bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neoadjuvant hormonal therapy and radical prostatectomy for clinical stage C carcinoma of the prostate
Authors: NARAYAN P. , LOWE B.A. , CARROLL P.R. , THOMPSON I.M. 
Published: November 2008

Objective To determine whether hormonal therapy prior to radical prostatectomy (neoadjuvant hormonal therapy) leads to improved results in patients with stage C prostate cancer. Patients and methods Thirty patients received neoadjuvant hormonal therapy for stage C carcinoma of the prostate. Eighteen patients who responded to treatment subsequently underwent extirpative surgery. Results Fourteen of the 30 patients (47%) were diagnosed as being downstaged to clinical stage B disease following therapy. No major complications occurred. Pathology staging revealed only three patients (10%) to have organ‐confined disease after radical prostatectomy. Conclusions Neoadjuvant hormonal therapy prior to radical prostatectomy offers little probability of rendering patients with clinical stage C carcinoma of the prostate free of disease. Further investigation of the efficacy of this treatment should be accomplished in randomized trials.
Iatrogenic ascent of the testis: an under‐recognized complication of inguinal hernia operation in children
Authors: SURANA R. , PURI P. 
Published: November 2008

Objective To determine the incidence of iatrogenic ascent of the testis following inguinal hernia repair in children. Patients and methods A total of 62 7 children underwent 747 groin explorations for inguinal hernia between January 1981 and December 1984. A retrospective review of their charts until December 1991 was undertaken. Results Nine patients subsequently required orchidopex‐ies at a mean interval of 3 years 171 days (range 229 days ‐ 6 years 6 months). The incidence of iatrogenic ascent of the testis was 1.3% (6/459) for patients under 2 years of age at the initial operation, 1.3% (2/155) for those between 2 years and 5 years and 0.75% (1/133) for those above 5 years. Conclusion The incidence of iatrogenic ascent of the testis was 1.2% after groin exploration for inguinal herniotomy in children, indicating the need for long‐term follow‐up.
Written information for transurethral resection of the prostate — a national audit
Authors: Montgomery B.S.I. , Venn S.N. , Beard R.C. 
Published: November 2008

Objectives To assess the use and content of written information relating to transurethral resection of the prostate (TURP). Materials and methods All 328 full members of the British Association of Urological Surgeons (BAUS) were requested to submit any information sheets or specialized consent forms given to patients about to undergo TURP. They were asked to record when the information was given and whether this was recorded in the notes. The sheets were analysed with reference to a nominally comprehensive list of topics suitable for inclusion in such sheets. Results One‐hundred and eleven replies were received (34%) which represents 44% of urological departments. Of those replying, only 56 used information sheets for TURP. The overall comprehensiveness of the information was surprisingly poor, with 12% omitting to mention retrograde ejaculation and 19% failing to discuss the need for a catheter. Conclusion The written information given to patients about to undergo TURP appears inadequate. There is a need for a nationally accepted information sheet that can be edited locally.
Post‐operative serial prostate‐specific antigen and transrectal ultrasound for staging incidental carcinoma of the prostate
Authors: Feneley M.R. , Webb J.A.W. , McLean A. , Kirby R.S. 
Published: November 2008

Objectives To examine the value of post‐operative serum prostate‐specific antigen (PSA), PSA density, incremental change in serial serum PSA (PSA slope) and transrectal ultrasound (TRUS) in the assessment of residual malignancy after the diagnosis of clinically unsuspected prostatic adenocarcinoma at transur‐ethral resection of the prostate (TURP). Patients and methods Forty‐eight untreated patients with incidental carcinoma of the prostate, demonstrated at TURP for a clinically benign gland, were evaluated post‐operatively with serum PSA and TRUS with multiple systematic prostatic biopsies. Prostatic volume was determined from TRUS measurements and PSA density was defined as serum PSA divided by gland volume. Those patients who did not undergo further treatment were monitored with serial PSA levels, and PSA slope was calculated as the overall annual percentage increase in serum PSA. Results Among 36 patients staged T1A (A1), 11 (31%) had histologically proven residual carcinoma, and five of the 12 patients (42%) with T1B (A2) disease had no residual disease on biopsy. Serum PSA levels following TURP were greater in those patients with residual disease than those without (P= 0.001), but at a cut‐off of 4.0 ng/mL — providing a sensitivity of 89%— the specificity of PSA alone was 57%. PSA density had an 83% sensitivity and a 67% specificity with a cut‐off of 0.15 ng/mL/cm3. TRUS had a sensitivity of 63% and a specificity of 52%. An incremental rise in PSA exceeding 20% per year in untreated patients gave a sensitivity of 90% and specificity of 79% for biopsy proven residual malignancy. Conclusion This study demonstrates the inaccuracy of staging incidental prostatic malignancy by TURP. Although the performance of PSA density is better than that of PSA alone, the reliability of both are limited by the lack of specificity, and TRUS imaging lacks both sensitivity and specificity. The PSA slope has sufficient sensitivity and specificity to distinguish reliably most patients with biopsy proven residual malignancy. Although ultrasound‐guided systematic biopsies provide a means for confirming residual malignancy, they may not be indicated in all patients with incidental carcinoma: for such patients, PSA progression may provide a rational basis for subsequent treatment.
Radical radiotherapy for localized adenocarcinoma of the prostate. A report of 191 cases
Authors: El‐Galley R.E.S. , Howard G.C.W. , Hawkyard S. , KLYS H. , Kerr G.R. , Duncan W. , Chisholm G.D. , Fowler J.W. 
Published: November 2008

Objective To assess the Results of radiotherapy in the treatment of localized prostate cancer. End points for assessment were survival, local control, development of metastases, and the toxicity of therapy. Materials and methods The case notes of 191 patients who were treated with radical radiotherapy between 1982 and 1992 were reviewed. The pathology of 130 patients was reviewed by a single pathologist. A multivariate analysis was performed to identify significant prognostic factors with regard to survival and relapse. Results One‐hundred and eighty‐two patients were assessable. The minimum length of follow‐up was one year (median = 40 months). The actuarial cause‐specific 5 and 10 year survival rates were 63% and 35% respectively. Local progression occurred in 41% of patients with 37% developing metastases. Multivariate statistical analysis demonstrated that T stage and Gleason Score were significant predictors for survival. Late complications were usually mild, with only 4% developing serious bladder toxicity. Conclusion Radical radiotherapy has a role in the curative treatment of prostate cancer. Survival is significantly related to T stage at the time of presentation, and to the Gleason Score of the tumour. Survival in this series was not as good as the best surgical series, but it is still not clear which patients should receive radiotherapy and which surgery as their primary management.
Anti‐bacterial activity of the fluid contents of spermatoceles and epididymal cysts
Authors: Günaydin G. , Özyurt C. , Koçak I. , Badak Z. , Girgin F. 
Published: November 2008

Objective To show that the fluids obtained from spermatoceles and epididymal cysts are not infected, even though they may be present for long periods, and that these fluids have bactericidal activity. Materials and methods Sixteen patients, 13 with a spermatocele and three with an epididymal cyst, were included in the study. Protein, glucose, chloride, inorganic phosphorus, calcium and magnesium contents were measured and cultures of the fluids were carried out. Bactericidal activity against the Escherichia coli NTCC 10418 clone was tested in different dilutions. Results Biochemical analysis showed that the protein, glucose and ionic content of the fluids was lower than that of serum, except for chloride. Microbiological cultures were negative for all samples. A significant bactericidal effect was obtained with 1/1 dilution and no reproduction was seen with this dilution. Conclusion These findings indicate that the fluids within spermatoceles and epididymal cysts do not become infected under normal circumstances.
Different susceptibilities of lymphokine‐activated killer cells (LAK cells) among primary and metastatic renal cell carcinoma derived from the same patient
Authors: Hattori T. , Satoh M. , Nishimura T. , Kawamura N. , Akimoto M. 
Published: November 2008

Objective To investigate the susceptibility of primary renal cell carcinoma (RCC) and metastatic RCC to lymphokine‐activated killer (LAK) cells using three RCC cell lines derived from the primary and metastatic tumours in a male patient with advanced RCC. Materials and methods Three RCC cell lines (named HANKS) were derived from a 44‐year‐old man with advanced RCC. HANKS‐Pr, HANKS‐Lu and HANKS‐LN were established from the primary lesion and the metastatic lung and lymph node lesions, respectively. The susceptibility of HANKS cell lines to 18 different LAK cells obtained from either patients with urological cancer or from healthy volunteers was studied. The three groups of LAK cells were divided as follows: (A) LAK cells from RCC patients (n= 6); (B) LAK cells from patients with transitional cell carcinoma (TCC)/prostatic carcinoma (CaP) (n= 4) and (C) healthy volunteers (n= 8). A 51Cr‐releasing cytotoxic assay was used to determine susceptibility. Results The mean percentage lysis of the HANKS cell lines to the 18 allogenic LAK cells were 28.1% in HANKS‐Pr, 20.2% in HANKS‐Lu and 10.4% in HANKS‐LN. The susceptibility of HANKS‐LN to LAK cells was significantly lower than that of HANKS‐Pr and HANKS‐Lu in all three groups (P<0.05). In contrast, the susceptibility of HANKS‐Pr was significantly higher than HANKS‐Lu in group A only (P<0.01). Conclusion This is the first report to describe the different susceptibilities of primary RCC and metastatic RCC derived from the same patient. HANKS‐LN itself might be the least susceptible to LAK cells because it was not related to the source of LAK cells. Furthermore, RCC may affect the cytotoxicity of LAK cells to HANKS‐Pr. These data indicate there are at least two different types of mechanisms leading to the different susceptibilities of HANKS cells to LAK cells.
Numerical chromosome aberrations in bladder cancer detected by in situ hybridization
Authors: Nemoto R. , Nakamura I. , Uchida K. , Harada M. 
Published: November 2008

Objective To investigate the relationship between interphase cytogenetics and the grade and stage of bladder Cancer in patients with transitional cell carcinomas of the urinary bladder. Patients and methods By use of in situ hybridization with chromosome‐specific DNA probes, the copy number of pericentromeric sequences on chromosomes 7, 10, 11, 17, 18, X and Y was detected within interphase nuclei in formalin‐fixed and paraffin‐embedded sections of the routinely processed bladder cancers from 20 patients. The percentage of hyperdi‐ploid cells (three or more spots) was estimated using light microscopy. Results The percentage of hyperdiploid cells for chromosomes 7, 11 and 17 was highly correlated with increasing tumour grade (P<0.01, Spearman rank correlation) or increasing pathological stage (P<0.01). The percentage of hyperdiploid cells for chromosome Y was not correlated with either grade or stage (P>0.05). As high tumour grade and stage are both indicative of more aggressive tumour behaviour and a worse prognosis, these findings suggest that the percentage of hyperdiploid cells, especially for chromosomes 7,11 and 17, may be highly predictive of bladder tumour aggressiveness. Conclusion These preliminary results suggest that measurement of numerical chromosome aberrations using in situ hybridization in bladder cancer may offer a new objective and quantitative assay of the biological potential of individual tumours.
Laparoscopic varicocelectomy: technique and results
Authors: Tan S.M. , Ng F.C. , Ravintharan T. , Lim P.H.C. , Chng H.C. 
Published: November 2008

Objective To determine the safety and efficacy of laparoscopic varicocelectomy in the treatment of symptomatic varicocele. Patients and methods Indications for surgery were subfertility in 98 patients and pain in nine. All varico‐celes were confirmed on Doppler ultrasound. Seventy‐two per cent of the patients had left‐sided varicoceles and bilateral varicoceles were seen in 27%. A three‐puncture technique was used with carbon dioxide insufflation. The spermatic vessels were individually identified and clips were used to ligate the veins. The spermatic artery was preserved in all cases. The operation was performed on a day surgery basis with an average operative time of 61.4 min (56.6 min for unilateral and 75.8 min for bilateral varicocelectomy). Results Morbidity was low, with pneumoscrotum in two patients and wound infection in two others. Sixty‐one patients for whom pre‐ and post‐operative seminal analyses were available showed improvement in sperm count and motility, with a concomitant fall in the percentage of abnormal sperm forms. Conclusion Laparoscopic varicocelectomy is safe and effective, causing minimal discomfort and allowing patients an early return to activity.
Delayed management of posterior urethral disruption in children
Authors: Kardar A.H. , Sundin T. , Ahmed S. 
Published: November 2008

Objective To review the results of delayed operative treatment of total disruption of the posterior urethra in children. Patients and methods Twelve boys (3–12 years, mean 7.5) with a suprapubic catheter were referred after primary management in other hospitals. All but one had been involved in road traffic accidents. In addition to their urethral injury, they all had pelvic fractures and the majority also had other major associated injuries. Six to 14 months after injury, abdominoperi‐neal transpubic urethroplasty was performed in 11 patients according to Turner—Warwick. In one case a perineal anastomotic urethroplasty was performed. Results After the operation, voiding cysto‐urethro‐graphy showed a wide anastomosis in all cases. After 3 to 45 months follow‐up, there were no strictures. Eight boys were continent, two were totally incontinent, two had stress incontinence and one nocturnal enuresis. All patients with confirmed erections after injury also had erections after their operation. Conclusion Primary suprapubic cystostomy and delayed repair can be used successfully for the treatment of posterior urethral disruption in children.
The influence of age on treatment choice and survival in 735 patients with renal carcinoma
Authors: Damhuis R.A.M. , Blom J.H.M. 
Published: November 2008

Objective To determine whether age is related to treatment choice and survival in patients with renal carcinoma. Patients and methods In this retrospective study 735 patients with renal carcinoma, diagnosed between 1982 and 1990 in one of the hospitals connected to the Rotterdam Cancer Registry, were evaluated with respect to treatment choice and survival. Results Nephrectomy was performed less often in elderly patients, both with and without distant metastases. The resection rate for patients aged 70 years and older was 63% against 82% for younger patients (P < 0.001). Crude 5‐year survival rates for patients aged 20–59, 60–69 and 70+ were 54, 38 and 22% respectively. For patients with tumours restricted to the kidney (Robson stage 1), corrected survival rates were 80, 70 and 48% respectively. The overall postoperative mortality was 3.8% and was not related to age (P = 0.73). Conclusion Treatment choice and outcome in patients with renal carcinoma were affected by age. As the proportion of patients aged 70 years and older, now 38%, will inevitably increase in the next decades, more attention is needed with respect to contraindications for surgical treatment in the elderly.
Expression of retinoblastoma gene product and p53 protein in bladder carcinoma: correlation with Ki67 index
Authors: Wright C. , Thomas D. , Mellon K. , Neal D.E. , Horne C.H. Wilson 
Published: November 2008

Objectives To determine whether loss of the tumour suppressor gene retinoblastoma (Rb) and increased expression of the p53 protein were associated with increased tumour cell growth fraction. Patients and methods Tumours from 105 patients (72 men, 33 women; median age 69 years, range 35–89) with newly diagnosed primary transitional cell bladder carcinoma were studied. Tumour samples were taken by means of cystoscopic resection. Expression of the retinoblastoma (Rb) and p53 gene products was assessed immunohistochemically in 98 of the carcinomas. The proportion of cells expressing the Ki67 antigen (Ki67 index which is a measure of growth fraction) was determined in 64 cases. Results p53 protein was detectable in 50% and Rb protein in 82% of the tumours. Staining for p53 and lack of staining for Rb protein were associated with muscle‐invasive growth and high tumour grade (G3). The Ki67 index varied over a wide range (1–47%), but there were significant differences between mean indices for poorly differentiated (G3) and well or moderately differentiated (G1/G2) tumours, and between indices for muscle‐invasive and the remaining tumours. The mean Ki67 indices for Rb‐negative tumours and p53‐positive tumours were approximately twice those for Rb‐positive and p53‐negative tumours. Only 10% of the tumours expressed high levels of p53 protein and failed to express Rb. Conclusion These observations are consistent with the hypothesis that loss of Rb and mutation and overexpr‐ession of p53 are associated with an increased tumour cell growth fraction and that such changes may play a role in the de‐regulation of cell proliferation in transitional cell carcinoma of the bladder.
Low‐dose bacille Calmette‐Guerin (BCG) therapy in superficial high‐risk bladder cancer: a phase II study with the BCG strain Connaught Canada
Authors: Mack D. , Frick J. 
Published: November 2008

Objective To evaluate low‐dose bacille Calmette‐Guerin (BCG) therapy, with the Connaught Canada strain, in patients with superficial transitional cell carcinoma (STCC) of the urinary bladder. Patients and methods Between September 1990 and December 1992 25 patients were entered into a phase II study to evaluate the feasibility, response and tox‐icity of BCG immunotherapy for patients with high‐risk STCC. Therapy consisted of six, weekly instillations of 27 mg (3 times 108 colony‐forming units) of the BCG strain Connaught Canada. Maintenance therapy was administered monthly for 1 year with the same dosage. Results Of 25 eligible patients, 84% had complete responses after the initial cycle with low‐dose BCG and had stable disease. Four patients had no response, three of whom subsequently underwent radical cystec‐tomy. The mean length of follow‐up was 30.8 months (25–36). Toxicity included profound local reactions such as severe dysuria, frequency and gross haema‐turia. No systemic infections, except fever, were seen; none of the patients needed isoniazid. All reactions were treated symptomatically. Conclusions The results of this study suggest that low‐dose BCG with the strain Connaught Canada can be successfully used in the treatment of patients with high‐risk STCC. Toxicity was not reduced substantially by the lower dosage of BCG used.
Results of radiotherapy on ureteric obstruction in muscle‐invasive bladder cancer
Authors: De Lichtenberg M. Honnens , Miskowiak J. , Rolff H. 
Published: November 2008

Objective To evaluate the effect of radiotherapy on ureteric obstruction due to muscle‐invasive bladder cancer. Patients and methods Retrospective evaluation of the records of 5 74 patients with muscle‐invasive bladder cancer revealed 90 patients (16%) with ureteric obstruction; the obstruction was bilateral in 24%. The effect of radiotherapy was assessed in 55 patients with 68 obstructed kidneys. Six patients with eight obstructed kidneys required percutaneous nephros‐tomy or ureteric catheters in addition to radiotherapy. Results Drainage improved in 20% of kidneys and the diverting catheter was withdrawn permanently in one (17%) of the diverted patients. The median survival was 11 months. Irradiation was followed by significant complications in 37 patients (67%). Conclusion The results of this study raise doubts about the assumed beneficial effect of irradiation on ureteric obstruction due to muscle‐invasive bladder cancer. The short median survival of 11 months confirms that ureteric obstruction is a poor prognostic factor in muscle‐invasive bladder cancer.
Correlation of transrectal ultrasound imaging and theResults of systematic biopsy with pathological examination of radical prostatectomy specimens
Authors: Gohji K. , Morisue K. , Kizaki T. , Fujii A. 
Published: November 2008

Objective To determine the usefulness of transrectal ultrasound (TRUS) and systematic biopsy by correlating these Results with pathological findings after radical prostatectomy. Patients and methods Pre‐operative TRUS examination combined with the findings on systematic biopsy in 15 patients (mean age 70.6 years, range 57‐87) who underwent radical prostatectomy between October 1992 and February 1994 were compared retrospectively to the histological features of whole mount sections of the surgical specimens. Results In all cases, the tumour was visualized as a hypoechoic area on the sonogram. In addition, in six of 15 cases the tumour was localized in an isoechoic area which was examined before the operation by systematic biopsy. In this series, a systematic biopsy before operating detected tumour grade and localization of the tumour in 14 and 15 patients, respectively. The positive predictive value of capsular penetration and seminal vesicle invasion on the sonogram was 0.71 and 1.00, respectively, while sensitivity was 1.00 and 0.33, respectively. Five of seven patients with findings of capsular penetration on the sonogram revealed capsular penetration in the resected prostate, whereas, of three patients with pathologically detected seminal vesicle invasion, only one had findings of seminal vesicle invasion by ultrasonography. The serum prostate specific antigen level of all three patients was more than 30 ng/mL. Moreover, in this series of 15 patients TRUS detected the precise stage in 11 patients. In the remaining four patients, two were overstaged and two were understaged. Tumours with hypoechogenicity were of higher grade and larger than tumours with isoechogenicity. AH tumours with hypoechogenicity were palpable and all with isoechogenicity were not. Conclusions TRUS combined with a systematic biopsy was useful in predicting tumour grade, exact location and capsular penetration. However, it was not useful for determining tumour stage or predicting seminal vesicle invasion of prostate cancer. TRUS‐guided seminal vesicle biopsy must be performed in patients with a serum prostate specific antigen of more than 30 ng/mL.