bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transitional Cell Carcinoma of the Upper Urinary Tract: Prognostic Variables and Post‐operative Recurrences
Authors: KROGH J. , KVIST E. , RYE B. 
Published: November 2008

Summary— In a retrospective study of 198 patients with transitional cell carcinoma of the upper urinary tract, post‐operative recurrences developed as contralateral tumours in 2.5%, in the ureteric stump after conservative resection in 19% and in the bladder in 36.4%. Upper tract recurrences resembled the primary tumours in terms of grade and stage; of the bladder tumours, 89% were similar in grade and 72% similar in stage to the primary tumours.Age, sex, grade and stage had no effect on the number of bladder recurrences, but ureteric tumours had significantly more recurrences than renal pericaliceal tumours. Sex, bladder recurrences and site of primary tumours did not influence survival. Thus grade and stage of the primary tumour were the only predictive variables of the final outcome.
Cavernosometry: Methodology and Reproducibility with and without Pharmacological Agents in the Evaluation of Venous Impotence
Authors: KROMANN‐ANDERSEN B. , NIELSEN K. KRØYER , NORDLING J. 
Published: November 2008

Summary— Venous impotence can be evaluated by cavernosometry, although this is a controversial issue.We have evaluated various techniques for cavernosometry: with and without intracavernous papaverine, with different dosages and modalities, with different modes of induction flow and at various intracavernous pressures. A standardised technique was tested and retested in 32 impotent men. If pharmacocavernosometry is accepted as the most reliable test and a maintenance flow < 20 ml/min indicates optimal venous occulsion, plain cavernosometry gave 6% false positive and 16% false negative results.Pharmacocavernosometry was found to be highly reproducible with regard to maintenance flow for patients thought to have optimal venous occlusion and for those with supposed leakage. The induction flow was of no diagnostic value.After injection of papaverine the maintenance flow became a reproducible parameter for quantifying venous outflow and could be measured with an intracavernous pressure equivalent to systolic blood pressure to minimise cavernous arterial inflow and increase reproducibility.
The Winchester Experience with the TDS Hospital Information System
Authors: HARRISON G. S. M. 
Published: November 2008

Summary— The Royal Hampshire County Hospital is a pilot site for the Resource Management Initiative. It is also the pilot site within the Wessex Region for the Hospital Information System (HIS).We have pursued an ambitious, integrated information system strategy within the hospital. This has been planned and most of it implemented within a short timescale. Although some of the remaining difficulties are technical, the greatest challenges relate to people, their reactions to the introduction of new technology and the need to acquire new skills. The training and development of staff become critical. The importance of an effective management structure with major medical and nursing involvement has been, and will remain, crucial to our continued progress.
Urethral Pressure and Power Generation during Coughing and Voluntary Contraction of the Pelvic Floor in Females with Genuine Stress Incontinence
Authors: LOSE G. 
Published: November 2008

Summary— A probe which permits continuous measurement of the related values of pressure and cross‐sectional area in the female urethra was used for a quantitative description of the adjunctive closure forces in terms of pressure and power generation during coughing and squeezing in 30 females with genuine stress incontinence (GSI). Measurements were performed at the bladder neck, midurethrally and distally in the urethra.A statistically significant decrease in power generation was found at the bladder neck and midurethrally during squeezing compared with the values in healthy females. During coughing the power generation was significantly decreased midurethrally and measurement of pressure generation revealed similar results. These findings indicate that the active closure mechanisms at the bladder neck and midurethra are significantly weakened in females with GSI. The results do not support the concept that impaired passive pressure transmission to the urethra is an important pathophysiological factor in GSI.
Forced Hydration Prior to Renography in Children with Hydronephrosis. An Evaluation
Authors: NAUTA J. , POT D. J. , KOOIJ P. P. M. , NIJMAN J. M. , WOLFF E. D. 
Published: November 2008

Summary We have developed a method of diuretic renography for the assessment of upper urinary tract obstruction in children. A maximal diuresis under standardised conditions is obtained by forced intravenous hydration over a 2‐h period prior to renography.We evaluated the predictive value of this method for the clinical and functional outcome in 73 children with apparent unilateral pelviureteric junction obstruction. The predictive value of a nonobstructive pattern was 94%, while the predictive value of an obstructive pattern could not be assessed accurately because the patients concerned subsequently underwent operation. The method is safe and reliable and offers advantages over conventional diuretic renography.
Diagnostic and Surgical Aspects of Renal Carcinoma with Involvement of the Inferior Vena Cava
Authors: VALE J. A. , HENDRY W. F. , KIRBY R. S. , WHITFIELD H. N. , LUMLEY J. S. P. 
Published: November 2008

Summary Over the past 10 years, 13 patients presented with operable renal carcinoma and tumour extension within the inferior vena cava. This was diagnosed accurately in all but 1 patient, using ultrasound.Radical nephrectomy with removal of tumour within the inferior vena cava was performed in all 13 cases, 2 requiring cardiac bypass. There were no operative deaths and 6 patients remain alive and well with a mean follow‐up of 2 years. The presence and level of vena caval extension did not appear to have an adverse affect on prognosis.
Megalourethra
Authors: REISSIGL A. , EBERLE J. , BARTSCH G. 
Published: November 2008

Megalourethra is a rare congenital anomaly characterised by a failure of development of erectile tissue and subsequent dilatation of the penile urethra. The term was first used by Nesbitt (1955) and since then many of these defects concerning the corpus spongiosum and the corpora cavernosa have been reported (Mortensen et al., 1985; Appel et al., 1986; Aigen et al., 1987).Concomitant malformations, which are sometimes incompatible with survival, have important implications for therapy and prognosis. Associated anomalies may involve the urinary tract (renal hypoplasia, ureterohydronephrosis, megaureter, megacystis, reflux, bladder diverticula, hypospadias, manifestations of intersex, urethral valves, prune belly syndrome) as well as other organs (teeth, heart, intestines).
Does Further Extracorporeal Lithotripsy Promote Clearance of Small Residual Fragments?
Authors: PARR N. J. , RITCHIE A. W. S. , SMITH G. , MOUSSA S. A. , TOLLEY D. A. 
Published: November 2008

Summary— Small persistent fragments (≤ 4 mm) following extracorporeal shock wave lithotripsy have been termed clinically insignificant residual fragments (CIRF), but their presence may be associated with an increased rate of development of recurrent symtomatic renal calculi. We have adopted a policy of further extracorporeal piezoelectric shock wave lithotripsy (EPL) for patients with CIRF in an attempt to promote complete clearance.A series of 22 patients with a mean initial stone burden of 16 mm (range 7–48) developed CIRF after a median of 2 EPL treatment sessions (range 1–9). CIRF were in the lower calices (n = 20), middle calices (n = 1) and upper calices (n = 1). These calices were normal (n = 6), slightly dilated (n = 9), moderately dilated (n = 2) or grossly dilated (n = 5). After 6 to 14 months, patients underwent a further session of EPL. One month later, 3 patients with normal calices had become stone‐free, 1 patient with normal calices and 3 with slightly dilated calices showed a considerable reduction in CIRF, but all other patients showed no change.When CIRF form in normal calices a further session of EPL may promote clearance. However, when calices containing CIRF are significantly dilated, further EPL is of no value.
Bilharzial Vesicoureteric Reflux and Bladder Neck Stenosis: Fact or Fiction ?
Authors: IBRAHIM A. I. A. , PATIL K. P. , TAHIR M. I. EL , SHETTY S. D. , ANANDAN N. 
Published: November 2008

Summary— A group of 47 patients with histologically confirmed chronic urinary bilharziasis underwent micturating cystourethrography to look for vesicoureteric reflux (VUR) and bladder neck stenosis (BNS); 13 patients were found to have VUR of varying grades (8 unilateral and 5 bilateral). None had evidence of BNS.Urinary tract infection (UTI), loin pain, hydroureter and renal failure were compared in patients with and without VUR. Of the 13 patients with reflux, 3 had UTI, loin pain was present in 8, 11 had an ipsilateral hydroureter and 2 presented with renal failure. In the 34 patients without reflux, 8 had UTI, loin pain was present in 22, 30 had hydroureter and 3 presented with renal failure.It was concluded that the incidence of UTI, loin pain, hydroureter and renal deterioration associated with bilharzial VUR was not significantly different from that found in bilharzial patients without VUR. Thus the clinical significance and the need for surgical correction of isolated VUR in bilharziasis are questionable.
Erectile Response to Visual Erotic Stimuli Before and After Intracavernosal Papaverine, and its Relationship to Nocturnal Penile Tumescence and Psychometric Assessment
Authors: BANCROFT J. , SMITH G. , MUNOZ M. , RONALD P. 
Published: November 2008

Summary—Three methods of assessing erectile capacity—nocturnal penile tumescence (NPT), response to visual erotic stimuli (VES) and to intracavernosal papaverine (ICI)—have been assessed in 42 men presenting with erectile dysfunction. There was some overlap but also important differences between the 3 measures.Subjects were divided into “high” and “low” NPT groups. The “high” group produced greater erectile responses to both VES and ICI. The combination of VES and ICI was the best discriminator of the two NPT groups, and may be of diagnostic value, particularly in younger men, reducing the need for repeated injections and higher doses of papaverine.In the “low” NPT group, presumed predominantly organic, the ICI response correlated better than the VES response with NPT. In the “high” NPT group, the opposite applied, suggesting that in “psychogenic” cases, response to ICI may be modified by psychological mechanisms which could be of aetiological importance and which deserve further study.These three methods should be regarded as measuring different aspects of erectile function and not as alternative diagnostic procedures. More research is required before their respective diagnostic values are established.
The Importance of Renal Function in the Interpretation of Diuresis Renography
Authors: BROWN S. C. W. , UPSDELL S. M. , O'REILLY P. H. 
Published: November 2008

SummaryInterpretation of the diuresis renogram is dependent on a full understanding of the factors that contribute to the washout curve, a major determinant being the urinary flow rate induced by the diuretic. Frusemide‐induced flow rates were measured in 86 patients over a 30‐min period and related to creatinine clearance in 39, 99mTc‐DTPA clearance (glomerular filtration rate (GFR)) in 27, and 123l‐Hippuran clearance (effective renal plasma flow) in 20. The flow rates 3 to 6 min and 15 to 18 min after administration of the diuretic received specific attention because of their importance to F + 20 and F ‐ 15 diuresis renography respectively. The mean urinary flow rate 15 to 18 min after frusemide was 3.5 ml/min greater than at 3 to 6 min (P <0.001), explaining the value of the F ‐ 15 renogram in further evaluating equivocal F + 20 curves. Linear relationships were observed between each parameter of function and the 3 to 6 min and 15 to 18 min periods as follows: creatinine clearance r=0.66, r=0.77; 99mTc‐DTPA clearance r=0.66, r=0.77; 123l‐Hippuran clearance r=0.59, r=0.71. From regression analysis of the data presented it is possible, with knowledge of total and split function, to predict single‐kidney flow rates. It is demonstrated that these may commonly exceed flow rates used for perfusion studies if function is normal, but a single‐kidney flow rate of 10 ml/min is unlikely to be attained if the single‐kidney GFR is less than 15 ml/min.
Intravesical BCG Treatment for Superficial Bladder Cancer: Long‐term Results using Two Different Strains of BCG
Authors: MUKHERJEE A. , PERSAD R. , SMITH P. J. B. 
Published: November 2008

SummaryA total of 21 patients received intravesical BCG for the prevention of recurrence of superficial transitional cell carcinoma of the bladder. Twelve patients received the Glaxo strain and 9 the Pasteur strain of the bacillus. Although thought to have different anti‐tumour activities owing to a difference in antigenicity, these 2 strains produced similar tumour‐free rates at 5 years' mean follow‐up with an overall tumour‐free rate of 43%.
Deferred Treatment in Clinically Localised Prostatic Carcinoma
Authors: ADOLFSSON J. , CARSTENSEN J. , LÖWHAGEN T. 
Published: November 2008

SummaryA series of 122 patients with a cytological diagnosis of well or moderately differentiated and clinically localised (T1‐2) prostatic carcinoma were followed up without any initial anti‐tumour therapy. The median observation time was 91 months. During follow‐up the local tumour progressed to stage T3 in 67 patients (55%) and distant metastases developed in 17 (14%); 47 patients died (38%), 9 of them (7%) from prostatic carcinoma. The risk of dying from prostatic carcinoma was 1% after 5 years and 16% after 10 years for patients not dying from other causes.
Prevalence of Upper Urinary Tract Stone Disease in a Rural Community of North‐eastern Thailand
Authors: SRIBOONLUE P. , PRASONGWATANA V. , CHATA K. , TUNGSANGA K. 
Published: November 2008

SummaryA survey was conducted of upper urinary tract stone (UUTS) disease in an administrative subdivision of Khon Kaen Province in Thailand. Initial case screening was done by direct contact with the village health volunteers and village health communicators. A positive patient was defined as one who had had surgery for UUTS, previously been diagnosed by physicians, or had a history of stone passage. Those who belonged to the latter 2 categories were confirmed radiologically. The prevalence of UUTS was 3.76/1000. The male/female ratio was 2:1. The average age was 50‐13 years (range 8–71). Common associated symptoms were back pain, abdominal pain, painful urination, stone passage and blood‐stained urine; 75% of the patients were from a poor socio‐economic class. The data suggest that UUTS is common in north‐eastern Thailand. Although this is an approximate and, perhaps, an underestimated prevalence, the present method is cost‐effective, efficient and appropriate for conducting community surveys in developing nations.
Initial Combination Chemotherapy with Cisplatin, Methotrexate and Vinblastine in Locally Advanced Transitional Cell Carcinoma—Response Rate and Pitfalls
Authors: FOSSÅ S. D. , HARLAND S. J. , KAYE S. B. , RAGHAVAN D. , RUSSELL J. M. , PARMAR M. K. B. , USCINSKA BARBARA M. , WOOD R. 
Published: November 2008

Summary— A total of 51 patients with locally advanced transitional cell carcinoma of the bladder were entered into a phase II study to evaluate the effect of initial cisplatin (100 mg/m2, Day 2) combined with methotrexate (30 mg/m2. Days 1 and 8) and vinblastine (4 mg/m2, Days 1 and 8). Of 44 evaluable patients, 25 (57%) achieved an objective response of their primary bladder tumour (complete response (CR): 4 patients; partial response (PR): 21 patients); 30 of the 36 patients with micturition disturbances obtained relief. Toxicity was acceptable, but dose modifications due to haematological or renal toxicity were required in 153 of the 690 drug courses. Non‐protocol dose modifications were performed 45 times.The experience gained in this trial emphasises the need for improved co‐operation between urologists, radiologists and clinical oncologists in such multicentre phase II studies. Difficulties were observed in adhering to dose modification rules, assessing pre‐treatment tumour size (due to variation in quality of measure and in timing relative to initial transurethral resection (TUR)) and defining response to chemotherapy (due to failure to perform mandatory investigations at the right time). This study also illustrates that the accepted criteria for assessing response in the primary bladder tumour are difficult to apply in practice and that the results of any study using this indicator lesion require caution in their interpretation.
Vesica Fellea—A New Substitute for the Bladder? An Experimental Study
Authors: GÜÇER T. , ÖZKARDES H. 
Published: November 2008

Summary— The urinary bladders of 8 dogs were removed and replaced with their own gallbladders using microvascular anastomoses. Post‐operative assessment included measurement of blood urea nitrogen (BUN) and creatinine (Cr), intravenous urography and histological examination of the autotransplanted gallbladders.The neobladders proved to be good reservoirs without urinary leakage. Renal function was well preserved in 6 dogs; post‐operative BUN and Cr levels were raised in 2 dogs and the concentrating ability of the kidneys was reduced. The neobladders were perfect histologically.
A 12‐Week Placebo‐controlled Double‐blind Study of Prazosin in the Treatment of Prostatic Obstruction due to Benign Prostatic Hyperplasia
Authors: CHAPPLE C. R. , STOTT M. , ABRAMS P. H. , CHRISTMAS T. J. , MILROY E. J. G. 
Published: November 2008

Summary— A series of 93 normotensive patients with benign prostatic hyperplasia and maximum urinary flow rates < 15 ml/s, treated at 2 hospital centres using an identical protocol, was randomly assigned to receive a 12‐week course of treatment with prazosin or placebo in a double‐blind parallel group trial. A total of 75 patients completed the study and were suitable for the final analysis. Prazosin was administered orally in doses of 0.5 mg and then 1 mg twice daily for 4 days and 2 mg twice daily for the remainder of the trial.Patients on treatment with prazosin exhibited a significantly increased maximum urinary flow rate as compared with placebo, with a significant reduction in maximum voiding detrusor pressure. Prazosin therapy did not produce a significant effect on either frequency or standard parameters of detrusor instability. A double‐blind overall assessment of drug efficacy and tolerance significantly favoured prazosin therapy. A total of 30 patients receiving prazosin and 28 receiving placebo reported varied adverse effects. Eighteen patients were excluded from the final analysis, 10 being withdrawn because of adverse effects, 7 on treatment with prazosin and 3 in the placebo group.In long‐term usage oral prazosin was well tolerated and appeared to improve obstructed voiding in patients with benign prostatic hyperplasia.
Loss of Sensory Neuropeptides in the Obstructed Human Bladder
Authors: CHAPPLE C. R. , MILNER P. , MOSS H. E. , BURNSTOCK G. 
Published: November 2008

Summary—This is the first investigation of alterations in the innervation of the obstructed human bladder by nerves containing neuropeptides. The patient groups studied were those with stable detrusor function, those with unstable detrusor function, and those presenting with acute retention of urine. Specimens of bladder tissue were taken from the lateral wall of the bladder below the peritoneal reflection. A total of 23 patients was studied (control, n = 4; acute retention, n = 5; stable obstruction, n = 5; unstable obstruction, n = 9). Substance P, calcitonin gene‐related peptide and vasoactive intestinal polypeptide levels in the bladder were quantified by immunoassay. The density of innervation of the bladder detrusor by nerves containing these neurotransmitters and by those containing neuropeptide Y and somatostatin was assessed using both semiquantitative and quantitative immunohistochemical techniques.A reduction in the density of innervation by vasoactive intestinal polypeptide, calcitonin gene‐related peptide, substance P and somatostatin‐immunoreactive but not neuropeptide Y‐immunoreactive nerve fibres was shown in the obstructed bladder. These findings, combined with the significant reduction in substance P content of the obstructed bladder and in particular of the acute retention bladder, indicate that there may be an afferent nerve dysfunction resulting from prostatic bladder outflow obstruction.
Is Indoramin an Effective Alternative to Prostatectomy?
Authors: LLOYD S. N. , McMAHON A. , MULLER W. , BUCKLEY J. F. , DEANE R. F. , KIRK D. , KYLE K. F. 
Published: November 2008

Summary— Alpha‐1 ‐adrenergic antagonists are recommended for symptomatic treatment of patients awaiting prostatic surgery. Their efficacy has been confirmed in placebo controlled clinical trials, but to date no comparison of their effects with the results of subsequent prostatectomy has been made.Fifty‐five patients awaiting prostatectomy were assessed (by symptom scores and peak urinary flow rates) prior to treatment, on indoramin 20 mg bd, and 2 months following prostatectomy. Side effects while taking indoramin were experienced by 36% of patients. Despite an overall improvement in mean symptom scores, 26% of patients with obstructive and 30% of those with irritative symptoms who were assessed while taking indoramin failed to experience any improvement. Of the 31 patients assessed while on indoramin and again following surgery, prostatectomy produced a greater symptomatic relief than indoramin. The increase in peak flow rate following prostatectomy was 11.7 ml/s compared with 3.2 ml/s on indoramin. However, 5 patients preferred to continue taking indoramin rather than proceeding to surgery.Indoramin is no substitute for prostatectomy. Although some patients might benefit from treatment while awaiting surgery, significant side effects may severely restrict its use for this purpose. The response to indoramin cannot be used as an accurate predictor of response to prostatectomy.
Extracorporeal Shock Wave Lithotripsy of Ureteric Stones with the Modulith SL 20
Authors: RASSWEILER J. , HENKEL T. O. , JOYCE A. D. , KÖHRMANN K. U. , MANNING MARTINA , ALKEN P. 
Published: November 2008

Summary A series of 138 patients with ureteric calculi was treated by in situ extracorporeal shock wave lithotripsy (ESWL) during the clinical introduction of the Modulith SL 20. This machine represents a newly developed lithotriptor with an electromagnetic cylinder as shock wave source and a dual localisation system consisting of in‐line ultrasound and an integrated fluoroscope C‐arm. During the first 2 months, 12 patients (phase 1) were treated under ultrasound localisation alone; during the next 5 months, 37 patients (phase 2) were treated using dual imaging modalities with reduced peak pressure (max. 18 kV = 800 bar); during the final 7 months, 89 patients (phase 3) were treated under ultrasonic and fluoroscopic localisation combined with an increased maximal shock wave pressure (20 kV= 1024 bar).The introduction of fluoroscopic targeting (phases 2 and 3) resulted in satisfactory localisation of calculi in the mid‐ureter, previously limited by use of only coaxial ultrasound. The extension of stone localisation to the whole length of the ureter was associated with a marked decrease in treatment time, reflecting the easy handling of the dual localisation system. The rise in generator voltage (phase 3) improved the disintegration rate from 81% (phase 2) to 85%, whereas the number of impulses remained unchanged. However, the rate of auxiliary procedures following ESWL (adjuvant and curative) was reduced from 33% (phase 2) to 24.5%.Thus the Modulith SL 20 in its final design enables in situ ESWL to be the treatment of choice for all ureteric calculi, rendering special positioning techniques or multiple treatment unnecessary.