bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between Prostate Specific Antigen, Prostate Volume and Age in the Benign Prostate
Authors: COLLINS G. N. , LEE R. J. , McKELVIE G. B. , ROGERS A. C. N. , HEHIR M. 
Published: November 2008

Summary— The relationship between prostate specific antigen (PSA) levels, prostate volume and age was examined in 472 men who underwent PSA assay (Hybritech), digital rectal examination (D RE) and transrectal ultrasound (TRUS) as part of a community survey of benign prostatic hyperplasia following exclusion of men with prostate cancer.The mean age of the study population was 60 years (range 40–79). The mean PSA was 2.4 ng/ml and 85% of the men had levels <4 ng/ml. There was a modest correlation between PSA and both age and prostate volume. The mean prostate and adenoma volumes were 32 ml (SD 13.4) and 15 ml (SD 10.7) respectively. Prostate volume increased with age. Linear regression analysis revealed an independent association between PSA and age when controlling for volume. The mean ratio of PSA per unit of prostate volume was 0.072 ng/ml. This ratio also increased with age.Age and prostate volume influences PSA levels independently. The sensitivity and specificity of PSA adjusted for volume and age in the diagnosis of prostate cancer need to be evaluated in association with DRE and TRUS.
Influence of Ionic Strength on Crystal Adsorption and Inhibitory Activity of Macromolecules
Authors: UTSUNOMIYA M. , KOIDE T. , YOSHIOKA T. , YAMAGUCHI S. , OKUYAMA A. 
Published: November 2008

Summary— We investigated the influence of ionic strength on both the binding ability of macromolecules onto calcium oxalate crystals and the inhibitory activity of macromolecules related to calcium oxalate crystal growth and aggregation in vitro. The amount of heparin sodium salt adsorbed onto calcium oxalate crystals was studied in both a seed and a non‐seed crystal system at various ionic strengths with the aid of radiolabelled heparin. In both adsorption models, adsorption of heparin was greater in the buffered solutions of lower ionic strength, and significantly so in the range of physiological ionic strength. The inhibitory activity of heparin in the non‐seed crystal system, which was determined using a Coulter Multisizer, increased as the adsorbed dose increased. The naturally existing urinary macromolecules showed a similar change in their inhibitory activity on calcium oxalate crystal growth and/or aggregation in accordance with changes in ionic strength.These results indicate that macromolecular inhibitory activity seems to be enhanced in urine of lower ionic strength as a result of an increased adsorption of macromolecules on the surface of calcium oxalate crystals.
Serum and Urinary Zinc Levels in Urolithiasis
Authors: RANGNEKAR G. V. , GAUR M. S. 
Published: November 2008

Summary— Zinc has an important place amongst inhibitors of crystallisation and crystal growth. These views are supported by in vivo and in vitro studies which suggest that the urinary zinc level is a significant factor in urolithiasis. Some recent studies have given contradictory results.Blood serum and urinary zinc levels were measured in 30 normal healthy controls and 42 stone forming patients (renal, ureteric and vesical). Statistically significant levels were found in all groups, varying according to the number of calculi. Increased urinary zinc levels and decreased serum zinc levels appear to be secondary to the process of stone formation. The role of zinc as an inhibitor of urolithiasis is questionable.
Can Renal Blood Flow, Glomerular Filtration Rate or 99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?
Authors: KELLEHER J. P. , ANDERSON P. J. , GORDON I. , RANSLEY P. G. , SNELL M. E. 
Published: November 2008

Summary— Single kidney glomerular filtration rate (SKGFR), single kidney blood flow (SKBF) and differential renal function (DRF), using both technetium labelled diethylenepenta‐acetic acid (99mTc‐DTPA) and dimercaptosuccinic acid (99mTc‐DMSA), were examined as predictors of outcome in a pig model of complete unilateral ureteric obstruction. SKGFR and SKBF were unable to predict outcome following relief of obstruction but there was a high curvilinear correlation between DRF assessed at the end of defined periods of obstruction and after relief of obstruction using 99mTc‐DMSA. Functional recovery was near complete using DMSA when the loss in DRF did not exceed 30%, after which there was an exponential decline in expected recovery.There was no difference between DRF using 99mTc‐DTPA or 99mTc‐DMSA in controls or before or after obstruction but significant differences between assessment by these radionuclides existed in the obstructed kidney at 24 h, 5 days, 10 days and 20 days. 99mTc‐DMSA is a sensitive agent in the prediction of outcome following acute complete obstruction in the pig but its assessment of DRF in the obstructed kidney differs markedly from that of 99mTc‐DTPA.
Is Planned Continuous Irrigation Indicated for Haemorrhage following Transurethral Resection of the Prostate?
Authors: MOBB GILLIAN E. , FARRAR D. J. 
Published: November 2008

Summary— A prospective audit was carried out of this unit's policy of non‐irrigation following transurethral prostatectomy (TURP). Over an 11‐month period 121 TURPs were performed.Only 29 patients required intervention to maintain bladder drainage post‐operatively, 23 of these requiring bladder washout alone. In the remaining 6 patients catheter change and continuous irrigation were required.The weight of tissue resected was the only factor investigated which bore a significant relationship to the necessity for further intervention in bladder drainage post‐operatively. Despite this, patients requiring continuous irrigation post‐operatively could not be easily identified prior to or during surgery.
The Urethral Plug 11: An Alternative Treatment in Women with Genuine Urinary Stress Incontinence
Authors: NIELSEN K. K. , WALTER S. , MAEGAARD ELSEMARIE , KROMANN‐ANDERSEN B. 
Published: November 2008

SummaryAn improved design of the recently developed urethral plug was evaluated for the treatment of women with genuine urinary stress incontinence. The plug consists of an oval meatal plate, a soft stalk and 1 or 2 spheres along the stalk with fixed distances between the meatal plate and the spheres. Inside the stalk is a removable semi‐rigid guide pin to ease insertion. Forty women were randomly allocated to treatment with either the 2‐sphere or the 1 ‐sphere plug during period 1 (2 weeks). In period 2 (2 weeks) the patients used the other plug. They then continued with what they judged to be the better plug in period 3 (2 months). Eighteen patients (45%) completed period 3 with the “preference” plug and 17 were subjectively and objectively continent or improved. Fourteen of these women preferred the 2‐sphere device. The plugs were equally effective in patients with mild or severe incontinence. To accommodate variations in urethral length and to avoid the loss of plugs, the devices are available in different lengths. Six women developed urinary tract infections and 2 of these had a plug in the bladder.The urethral plug is an effective treatment in a group of women with stress incontinence. Removal by hand is advisable in order to avoid retention of plugs in the bladder.
Proliferation Indices as Independent Prognostic Factors in Papillary Ta‐T1 Transitional Cell Bladder Tumours
Authors: LIPPONEN P. K. , ESKELINEN M. J. , JAUHIAINEN K. , TERHO R. , NORDLING S. 
Published: November 2008

SummaryA cohort of 148 patients with papillary Ta‐T1 transitional cell carcinomas (TCCs) was followed up for over 10 years and flow cytometric (DNAploidy, S phase fraction) and morphometric variables (5 nuclear factors, volume corrected mitotic index) were related to prognosis during this period. Recurrence‐free survival was significantly related to DNAploidy, S phase fraction and M/V index. Progression in T‐category was predicted by M/V index, S phase fraction, DNA ploidy and WHO grade. The same variables predicted progression in N‐ and M‐categories. In a multivariate analysis only M/V index and S phase fraction were independent predictors of progression. Univariate analysis showed that M/V index, SPF, DNA ploidy and WHO grade predicted survival. In a multivariate survival analysis only M/V index and SPF were independent predictors. The results showed that proliferation indices had independent prognostic value in papillary Ta‐T1 TCCs and the grading of these tumours could be based on the proliferation indices. Papillary Ta‐T1 tumours with a M/V index value 10/mm2or SPF 10% had a favourable prognosis whereas tumours with M/V index > 10/mm2or SPF > 10% had a high malignant potential.
Positive Margins after Radical Prostatectomy: Correlation with Local Recurrence and Distant Progression
Authors: Van den OUDEN D. , BENTVELSEN F. M. , BOEVE E. R. , SCHRODER F. H. 
Published: November 2008

SummaryThe impact of positive and negative surgical margins of resection on the interval to and incidence of progression was analysed in 172 patients after radical retropubic prostatectomy combined with lymphadenectomy; 56 had positive margins. Lateral and apical positive margins were evaluated separately.The status of surgical margins was correlated with other prognostic factors, such as the T category, the presence or absence of seminal vesicle invasion and the G category. This analysis showed that positive and negative margins significantly influenced time to progression independently of the other prognostic factors. Positive margins at the apex contrary to lateral margins did not significantly influence time to progression. This may be due to the definition of the status of apical margins used in this analysis. A total of 108 patients underwent a nerve‐sparing radical prostatectomy, which did not lead to a higher incidence of positive margins than the standard procedure.Prostate specific antigen accurately predicted tumour recurrence after radical prostatectomy. A rise of 1.0 ng/ml preceded other evidence of recurrence by a mean of 11 months.
Extracorporeal Shock Wave Lithotripsy for Ureteric Calculi with the Dornier MFL5000 Lithotriptor at a Multi‐user Centre
Authors: WATSON R. B. , JAMES A.N. 
Published: November 2008

Summary We have reviewed 241 consecutive cases of ureteric calculi managed with the Dornier MFL5000 lithotriptor. The patients were individually managed by 24 visiting urologists between October 1990 and September 1991.There were 153 cases of upper ureteric calculi, of which 59 were successfully manipulated back to the renal pelvis prior to treatment, and 94 were treated in situ. There were 27 mid‐ureteric and 61 lower ureteric cases; in 51% of stones treated in situ ureteric stents were placed prior to extracorporeal shock wave lithotripsy. All stones were radio‐opaque and localised with on‐line fluoroscopy.The outcome of treatment was assessed at 3 months, with failure defined as residual calculi ≤4 mm. The follow‐up rate was 89%. The overall fragmentation rate after a single treatment was 72%, which increased to 81% with re‐treatment. Of the upper ureteric calculi, manipulated stones had a significantly higher fragmentation rate (85%) compared with in situ stones (63%). The fragmentation rate was 89% for mid‐ureteric stones and 71% for lower ureteric stones.Factors that significantly influenced fragmentation were retrograde manipulation of stone, number of impulses delivered and age of the patient. Stone size, the presence of a ureteric stent and mode of anaesthesia did not significantly influence fragmentation. These results suggest the Dornier MFL5000 lithotriptor is effective for the management of ureteric calculi in a multi‐user setting.
Salvage Cystectomy after Radical Irradiation for Bladder Cancer–Prognostic Factors and Complications
Authors: ABRATT R. P. , WILSON JENNIFER A. , PONTIN A. R. , BARNES R. D. 
Published: November 2008

Summary We have studied 46 patients who underwent salvage cystectomy between March 1981 and June 1992 for persistent or recurrent carcinoma after radical irradiation for bladder carcinoma.The overall 5‐year survival rate was 43%. There was a higher 5‐year survival rate in patients with an incomplete response compared with those with a complete response to their prior irradiation (50 and 36%), in patients with grades 1 or 2 compared with grade 3 histology (75 and 28%), and in patients with T1 orT2 tumours compared with T3 tumours (59 and 32%).The median interval between commencing irradiation and performing cystectomy was 11 months. In the 25 patients with a prior complete response the median interval was 16 months; this was statistically significantly longer than in the 21 patients with an incomplete response (median interval 7 months). A worsening of tumour grade and category was found in some patients when comparing the findings at cystectomy with those prior to irradiation. This was consistently higher in patients with a prior complete response than in those with an incomplete response.There were 3 deaths and 12 non‐fatal major complications due to the prior irradiation or surgery, with a mortality rate of 7% and an overall 5‐year complications rate of 35%. Only one of the complications occurred in the 13 patients treated with conventional 2 Gy fractions alone (5 fractions/week). Their overall complication rate was statistically significantly lower than that of the others.Salvage cystectomy is indicated for selected patients with persistent or recurrent disease after radical irradiation for bladder cancer. The expectation of a survival rate similar to that found in patients treated with immediate cystectomy may not be justified.
p53 Expression and Clinical Outcome in Prostate Cancer
Authors: THOMAS D. J. , ROBINSON M. , KING P. , HASAN T. , CHARLTON R. , MARTIN J. , CARR T. W. , NEAL D.E. 
Published: November 2008

Summary Abnormally high levels of expression of p53 protein are found in many human cancers. In most cases increased expression is associated with point mutations in one allele of the p53 gene and loss of the other allele. Accumulation of the protein product can be detected by immunohistochemistry.p53 protein expression in 68 men with prostate cancer, followed up for at least 8 years or until death, was assessed by immunohistochemistry. The aim of the study was to determine the association between p53 protein expression, cell cycling and clinical outcome. Nine (13%) of 68 tumours stained positively for p53; all 9 tumours were category T3 or T4. p53 positive tumours had a significantly greater Gleason score than p53 negative tumours. Eight of the 9 p53 positive tumours had > 10% cells in G2 +mitosis, compared with 61% of p53 negative tumours. All 7 patients with p53 positive tumours available for follow‐up progressed clinically, compared with 28 of 38 patients (74%) with p53 negative tumours. The median time to progression was 12 months in p53 positive tumours and 24 months in p53 negative tumours. Median survival in p53 positive tumours was 40 months, compared with 76 months in p53 negative tumours.This study demonstrates that overexpression of p53 in a small population of prostate cancers is associated with a poor prognosis in terms of progression and survival.
Long‐term Results of Combined Interstitial Gold Seed Implantation plus External Beam Irradiation in Localised Carcinoma of the Prostate
Authors: LANNON S. G. , EL‐ARABY A. A. , JOSEPH P. K. , EASTWOOD B. J. , AWAD S. A. 
Published: November 2008

Summary Carcinoma of the prostate is one of the leading causes of death in men. Patients with localised disease can be treated with radiotherapy, but controversy still exists regarding the most effective therapeutic technique. We report 180 patients with surgical stage A2‐C prostate cancer treated between 1976 and 1986 by pelvic lymphadenectomy and radioactive gold seed implantation followed by external irradiation. Annual post‐treatment biopsies were performed up to 5 years in most patients. Regular follow‐up included a digital rectal examination, prostatic acid phosphatase and bone scan. One hundred and sixty‐four patients had complete follow‐up data at the end‐point of data collection (December 1991).The actuarial 10‐year cancer‐free survival rates were 83.0% and 91.3% for stages A2 and B1 respectively. The incidence of positive biopsy at 2 and 5 years was 13% and 17.1% respectively for the whole series. A firm correlation was defined between biopsy result and subsequent development of local progression, distant metastases and overall survival.Combined interstitial gold seed implantation plus external beam irradiation represent a valid option for the treatment of patients with localised prostatic cancer.
Immunohistochemical Detection of Tissue‐infiltrating Lymphocytes in Mild Urothelial Dysplasia
Authors: MIGLIARI R. , DEMIRY *M. I. M. EL , MUSCAS G. , MELIS M. , USAI E. 
Published: November 2008

Summary The presence and distribution of immunocompetent cells in normal and dysplastic urothelium of the bladder were investigated in 3 patients. Using an indirect immunoperoxidase staining procedure, monoclonal antibodies reacting with B (Leu 12 +) and T (Leu4 +) cells, cells of the suppressor/cytotoxic (Leu2a +), helper/inducer (Leu3a +) and natural killer (Leu7 +) phenotypes, monocyte‐macrophages (LeuM3 +), and cells expressing interleukin‐2 receptor and HLA‐DR antigen (HLA‐DR+) were tested in all specimens.The results confirmed the presence of a well ordered and compartmentalised distribution of immunocompetent cells in the normal mucosa far from dysplasia. There was an increased number of lymphocytes in the hyperplastic/dysplastic urothelium with associated Von Brunn's nests. Leu2a + cells, HLA‐DR expressing cells and monocyte‐macrophages were present inside the epithelium, particularly within dysplasia and von Brunn's nests, but the Leu3a + /Leu2a + ratio was not inverted (0.48 + 0.1 to 0.74+ 0.2).These findings reveal that in mild urothelial dysplasia with von Brunn's nests there is a spatial modification of the immunological barrier associated with the mucosa.
Cytogenetic Analysis in Transitional Cell Carcinoma of the Bladder
Authors: SCHAPERS R. F. M. , SMEETS A. W. G. B. , PAUWELS R. P. E. , Van den BRANDT P. A. , BOSMAN F. T. 
Published: November 2008

SummaryThe potential use of numerical chromosomal abnormalities as predictive factors for the clinical behaviour of transitional cell carcinoma (TCC) was investigated. The effects on survival and progression‐free survival were measured in 91 patients with TCC treated by transurethral resection. The survival rate of patients having tumours with a diploid chromosomal modal number was significantly better than that of patients having tumours with a hyperdiploid chromosomal modal number. The survival rate of patients having TCC with diploid cells only was also significantly better than that of patients having TCC with both diploid and hyperdiploid cells. Progression‐free survival was significantly higher in patients having TCC with a diploid modal number of chromosomes than in patients with a hyperdiploid modal number.Simultaneous evaluation of the modal chromosome number or chromosomal range, histological grade, category and mitotic index of the tumour, and the patient's age and sex as prognostic factors in multivariate analyses showed that the category of bladder carcinomas was the most important factor in predicting the survival rate. In patients with superficial tumours (category Ta and T1) the modal chromosome number was the most important factor in predicting survival. For progression‐free survival, the modal chromosome number appeared to be the most important factor. It was concluded that the modal chromosome number in TCC was useful in predicting survival in patients with superficial tumours and in predicting progression‐free survival in patients with tumours of all categories.
The effects of sodium citrate and oral potassium citrate on urease‐induced crystallization
Authors: WANG Y. H. , GRENABO L. , HEDELIN H. , PETTERSSON S. 
Published: November 2008

Objectives To study the effects of citrate on urease‐induced crystallization in human urine.Materials and methods Urine samples were collected from seven healthy volunteers with no history of urinary tract infection or stone disease. Citrate was removed from the urine samples by decomposition with citrate lyase. Citrate was then added to the urine in increasing concentrations. Oral potassium citrate was given to the volunteers and their urine was collected. The samples were incubated with urease and the crystallization induced was observed by the Coulter counter technique, by using an optical microscope and by precipitated material analysis.Results The initiation of crystallization was markedly delayed by both the addition of citrate to the urine and after the ingestion of citrate. Crystal growth and the resulting precipitation of both calcium and magnesium showed a concentration‐dependent reduction when citrate was added up to a concentration of 4 mM. Crystal growth and precipitation of calcium and magnesium were also significantly decreased by oral citrate intake.Conclusion Citrate added to the urine or taken orally markedly delays urease‐induced crystallization in human urine.
Partial nephrectomy for incidental renal cell carcinoma
Authors: HERR H.W. 
Published: November 2008

Objective To evaluate the role of nephron‐sparing surgery in patients with incidental renal cell carcinoma and a normal contralateral kidney.Patients and methods A total of 230 patients underwent curative surgery for unilateral renal cancer between 1979 and 1991. Of these, 41 had a partial nephrectomy. The numbers of patients who underwent partial or radical nephrectomy over the course of the study are compared.Results The number of partial compared to total nephrectomies increased from 8% in 1979‐84, to 20% in 1984‐88 and 30% in 1989‐91. This reflected increased detection of incidental renal tumours by radiological imaging. The local recurrence rate in those patients who underwent partial nephrectomy was 2% and survival was 95%, with an average follow‐up of 3 years (range, 2–13).Conclusion Nephron‐sparing excision of small, incidental renal tumours achieved comparable early results to radical nephrectomy.