bluuebunny/crossref_metadata_2025_split huggingface dataset:
The significance of abdominal straining in men with lower urinary tract symptoms
Authors: Reynard J.M. , Peters T.J. , Lamond E. , Abrams P. 
Published: November 2008

Objective To determine the relationship between the symptom of straining to void, the presence of objectively demonstrated abdominal straining and bladder outflow obstruction in men with lower urinary tract symptoms (LUTS), and to assess the effect of straining on flow rate in these men. Patients and methods The presence of straining to void as a symptom was determined from a symptom questionnaire in 61 men presenting with LUTS. Objective evidence of straining to void was assessed by rectal pressure measurement and the presence of bladder outflow obstruction was determined by pressure‐flow studies. The effect of straining on flow rate was assessed in a separate group of 58 men with LUTS, by comparing the maximum flow rate on non‐strain and strain voids of similar volume. Results There was poor agreement between the complaint of straining and the presence of straining as measured by rectal pressure recording. Twelve of the 53 patients who claimed they never or occasionally strained to void in fact showed straining on each of four voids. There was no significant difference in the proportion of men who complained of straining in the obstructed and non‐obstructed groups (P= 0.86). The probability of obstruction in those men with objective evidence of straining on all voids was 80% and in those who did not strain on all voids was 51%, but this difference was not statistically significant (P= 0.53). There was no clinically significant effect of straining on maximum flow rate in men with LUTS. Conclusion As a symptom, straining is an uncommon complaint in men with benign prostatic hyperplasia (BPH), and the relationship between the symptom and objective evidence of its presence is poor. Both as a symptom and as an objectively measured voiding disorder, straining lacks sufficient sensitivity and specificity for it to be of value in the diagnosis of bladder outlet obstruction (BOO). Abdominal straining does not have a marked effect on flow rate in men with BPH. This study suggests that straining is an unreliable symptom of BOO, that it does not influence voiding function in elderly men and that its inclusion in symptom scores for BPH should be reconsidered.
Bladder mast cell expression of high affinity oestrogen receptors in patients with interstitial cystitis
Authors: Pang X. , Cotreau‐Bibbo M.M. , Sant G.R. , Theoharides T.C. 
Published: November 2008

Objective To investigate the role of oestrogens in the pathophysiology of interstitial cystitis (IC), specifically with respect to activated bladder mast cells (MC), as well as urine concentrations of MC‐derived histamine and methylhistamine, all of which are increased in patients with IC. This goal appeared important because IC is a bladder disorder which occurs almost exclusively in women, and is characterized by polyuria, nocturia and pelvic pain, which worsen peri‐menstrually. Patients and methods Biopsies from six patients with IC and four control patients were analysed blindly for the presence of oestrogen receptors (OR) using both custom‐made and commercially available antibodies against OR. Results Bladder MC alone were shown to express high‐affinity OR and there was a higher number of such cells present in patients with IC compared with controls. The identity of MC in the bladder was documented with immunohistochemistry for tryptase. OR were also identified in human MC (HMC‐1), a MC line kept in culture. These steps were necessary because of the unique finding that only MC express OR, in spite of the inflammatory infiltrate present. Conclusion These findings may help to explain why IC occurs primarily in women, why IC and other associated symptoms tend to be worst at the midcycle, and may also suggest the prognostic usefulness of staining bladder biopsies for OR. These results are particularly interesting because oestradiol has been shown to augment MC histamine secretion in response to the neuropeptide, substance P, which may be released in certain neuroinflammatory disorders which have a high prevalence in women, such as IC and irritable bowel syndrome.
Proliferating cell nuclear antigen cyclin in human transitional cell carcinoma
Authors: Hattori K. , Uchida K. , Akaza H. , Koiso K. , Nemoto R. , Harada M. 
Published: November 2008

Objectives To confirm the value of the proliferating cell nuclear antigen (PCNA) labelling index in relation to histological grade, stage and prognosis. Materials and methods Tissue specimens from 56 patients (49 men, 7 women; mean age 65 years [range 34–86J) with newly diagnosed transitional cell carcinoma of the urinary bladder were stained by an avidin‐biotin peroxidase method using an anti‐PCNA monoclonal antibody. Irnmunohistochemical analysis was performed on ethanol‐fixed, paraffin‐embedded tissue sections obtained by endoscopic biopsy or trans‐urethral resection (TUR). The PCNA labelling index was determined by counting the number of PCNA‐labelled cells in the tissue sections. Results Grade 1 tumours averaged 5.1 ±3.0% labelling versus 10.9 ± 5.2% in grade 2 tumours, and grade 3 tumours had a PCNA labelling index of 21.8 ±10.4%. The average labelling indices for superficial tumour (37 patients) and invasive tumour (19 patients) were 7.5±5.3% and 20.8 ±10.0% respectively. A distant metastatic bladder tumour showed an average labelling index of 42.3%. To analyse survival, tumours with PCNA indices above and below the median level (12%) were compared. Those patients with an index of < 12% (the mean of all of the PCNA values) had a worse prognosis than those with an index of > 12%. The mean PCNA labelling indices in recurrent and non‐recurrent tumours were 6.4 ±0.7% and 8.2 ±1.7% respectively, statistically not significant. Conclusion The higher PCNA labelling index may indicate biological malignancy. These results suggest that measurement of the PCNA labelling index in bladder cancer may prove to be an objective and quantitative assay of biological aggressiveness and provide significant prognostic information, though it does not help to select patients at high risk of recurrence in superficial tumours.
Spindle and giant cell carcinoma of the urinary bladder: a clinicopathological light microscopic and immunohistochemical study
Authors: Sfrio G. , Zampatti C. , Ceppi M. 
Published: November 2008

Objective To evaluate the cellular nature and biological behaviour of spindle and giant cell carcinoma (SGCC) of the urinary bladder. The clinicopathological. light microscopic and immunohistochemical features of seven patients are reported. Patients and methods Paraffin‐embedded I issue was available from each patient for microscopic and immu‐nohistochemical studies. There were five men and two women, ranging in age from 48 to 79 years. Clinical histories and follow ‐up information were obtained by review of ihe patients' churts. The clinical outcome was compared with that of transitional cell carcinoma (TCC) and small cell carcinoma (SCC). Results The tumours were large, polypoid and frequently ulcerated. They diffusely permeated the bladder musculature or the perivesical fat. On microscopic examination live tumours were composed mainly of interlacing sheets of spindle cells and occasional giant cells: two comprised giant cells only. Foci of identiliable TCC (papillary or in situ) were present in four tumours. Immunohislochemistry demonstrated that SGCCs exhibit a phenotype indicative of an epithelial nature. Conclusions The median survival (11 months) of the seven patients indicates that SGCCs have a poor prognosis and they are more aggressive than TcYs of the same stage. The unfavourable clinical course is similar to the rapidly fatal outcome of small cell carcinomas of the bladder. The prolonged survival periods of three patients who received additional chemotherapy suggest that this treatment may be profitable.
Does neoadjuvant cisplatin‐based chemotherapy improve the survival of patients with locally advanced bladder cancer: a meta‐analysis of individual patient data from randomized clinical trials*
Authors:   Advanced Bladder Cancer Overview Collaboration: (Collaborators: D. Ghersi L.A. Stewart, M.K.B. Parmar, C. Coppin, J. Martinez‐Pineiro, D. Raghavan, M.A. Wallace)
Published: November 2008

Objectives To assess whether neoadjuvant or concurrent platinum‐based chemotherapy improves the survival of patients with locally advanced bladder cancer, and to determine whether there is any evidence that chemotherapy is more or less effective within well‐defined subgroups of patients. Patients and methods A formal meta‐analysis (overview) was carried out using updated individual data from 479 patients (301 deaths) from four randomized trials comparing local definitive treatment alone with neoadjuvant or concurrent single‐agent cisplatin followed by local definitive treatment. Further summary data were available from a similar randomized trial of cisplatin and doxorubicin in 325 patients (127 deaths). Results Combined analysis of the individual patient data gave an overall hazard ratio of 1.02 in favour of local therapy alone (P= 0.845, 95% confidence interval = 0.81–1.26), representing a 2% increase in the relative risk of death with the use of chemotherapy. When this analysis was supplemented by data from the only trial for which individual patient information was not available, the hazard ratio was 0.91 in favour of chemotherapy (P= 0.328, 95% confidence interval = 0.75–1.10), representing a 9% reduction in the relative risk of death. The only prognostic factor for which the evidence suggested a differential treatment effect (interaction) across groups was age (chi‐square test for trend = 3.833, P= 0.05), with younger age groups (<60 years) exhibiting a possible effect in favour of chemotherapy. Conclusions Despite a meta‐analysis of all known randomized trials, there is still insufficient information to obtain a definitive answer to the question of whether neoadjuvant cisplatin‐based chemotherapy improves the survival of patients with locally advanced bladder cancer. Such chemotherapy cannot therefore be currently recommended for routine use and any planned clinical trial should include a ‘no chemotherapy’ control arm.
Implications of cavitation phenomena for shot intervals in extracorporeal shock wave lithotripsy
Authors: Wiksell H. , Kinn A.‐C. 
Published: November 2008

ObjectiveTo study the influence of shot intervals and the quality of the coupling medium (degassed water) in extracorporeal shock wave lithotripsy (ESWL).Materials and methodsAcoustic scattering and damping (and thereby also the focal size) were modelled with respect to the conditions of the coupling medium, using continuous wave high intensity ultrasound. The influence of the shot interval on rise time and attained shock wave pressure were quantified with a modified ESWL apparatus and a specially designed hydrophone.ResultsIn tap water, which has a high content of dissolved gases, the focus produced was bulb‐shaped, with a diameter of approximately 4 cm, whereas degassed water gave a small focus that produced a water jet only a few millimetres in diameter. The efficacy of the acoustic energy decreased with shot intervals shorter than 1.2 s. Longer pauses resulted only in prolonged treatment times.ConclusionESWL becomes inefficient if the intervals between pulses are too short, particularly when ECG R‐wave triggered pulses are used on patients with tachycardia. The gas content of the coupling medium is also important for successful ESWL. The efficacy of the system used for degassing the water should be checked at regular intervals.
Percutaneous drainage of renal hydatid cyst: early Results and follow‐up
Authors: Goel M.C. , Agarwal M.R. , Misra A. 
Published: November 2008

Objective To evaluate a combination of percutaneous drainage and medical prophylaxis in the treatment of renal hydatid cyst to assist renal preservation, decrease morbidity and shorten the duration of hospital stay. Patients and methods Four patients (three men and a woman, age range 26‐31 years) with non‐communicating renal hydatid cysts were selected for treatment using percutaneous drainage. This was performed under medical prophylaxis with albendazole and praziquentel. Ethanol (95%) was used as a scolici‐dal agent. Results The method was successful in preserving three of four renal units but one unit was ablated because of secondary infection and haematuria. The kidneys of three patients were functioning adequately after a mean follow‐up of 21.6 months from percutaneous drainage. Conclusions Percutaneous drainage of renal hydatid cysts is a safe and effective method for preventing renal loss, and decreasing morbidity and the duration of hospital stay. It should be employed as the first option for renal hydatid disease.
Is the transplant‐preserving management of renal allograft rupture justified?
Authors: Heimbach D. , Miersch W.‐D. , Buszello H. , Schoeneich G. , Klehr H.‐U. 
Published: November 2008

Objective To evaluate the transplant‐preserving management of renal allograft rupture. Patients and methods From April 1982 to January 1994 a total of 238 renal transplantations were performed on 227 patients. Eight cases (3.5%) of renal allograft rupture occurred. Transplant nephrectomy was necessary in one patient. Seven patients were surgically treated with collagen foam, fibrin glue and vicryl mesh. Results In all seven cases treated conservatively, renal salvage and satisfactory graft function was achieved. After a mean follow‐up of 52.9 months (range 2‐94) the mean creatinine level was 15.6 mg/L (range 11‐21). Of these seven patients with renal allograft rupture one returned to haemodialysis 22 months after transplantation and had several episodes of rejection. Almost 4.5 years after renal allograft rupture, the creatinine value in six of the seven patients was only slightly higher than the mean creatinine values of all donor kidney recipients (14.4 ± 5.5 mg/L). Conclusion There should be an attempt to salvage the transplant after allograft rupture in all cases. Using these transplant‐preserving techniques, renal function could be achieved for all patients with allograft rupture.
The expression of ferritin on renal cancers and its relationship with cellular differentiation and tumour stage
Authors: Yu D.‐S. , Yueh K.‐C. , Chang S.‐Y. , Yang T.‐H. , Ma C.‐P. 
Published: November 2008

Objectives To investigate ferritin expression in renal carcinoma and the correlation of expression with tumour differentiation and stage. Patients and methods Ferritin was immunohistologically detected in 35 patients (23 men and 12 women; mean age 58.2 years, range 40‐82) with renal carcinoma and the findings compared with cellular type, tumour stage and the ferritin expression of a similar control population of 16 patients. Results The incidence of ferritin expression in renal carcinomas was 51%. Expression was significantly related to tumour stage and not cellular type. Conclusion The Results of this study re‐emphasize the high expression of ferritin in renal cell carcinoma and the correlation of expression with tumour behaviour.
Intravesical mitozantrone in recurrent superficial bladder cancer: a phase II study
Authors: Namasivayam S. , Whelan P. 
Published: November 2008

Objective To assess the efficacy of adjuvant intravesical mitozantrone in recurrent superficial bladder cancer. Patients and methods Twenty‐one patients (15 men and six women, mean age 69 years, range 50‐91) with recurrent superficial bladder cancer were recruited for the trial between 1990 and 1992. After transurethral resection or diathermy of the tumour, each patient received 20 mg mitozantrone intravesically in 50 mL normal saline, which was retained for 1 h. The instillations were repeated at 2‐weekly intervals to a total of four instillations. The patients were followed up for 1 year. Results Ten patients had a complete response, but only four were free of tumour at 1 year. Seven patients had a partial response whilst four had progression of their tumour. Only two patients withdrew from treatment due to chemical cystitis. Conclusion Mitozantrone at the dose used in this study produced a high response rate and a low incidence of side‐effects compared with established agents.
Malignancies of the genito‐urinary system following renal transplantation
Authors: Schmidt R. , Stippel D. , Krings F. , Pollok M. 
Published: November 2008

Objective To analyse the development of malignancies of the genito‐urinary system after renal transplantation.Patients and methods A total of 868 renal graft recipients were followed up over a mean period of 41.8±45 months. Fifteen patients received grafts from living related donors and 853 were transplanted with kidneys from cadavers.Results Twelve patients (1.4%) exhibited Cancer of the genito‐urinary system: 11 tumours were de novo malignancies. One small renal carcinoma was transplanted from a living related donor. The incidence of tumours of the genito‐urinary system was 34 in 100000 patient years in the patients treated with cyclosporin and 32 in 100000 patient years in the conventional therapy group. Four patients died within a mean survival time of 14.4 months. Comparison of our results with sex‐ and age‐specific incidence rates in a reference population showed an increase in malignant tumours of the genitourinary system by a factor of 7.3 in males and 11.2 in females.Conclusions The frequency of disorders after transplantation necessitates routine examinations in organ transplanted recipients both before and at regular intervals after transplantation, including the patient's native kidneys and cervical smears in females.
Differential suppression of serum prostatic acid phosphatase and prostate‐specific antigen by 5‐alpha‐reductase inhibitor
Authors: Narayan P. , Tewari A. , Jacob G. , Mahmood I. , Gajendran V. , Presti J. 
Published: November 2008

Objective To evaluate the effect of finasteride (Proscar®) on the serum levels of prostatic acid phosphatase (PAP) and prostate‐specific antigen (PSA) in patients with benign prostatic hyperplasia (BPH).Patients and methods Thirty patients on finasteride therapy for BPH formed the study group. Serum PSA and PAP levels were monitored for 2 years while the patients were receiving finasteride.Results During 12 months of finasteride therapy the serum PSA was suppressed but serum PAP was unaffected. The baseline mean PAP value was 1.303 ng/mL prior to finasteride therapy; this changed to 1.510 ng/mL (P=0.195) at 6 months and 1.166 ng/mL (P= 0.383) at 12 months. The serum PSA was 2.630 ng/mL at baseline, 1.757 ng/mL (P<0.001) at 6 months and 1.545 ng/mL (P= 0.001) at 12 months.Conclusions Further studies are warranted to determine if PAP has a role as a tumour marker in patients whose PSA is suppressed as a result of finasteride therapy.
The Kropp‐onlay procedure (Pippi Salle procedure): a simplification of the technique of urethral lengthening. Preliminary Results in eight patients
Authors: Mouriquand P.D.E. , Sheard R. , Phillips N. , White J. , Sharma S. , Vandeberg C. 
Published: November 2008

Objective To lengthen the urethra to increase bladder outlet resistance in adolescent girls with a neuro‐genic bladder.Patients and methods During a 2‐year period (1992–94), eight girls (mean age 13.5 years, range 9–19) underwent a Kropp‐onlay urethral lengthening associated, for six of them, with a bladder augmentation. Seven of the eight patients patients were spina biflda and confined to a wheelchair. One patient had had a previous transverse myelitis. A Benchekroun hydraulic valve (in three cases) and a Malone procedure (in two cases) were performed at the same stage. The technique of Kropp‐onlay urethral lengthening, which creates a flap valve mechanism which leaks when the bladder is too full, is described and illustrated.Results Seven of eight patients were dry during the day and four were occasionally damp during the second part of the night. One could not be dry for more than 2 h during the day but had a very hyperactive detrusor. She developed two bladder stones which required an open vesicotomy. One developed a urethral fistula requiring a second Kropp‐onlay procedure and became dry afterwards. Two patients, who did not undergo a bladder augmentation, needed oxybutinin therapy to obtain a satisfactory result. Post‐operative urodynamic measurements are discussed.Conclusion The Kropp‐onlay urethral lengthening is easier to perform than the original Kropp procedure. The preliminary Resultsare similar to those of alternative techniques (e.g. urethral suspension) but long‐term reliability of this technique remains unknown.
Histological response to injected Polytef and Bioplastique in the sheep brain
Authors: Dewan P.A. , Owen A.J. , Byard R.W. 
Published: November 2008

Objective To assess the histological response of the sheep brain to the intra‐arterial injection of particulate plastic.Materials and methods Four sheep had either polyte‐trafluoroethyene‐containing Polytef or silicone‐containing Bioplastique injected into the left carotid artery under direct vision. Two were killed soon after and the others were studied at 6 months. The brains of the animals were examined using routine histology, phase contrast and polarized light.Results The polytetrafluoroethylene or silicone particles were identified in the two animals killed soon after the injection, and the two animals examined 6 months later. There was no evidence of demyelination and only a minimal inflammatory response to the plastic particles which had found their way into the brain parenchyma.Conclusion Demyelination does not occur in the sheep brain after intra‐arterial injection of Polytef and Bioplastique, and inflammation occurs only to a minor degree.
Acid mucin and high molecular weight cytokeratin in prostatic lesions: evaluation of a combined histochemical and immunohistochemical stain
Authors: GAL R. , HALPERN M. , KOREN R. , RATH‐WOLFSON L. , KLEIN B. , SIEGAL A. 
Published: November 2008

Objective To evaluate the presence of acid mucins and high molecular weight cytokeratin (KER) in prostatic lesions using a combined histochemical and immunohistochemical stain consisting of Alcian blue at pH 2.5(AB) with a strept‐avidin‐biotin complex (SAB) staining for KER (SAB‐KER).Materials and methods Sections were obtained from archival paraffin blocks which included 20 cases of prostatic carcinoma, 30 cases of benign hyperplasia, and five cases of basal cell hyperplasia. Sections were stained for mucosubstances using the AB stain, for KER using SAB‐KER and by both AB and SAB‐KER, the combined stain (CS).Results With the CS stain KER, which is present in the prostatic basal cells, was not detected in malignant glands and in 60% of these cases intraluminal blue‐stained acidic mucin was seen. On the other hand, all benign hyperplastic prostatic glands were devoid of intraluminal acidic mucin and showed staining for KER of their basal cells. Areas of basal cell hyperplasia were strongly positive for KER and intraluminal acidic mucin was seen in one case. Each of the stains separately gave similar results to the CS method but the contrast between the areas of carcinoma and hyperplasia was accentuated by the CS. and small foci of carcinoma were easily detected.Conclusion The combined AB + SAB‐KER stain is quicker to perform and allows the simultaneous appraisal of acid mucin and KER.