is due to persistence of an embryological attachment between the distal verumontanum and the anterior wall of the posterior urethra. The more distal narrowing is not always obstructive and is primarily a bulbar urethral membrane, is independent of the verumontanum and external sphincter, and may represent a persistence of part of the urogenital membrane.Conclusions There are two distinct types of congenital obstruction of the proximal urethra, with the association to the verumontanum being the distinguishing feature.
The pathophysiological changes in the bladder obstructed by benign prostatic hyperplasia
Authors: CHAPPLE C. R. , SMITH D. 
Published: November 2008

SummaryNone of the hypotheses to explain the genesis of obstructed detrusor instability covered in this report provide a satisfactory explanation, by themselves, for the condition. While symptoms associated with prostatic obstruction are a common cause of patient referral to a urologist, all therapeutic advances so far have been directed towards the relief of bladder outflow resistance. It is possible that pharmacotherapy, for example, with drugs which stabilize muscle cell membranes and autonomically active drugs such as α1‐antagonists, possibly combined with anticholinergics, will have a therapeutic role in the treatment of obstructive detrusor instability. Further studies of obstructed human bladder are necessary to investigate the importance of changes in receptor density, affinity and distribution, agonist release and degradation and subsequently the ultrastructural and physiological alterations following the relief of obstruction.
Intravesical Evans bacille Calmette‐Guérin for carcinoma in situ of the urinary bladder
Authors: TALIC R.F. , HARGREAVE T.B. , BISHOP M.C. , KIRK D. , PRESCOTT S. ,   Members Of The Scottish Urological Oncology Group
Published: November 2008

Objective To study the long‐term results of a single 8 week course of intravesical Evans bacillus Calmette‐Guérin (BCG) on carcinoma in situ (CIS) of the urinary bladder.Patients and methods This study reports on 43 patients who each received a single 8 week course of intravesical BCG.Results In spite of the good initial complete response rate of 70%, the long‐term follow‐up was disappointing with half the patients either having recurrence or progression of their disease by 2 years. The patients had a close follow‐up protocol with early radical treatment when disease progressed. The cause specific survival at 5 years was 70%.Conclusion We feel that similar future treatment protocols without maintenance treatment are not justified.
Prognostic factors in pTa‐pT1 superficial bladder tumours treated with intravesical instillations
Authors: MULDERS P. F. A. , MEYDEN A. P. M. v. d. , DOESBURG W. H. , OOSTERHOF G. O. N. , DEBRUYNE F. M. J. ,   MEMBERS OF THE DUTCH SOUTH‐EASTERN UROLOGICAL COLLABORATIVE GROUP
Published: November 2008

Objective To identify prognostic factors that enable patients with superficial bladder cancer to be divided into groups who will probably respond to therapy and those who will not. Patients and methods In a prospective randomized study 38 7 patients with pTn‐pT1 superficial bladder carcinoma received, after transurethral resection, intravesical instillations with immuno‐ or chemotherapy. A simultaneous computerized analysis of factors predicting the recurrence‐free interval was performed, All these patients had negative random biopsies. Pretreatment factors analysed for recurrence were gender, age, history (primary or recurrent disease), location of tumour, number of tumours, pT‐stage and grade. Results Median follow‐up was 2 7 months (range 12–56). During the follow‐up period 37.2% of the patients had recurrence and eight patients (2.2%) had progression into muscle invasive disease. After a univariate analysis the number of tumours and location of the tumour in the bladder appeared to be a significant influence on the recurrence‐free interval. Location of at least one of the tumours in the prostatic urethra, bladder neck, posterior wall, and trigone area was significantly related to a shorter recurrence‐free interval: these areas were defined as high risk. Tumour stage showed borderline significance. By using multivariate methods to assess the relative importance of these factors, location of tumour in the high risk region was related especially to a short recurrence‐free interval. The factor found to be of significance for the prognosis for recurrence was tumour multiplicity. Gender, age, history of recurrent disease, size of the largest tumour, tumour stage or grade gave no additional information about the risk of recurrence. Conclusion Prognostic factor analysis, as an auxilliary study of trials of patients treated for superficial bladder tumours, is mandatory. The prognostic factors related to recurrence‐free interval found in this study, location of the tumour and multiplicity, may be of use in the stratification necessary for current protocol design.
Criteria for differentiation of normal and abnormal uroflowmetrograms in adult men
Authors: NISHIMOTO K. , IIMORI H. , IKEMOTO S. , HAYAHARA N. 
Published: November 2008

Objective To study parameters which serve as criteria for differentiation of normal and abnormal uroflowmetrograms. Subjects and methods A total of 105 subjects were investigated, 43 of whom had no symptoms of dysuria, 57 of whom had dysuria demonstrated as an abnormal uroflowmetrogram, subjective symptoms and a small residual urine volume, and five patients who were about to undergo transurethral resection of the prostate. The three parameters used to specify the shapes of the uroflowmetrogram curves were: (i) the ratio of the maximum flow rate (Qmax) and the voiding time (T100)‐ Qmax/T100; (ii) the ratio of the time to peak flow (TQmax) and the voiding time, TQmax/T100; and (iii) the newly introduced voiding efficiency (e), measured by the ratio of the voided volume (VV) and T100× Qmax, 8 = VV/(T100× Qmax), were taken for each patient. Results The criteria for normal uroflowmetrograms were: Qmax/T100 0.78, 0.32 TQmax/T100 0.54, 0.63 ε < l, respectively. In the patients who underwent transurethral resection of the prostate the values of all three parameters improved and returned almost to normal after operation. Conclusion Using these three parameters the micturition pattern can be expressed quantitatively.
Involvement of the inferior vena cava by renal tumour: surgical excision using hypothermie circulatory arrest
Authors: Matthews P.N. , Evans C. , Breckenridge I.M. 
Published: November 2008

Objective To evaluate the immediate and long‐term results of a radical surgical technique in the treatment of renal tumours with extensive involvement of the inferior vena cava (IVC). Patients and methods Seven patients with extensive involvement of renal tumours into the IVC were operated upon using a cardiopulmonary by‐pass, hypothermia and cardiac arrest to facilitate surgery. Wide exposure of the IVC in a bloodless field permitted complete removal of all visible tumour in each case. Histological sections confirmed renal cell cancer in six patients and Wilms tumour in a 15‐year‐old girl.Results All patients recovered well from their surgery with no major complications and spent one or two days in the Intensive Treatment Unit and an average of 13 days in hospital after the operation. Of the seven patients, four are alive and well with no obvious disease after an average follow‐up time of 30 months (range 8–54). The other three patients have died from disseminated renal cancer. Conclusion This procedure provides good local control of the tumour and offers the only hope of cure in patients with this disease. In collaboration with the surgical cardiac team it can be safely carried out with acceptable morbidity and mortality.
A novel anti‐seminoma monoclonal antibody (M2A) labelled with technetium‐99m: potential application for radioimmunoscintigraphy
Authors: Marks A. , Ballinger J.R. , Reilly R.M. , Law J. , Baumal R. 
Published: November 2008

Objective To study the potential usefulness of monoclonal antibody (mAb) M2A specific for seminoma to image tumour nodules in a preclinical nude mouse model. Materials and methods MAb M2A was labelled with technetium‐99m (99mTc) following reduction and was administered intraperitoneally to nude mice bearing subcutaneous HEY cell xenografts against which the antibody was originally raised. Biodistribution and gamma scintigraphy studies were performed 24 h after administration of 99mTc‐M2A. Results Biodistribution studies showed specific targeting of 99mTc‐M2A to HEY tumours in comparison with control mAb 99mTc‐6E8 and 99mTc‐2G3 which do not bind to HEY cells. Subcutaneous HEY cell tumours (0.5–1.0 g) were successfully imaged using gamma‐scintigraphy following administration of 99mTc‐M2A. Conclusion The results of this study indicate the potential usefulness of 99mTc‐M2A as a clinical reagent for imaging seminoma metastases.
Immunohistochemical localization of neuromarkers and neuropeptides in human fetal and neonatal urinary bladder
Authors: Jen P.Y.P. , Dixon J.S. , GOSLING J.A. 
Published: November 2008

Objective To use immunohistochemical techniques to determine the spatial and temporal distribution of a variety of neuropeptides in the human fetal and neonatal urinary bladder. Materials and methods Thirteen pre‐natal specimens ranging in gestational age from 17 to 35 weeks were acquired following abortion or miscarriage. In addition two post‐natal specimens aged 8 and 12 weeks were obtained at post‐mortem and were included in this study. The overall innervation of each specimen was visualized using the general nerve marker protein gene product 9.5 (PGP). Localization of dopamine‐β‐hydroxylase (DBH) and tyrosine hydroxylase (TH) revealed putative noradrenergic nerves. The neuropeptides studied included neuropeptide Y (NPY), vasoac‐tive intestinal polypeptide (VIP), substance P (SP), and calcitonin gene‐related peptide (CGRP). Results At 17 weeks a rich plexus of PGP and NPY‐containing nerves was present throughout the detrusor muscle coat. As gestational age increased, VIP, SP and CGRP‐containing nerves were observed with increasing frequency although SP and CGRP were mainly confined to perivascular nerve plexuses. TH‐ and DBH‐containing nerves were first observed in the intramural ureters at 30 weeks and the detrusor muscle at 35 weeks and were relatively numerous in the intramural ureters and muscle of the superficial trigone in the two post‐natal specimens. PGP‐containing nerves were first observed beneath the bladder epithelium at 23 weeks and gradually became more numerous with increasing age. Occasional NPY, VIP, SP and CGRP‐containing nerves were observed in the submucosa but TH‐ and DBH‐immunostained nerves were especially numerous in the mucosa of the trigone in the two post‐natal specimens, many such nerves being unrelated to the vascular supply. Conclusions The bladder detrusor possesses a rich auto‐nomic innervation by 17 weeks of gestation and this presumptive cholinergic innervation is associated with NPY immunoreactivity. Presumptive noradrenergic nerves appear relatively late in pre‐natal development and mainly supply the intramural ureters and superficial trigone. A submucosal plexus of nerves has been demonstrated, the functional significance of which remains uncertain.
Percutaneous endoscopic treatment of urothelial tumours of the renal pelvis
Authors: Plancke H.R.F. , Strijbos W.E.M. , Delaere K.P.J. 
Published: November 2008

Objective To evaluate the Results of percutaneous endoscopic treatment of renal pelvic transitional cell carcinoma (TCC). Patients and methods Ten patients (median age, 70 years; range 56‐86) with a renal pelvic TCC were treated by percutaneous endoscopic resection. Seven had a normal contralateral kidney and were treated electively. Results Follow‐up was from 3 to 77 months. There was one recurrence locally and one recurrence in the bladder. There have been no recurrences in the nephrostomy tract. Conclusion We have shown that percutaneous resection of intrarenal TCC is a possible and safe technique. Further follow‐up is needed to confirm its safety.
Outcome of endoscopic bladder transection
Authors: Hasan S.T. , Robson W.A. , Ramsden P.D. , Essenhigh D.M. , Neal D.E. 
Published: November 2008

Objective To determine the clinical, symptomatic and Objective urodynamic outcome of patients undergoing endoscopic bladder transection.Patients and methods The study included 20 men and 30 women (mean age of 50±15 years, range 20–86) who underwent endoscopic bladder transection. Their underlying diagnoses were idiopathic detrusor instability (41), enuresis with instability (6), multiple sclerosis (2) and Parkinson's disease (1). A full‐thickness endoscopic transection of the bladder was performed under general anaesthesia. Subjective assessment was performed using symptom scores (0–14 points) and a Visick grading system (group A‐E). Objective assessment was carried out using urodynamic studies. The mean follow‐up period was 6 years (57 ± 22 months, range 6–85).Results The mean hospital stay was 8 ± 3 days (range 3–22). No patients died after the operation. Postoperative complications included extra‐peritoneal extravasation (2), recurrent urinary tract infection (5) and urethral stricture (1). Symptom scores before and after the operation were 9±2 (range 4–14) and 8 ± 3 (range 1–14) points respectively. The overall outcome of the procedure was satisfactory in only eight (16%) patients. The mean duration of symptomatic relief was 17 weeks (range 3–53). There was no significant difference between urodynamic results before and after the operation. Bladder instability observed in all patients before operating was demonstrated in 93% of patients after the operation.Conclusion The results of our study suggests that endoscopic bladder transection produces only a transient symptomatic relief in a few of those patients who have failed to respond to pharmacological manipulations. We do not feel that its continued role is justified.
Does catheter traction reduce post‐transurethral resection of the prostate blood loss?
Authors: Walker E.M. , Bera S. , Faiz M. 
Published: November 2008

Objective To determine if traction on a catheter after transurethral resection of the prostate (TURP) reduces post‐operative bleeding.Patients and methods This prospective trial included 115 consecutive patients undergoing TURP. After resection patients were randomly selected to have either traction (57) or no traction (58) on the catheter for 30 min. Blood loss was measured during and for 2 h after the operation. A simple method for applying constant traction is described.Results. Catheter traction reduced post‐operative bleeding while applied, but had no further effect after the removal of traction.Conclusion Catheter traction is a useful technique to aid the control of post‐TURP bleeding.
A urodynamic study of laser ablation of the prostate and a comparison of techniques
Authors: JAMES M.J. , HARRISS D.R. , CECCHERINI A. , MANHIRE A.R. , BATES C.P. 
Published: November 2008

Objective To evaluate the effect of laser ablation of the prostate on symptomatic and urodynamic parameters and to compare laser delivery systems.Patients and methods The study comprised 81 patients of whom 79 were waiting for transurethral resection of the prostate (TURP) and two who presented in acute urinary retention. The 79 patients (median age 65 years, range 45–82) underwent pre‐operative uro‐dynamics and all patients completed American Urological Association (AUA) symptom score questionnaires before surgery. Visually‐guided laser ablation of the prostate (VLAP) was performed and the urodyn‐amics and symptom scores were repeated 3 months later.Results The improvements in symptom scores and flow rates were statistically significant and comparable with other published data. There were also significant improvements in voiding pressure. There were no significant differences between the various laser fibres used. There were few complications.Conclusion The effectiveness of VLAP in improving symptoms and flow rates in patients with benign prostatic hyperplasia (BPH) is confirmed. The procedure also reduced voiding pressure, confirming the relief of bladder outflow tract obstruction. VLAP is confirmed as a safe and effective treatment for BPH. Continued follow‐up is needed to determine the long‐term effects.
Ultrasonographic evaluation and clinical correlation of intratesticular lesions: a series of 39 cases
Authors: CORET A. , LEIBOVITCH I. , HEYMAN Z. , GOLDWASSER B. , ITZCHAK Y. 
Published: November 2008

Objective To assess the accuracy, specificity and sensitivity of ultrasonography (US) for diagnosing testicular tumours.Patients and methods Ultrasonography of the scrotum was performed in 39 patients (mean age 20.3 years, range 3–61) referred to the hospital because of pain, tenderness, appearance of a mass in the scrotum or swelling of the scrotum after trauma.Results Intratesticular lesions were detected by US in 35 patients and four had no suspicious findings after surgical exploration of the scrotum based solely on clinical findings. In five patients the findings on US were compatible with neoplasm, but at surgery or follow‐up, no tumour was found. In one case, the US findings suggested inflammation, but on exploration 3 weeks later, an embryonal cell carcinoma was found.Conclusions While very sensitive in differentiating an intra‐from an extratesticular lesion, and in ruling out a testicular tumour (sensitivity 96.6%), the US examination is less specific (specificity 44.4%) as the US pattern of different benign process may be similar to those of tumours. The positive predictive value (85.3%) and the accuracy (84.6%) imply that when an intratesticular lesion is detected on US, even when there is no clinical suspicion of neoplasm, exploration of the scrotum is indicated.
Pain relief and quality‐of‐life assessment following intravenous and oral clodronate in hormone‐escaped metastatic prostate cancer
Authors: CRESSWELL S.M. , ENGLISH P.J. , HALL R.R. , ROBERT J.T. , MARSH M.M. 
Published: November 2008

Objective To establish the efficacy of intravenous clodronate followed by maintenance oral clodronate in patients with painful bone metastases resulting from hormone‐resistant prostate cancer.Patients and methods A multicentre open study of 27 patients assessed the efficacy of clodronate treatment by estimating the reduction in World Health Organization (WHO) Pain Score, the increase in WHO Performance Status and by a novel quality‐of‐life/ activity score.Results Ten of 27 patients achieved significant pain relief after receiving 300 mg/day of intravenous clodronate for 10 days. This was matched by an improvement in the activity score and WHO Performance Status. Three of 27 patients continued to have relief from pain after 3 months of oral clodronate therapy.Conclusion Intravenous clodronate therapy was effective in relieving the pain resulting from prostate cancer bone metastases in 10 of 27 patients but the benefit was shortlived. The use of a personal quality‐of‐life/ activity questionnaire which assesses aspects of everyday life that are important to the patient may be more appropriate for patients with very advanced prostate cancer than are other quality‐of‐life questionnaires in current use.
Is nephrocalcin related to the urinary derivative (bikunin) of inter‐α‐trypsin inhibitor?
Authors: TANG Y. , GROVER P.K. , MORITZ R.L. , SIMPSON R.J. , RYALL R.L. 
Published: November 2008

Objective To isolate, purify, sequence and characterize nephrocalcin (NC), a urinary protein that may be an important determinant of calcium oxalate (CaOx) kidney‐stone disease.Materials and methods Proteins were isolated from human urine using cellulose and resin columns and were sequenced using Edman degradation and SDS‐polyacrylamide gel electrophoresis (SDS‐PAGE). Inhibition of CaOx crystal growth by the isolated proteins was assessed by measuring the deposition of 14C‐labelled CaOx.Results A protein assumed to be NC on the basis of SDS‐PAGE, inhibitory and gel filtration properties was isolated from healthy human urine. Its molecular weight and the amino acid sequences of two of its peptides suggested it was identical to fragment HI‐14 of the light chain (bikunin) of inter‐α‐trypsin inhibitor (ITI).Conclusions NC represents a portion of the light chain of ITI, although this conclusion must remain tentative until confirmed using authentic NC.