bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous Nephrostomy under Guidance of Ultrasonography and Fluoroscopy Using a Pigtail Catheter
Authors: ELYADERANI M. K. , KANDZARI S. J. , GABRIELE O. F. 
Published: November 2008

SUMMARY— Percutaneous nephrostomy using a pigtail catheter was performed in 37 patients under the guidance of ultrasonography and fluoroscopy. The only failure in 60 attempts was due to a subcapsular haematoma. The catheter appears to be well tolerated and is large enough for good drainage.Ultrasonography has proved to be a valuable part of this technique and has made antegrade pyelography easy.
Histological and Urodynamic Study of the Bladder in Enuretic Children
Authors: BOOTH C. M. , GOSLING J. A. 
Published: November 2008

Summary— In a study of the bladders of 12 enuretic children by cystoscopy, light microscopy and urodynamics, cystoscopic trabeculation was found in 10 cases. Histologically, the trabeculation resembled adult trabeculation of obstructive aetiology, collagen infiltration being the characteristic hallmark.Using urodynamic measurements, the bladders behaved like those of adult enuretics; 10 out of 12 were unstable and voiding occurred at relatively high pressures.There was no correlation between symptoms and either cystoscopic or histological trabeculation.
Cutaneous Ureterostomy as Last Resort Treatment of Intractable Haemorrhagic Cystitis Following Radiation
Authors: POMER S. , KARCHER G. , SIMON W. 
Published: November 2008

Summary— Sixteen patients with severe intractable haemorrhagic cystitis following radiotherapy, two of them with bleeding tumours, were treated surgically by cutaneous ureterostomy with or without contralateral nephrectomy. They had undergone various forms of conservative treatment and were treated by surgery only when conservative therapy had failed. In these poor risk patients a cutaneous ureterostomy was employed as a lesser procedure than an ileal loop.Of the 16 who underwent urinary diversion 11 were completely free of haemorrhage and three continued to have slight intermittent haematuria.
Bilharzial Strictures of the Lower Third of the Ureter: a Critical Review of 560 Strictures
Authors: AL‐SHUKRI S. , ALWAN M. H. 
Published: November 2008

Summary— In a series of 329 patients with urinary bilharziasis, 560 strictures occurred in the lower third of the ureter. Bilateral ureteric involvement was seen in 231 patients (70.2%).Two hundred and fifty‐two strictures (45%) were juxtavesical, 210 (37.5%) intramural, 50 (8.9%) were combined juxtavesical and intramural, 43 (7.7%) were pelvic and 5 (0.9%) were ureteric meatal strictures.The main operative procedures were pull‐through ureteroneocystostomy (47.1%), ureteric reimplantation into the dome of the bladder (28.8%) and nipple ureteroneocystostomy (20.3%). Post‐operative complications occurred in 17 patients (5.2%) and the operative mortality was nil.It is concluded that the best results are achieved through selection of the appropriate operative procedure and prevention of reinfestation.
Computed Tomography and Transrectal Ultrasound in the Diagnosis of Prostatic Disease—a Comparative Study
Authors: RICKARDS D. , GOWLAND M. , BROOMAN P. , MAMTORA H. , BLACKLOCK N. J. , ISHERWOOD I. 
Published: November 2008

Summary— Computed tomography (CT) and transreclal ultrasound were performed in 88 patients with clinically and histologically proven prostatic disease. An ultrasound diagnosis of prostatic cancer was suggested in 49 of 54 patients with proven disease, whereas CT identified only 21 of those patients. There were no specific features of confined prostatic malignancy on CT and the most reliable feature of an unconfined tumour was infiltration of the posterior aspect of the bladder base.It was not possible on ultrasound to differentiate between prostatic inflammatory disease and a confined carcinoma but ultrasound was accurate in detecting defects in the prostatic capsule, the hallmark of unconfined prostatic malignancy.
Orchiectomy Alone for Stage I Testicular Non‐Seminoma. A Progress Report on the Royal Marsden Hospital Study
Authors: PECKHAM M. J. , BARRETT A. , HORWICH A. , HENDRY W. F. 
Published: November 2008

Summary— Eighty‐four patients with clinical Stage I nun‐seminomatous germ‐cell testicular tumours were entered into a prospective study after orchiectomy to evaluate a policy of close surveillance without lymph node irradiation or node dissection; 16 (19%) have manifested evidence of metastatic disease and received chemotherapy.All patients in the study are alive, 3 of the 16 relapsing patients are receiving chemotherapy and the 13 who have completed it are in complete remission at 4 to 43 months (mean 21). Relapses were diagnosed at 2 to 8 months (mean 5.3 months) after orchiectomy and were not invariably associated with elevated serum markers. The relapse rate was significantly higher for malignant teratoma undifferentiated (MTU) primary turnours than malignant teratoma intermediate (MTI) (40.7 and 6.8% respectively) and preliminary data suggest that the association of MTU with vascular invasion places the patient at high risk of relapse. Pre‐orchiectomy serum marker status was not a significant prognostic factor. Despite sub‐optimal surgical management in 11/84 patients no example of scrotal recurrence has been encountered.It is concluded that a rigorously monitored policy of close surveillance after orchiectomy is a feasible and successful method of management in Stage I testicular non‐seminoma. Further experience should allow patients requiring immediate post‐orchiectomy chemotherapy to be identified.
Periurethral Teflon Injection: a Simple Treatment for Urinary Incontinence
Authors: LIM K. B. , BALL A. J. , FENELEY R. C. L. 
Published: November 2008

Summary— The follow‐up of 28 patients with urinary incontinence treated with periurethral Teflon injection revealed significant improvement in 53.6% and complete cure in 21.4%. Patients most likely to benefit were those with weak sphincters and stable detrusors.The method is quick and safe and requires only a brief hospital stay. It is suitable for patients in whom conventional operative techniques have failed or in whom surgery is best avoided on medical grounds.
Lymphocyte Subsets in Renal Carcinoma—a Sequential Study Using Monoclonal Antibodies
Authors: Ritchie A. W. S. , James K. , Micklem H. S. , Chisholm G. D. 
Published: November 2008

Summary— Using monoclonal antibodies in conjunction with flow cytometry, circulating lymphocyte subsets with distinct functions in the regulation of the immune response were enumerated in 32 patients with proven renal carcinoma. Analyses were performed at presentation and sequentially during the clinical course of the patients.Untreated patients with advanced disease had a deficit of T cells with the “helper/inducer” phenotype (Leu‐3a+) and this resulted in abnormal T “helper/suppressor” (Leu‐3a+/Leu‐2a+) ratios.Following nephrectomy, performed in 26 patients, there was a significant increase in the number of T cells with the “helper/inducer” phenotype and a significant increase in T “H/S” ratios. Subsequent follow‐up at a minimum of 2 months after nephrectomy showed that the increase in T cells with the “helper/inducer” phenotype was maintained (with the exception of 6 patients with disease progression) and was then accompanied by a significant increase of the T cell subset with the “suppressor/cytotoxic” phenotype (Leu‐2a+).Pre‐operative renal arterial embolisation resulted in an early transient lymphopenia. The response to embolisation combined with nephrectomy was little different when compared with nephrectomy alone. These observations represent a novel view of the immunosuppressive effects of renal carcinoma and their relation to anaemia and disease progression are discussed.
The Stable State is not an Objective Response in Hormone‐escaped Carcinoma of Prostate
Authors: BEYNON L. L. , CHISHOLM G. D. 
Published: November 2008

Summary— In some clinical trials the use of criteria of stable response of hormone‐escaped prostate cancer is justified on the ground that it delineates patients with markedly improved survival, similar to that of partial regression patients. Forty‐three patients with hormone‐escaped prostate cancer were studied in order to identify other factors which might also predict improved survival. Fifteen patients received palliative treatment only, 17 secondary hormone therapy and 11 chemotherapy. Only one objective partial regression was seen. Thirty‐seven patients have died of prostatic cancer, 3 have died of other causes and 3 remain alive.The mean initial hormone response was 14.8 months, the mean time from progression to death 11.3 months, and the mean time from symptoms to death 5.9 months. There was no significant correlation between length of initial response and survival following progression (r= 0.25).Six features of progression were reviewed. Patients presenting with one feature of progression had a significantly better mean survival, 14.8 months, compared with 8.2 months when multiple features indicated progression.It is concluded that the stable state is not an objective response in hormone‐escaped carcinoma of prostate but a reflection of the patient's natural disease progression and that the mode of presentation may be a significant prognostic indicator.
Function of Human Autologous Kidney Grafts after Extracorporeal Preservation with Sacks' II Solution
Authors: RANCH T. , BRYNGER H. , GRANERUS G. , HENRIKSSON Ch. , NILSON A. E. , PETTERSSON S. 
Published: November 2008

Summary— The function of 18 human kidney grafts was studied before and 3 months after autotransplantation without prior bench surgery on the parenchyma or the vessels. Kidney protection was accomplished by pre‐treating the patient with mannitol and low molecular weight dextran solution and flushing the kidney with a Xylocaine‐heparin mixture and cold Sacks' II solution. The mean cold ischaemia time was 239 min (range 140–345 min).The glomerular filtration rate (GFR) remained unchanged post‐operatively in terms of both total and split kidney GFR. Proximal and distal tubular integrity, as studied by determination of beta2‐microglobulin excretion and concentration ability respectively, was also preserved.
Immunohistological Detection of T Antigen and ABH Blood Group Antigens in Upper Urinary Tract Tumours
Authors: KAGAWA S. , TAKIGAWA H. , GHAZIZADEH M. , KUROKAWA K. 
Published: November 2008

Summary— The status of T antigen was assessed by means of peanut agglutinin (PNA) used in an immunoperoxidase technique, and the status of ABH blood group antigens was determined by the specific red cell adherence (SRCA) test. Thirty‐eight patients with upper urinary tract tumours were examined.Our data indicated that T antigen status did not correlate with conventional prognostic indicators such as grade and stage of tumour and survival of patients, while the expression or deletion of ABH blood group antigens did correlate well.It was concluded that ABH blood group antigen determination might provide a useful prognostic probe in upper urinary tract tumours should it find clinical application.
Prostatic Ultrasonography: a Useful Technique?
Authors: KADOW C. , GINGELL J. C. , PENRY J. B. 
Published: November 2008

Summary— Two hundred and forty‐four transrectal prostatic ultrasonograms have been reviewed and the findings compared with the final pathological or clinical diagnosis. A high degree of accuracy was achieved in diagnosing benign prostatic hyperplasia.Ultrasonography proved invaluable in staging proven prostatic carcinomas but it was disappointing as a primary diagnostic tool for cancer, with false positive and negatives rates of 12 and 31 % respectively. These findings are discussed in the light of other workers' results.Further applications for prostatic ultrasonography are outlined.
The Changing Workload in Paediatric Urology
Authors: O'DONNELL BARRY , BUICK R. G. 
Published: November 2008

Summary— Almost 3000 (2969) paediatric urological procedures carried out by three paediatric surgeons over a 3‐year period have been analysed. Almost half of the patients were managed as day cases. The content of the work has been examined and the implications for continuing patient care, surgical training and the desirable paediatric infrastructure noted. Inguinoscrotal operations, surgery for hypospadias and ureteric reimplant for vesicoureteric reflux are the commonest “open” operations.Most paediatric urological procedures will continue to be done by a variety of surgeons of different specialities.
Ureteroscopy. An Alternative View
Authors: TOLLEY D. A. , BEYNON L. L. 
Published: November 2008

Summary— Forty‐six ureteroscopies were carried out over a 12‐month period. A simple technique is described. The desired level was reached in 72% of cases and the pre‐operative objective achieved in 60% of cases overall. Fifty per cent of all ureteric stones were safely retrieved by ureteroscopy. The instrument was used to establish a diagnosis of upper urinary tract abnormality in 16 of 23 cases. The overall complication rate was low, most problems relating to short‐lived ureteric colic (23%) which was seen mainly after stone manipulation.Transurethral ureteroscopy is a safe procedure with a number of diagnostic and therapeutic possibilities.
Bone Imaging and Serum Phosphatases in Prostatic Carcinoma
Authors: BISHOP M. C. , HARDY J. G. , TAYLOR M. C. , WASTIE M. L. , LEMBERGER R. J. 
Published: November 2008

Summary— One hundred and twenty‐seven patients with locally advanced prostatic cancer were evaluated for the presence and progress of bone metastases before and during hormonal therapy, by serial radionuclide imaging and frequent measurement of plasma acid (tartrate‐labile) and alkaline phosphatase. For comparison, serial changes in imaging and phosphatases were classified in each patient into one of six groups.Of 71 patients with negative imaging before treatment, 82% had normal alkaline phosphatase levels and 83% had normal acid phosphatase levels. Of 56 patients with bone metastases at presentation, false negative alkaline and acid phosphatase levels were noted in 18% and 36% respectively, though a few patients eventually developed abnormal levels.Serial plasma biochemistry and particularly alkaline phosphatase showed a response to treatment which was not always obvious on imaging. An assessment of the hepatic component of alkaline phosphatase by reference to plasma gamma glutamyl transpeptidase and isoenzyme electrophoresis was helpful in the evaluation of a false positive result but unnecessary where imaging was positive and phosphatase elevated.It is concluded that serial alkaline phosphatase estimation is essential in the follow‐up of patients with prostatic cancer and bone metastases, and probably renders serial imaging studies superfluous once the presence of skeletal metastases has been proven. By comparison, acid phosphatase is a much less effective marker.
Post‐treatment Fertility in Patients with Testicular Cancer: I. Influence of Retroperitoneal Lymph Node Dissection on Ejaculatory Potency
Authors: FOSSÅ SOPHIE D. , OUS S. , ÅBYHOLM T. , LOEB M. 
Published: November 2008

Summary— “Dry ejaculation” occurred in none of 1 5 patients with testicular cancer treated by right‐sided retroperitoneal lymph node dissection (RLND). After left‐sided and bilateral RLND, “dry ejaculation” was observed in 7/21 and 51 /61 men respectively. Twelve of 21 patients with “dry ejaculation” or small volumes of seminal fluid had true retrograde ejaculation. In 7 of 10 men the ejaculatory volume increased significantly after treatment with imipramine chloride. Four men impregnated their wives during treatment with the drug.Without impairing the results of therapy it is possible to spare fibres from the sympathetic chains and pre‐sacral plexus during RLND due to testicular cancer, thus preserving fertility in at least 40% of patients.
Prognostic Significance of Alkaline and Acid Phosphatase and Skeletal Scintigraphy in Carcinoma of the Prostate
Authors: MERRICK M. V. , DING C. L. , CHISHOLM G. D. , ELTON R. A. 
Published: November 2008

Summary— The prognostic significance of skeletal scintigraphy has been reassessed in relation to other tests by extended follow‐up of 220 patients. Skeletal metastases increased in prevalence with T stage and were associated with shorter survival irrespective of age. Early disease, a normal acid or alkaline phosphatase at presentation and well differentiated tumours were associated with longer survival. Alkaline phosphatase alone accounted for all of the differences in survival.Scintigraphic change preceded elevation of the prostatic acid phosphatase in 81% of the patients whose initial scintigraphy and prostatic acid phosphatase were normal but who developed evidence of distant metastases on follow‐up. The mean interval between scintigraphic conversion and the development of overt symptoms was 5.8 months. Our findings discount the value of skeletal scintigraphy for determining prognosis but do indicate that it is more sensitive than the acid phosphatase in identifying patients before they become symptomatic.Scintigraphy is indicated as a routine staging procedure in all new patients with carcinoma of prostate. In patients with a normal alkaline phosphatase, a baseline and regular follow‐up are needed to identify patients likely soon to develop symptoms. If the alkaline phosphatase is elevated at presentation, scintigraphy is necessary to distinguish benign from malignant causes and to determine the extent of skeletal involvement.
Why Does Vasectomy Reversal Fail?
Authors: ROYLE M. G. , HENDRY W. F. 
Published: November 2008

Summary— The scrotum was explored in 32 patients who had vasectomy reversal which failed to restore their fertility. Twenty‐three patients were azoospermic and nine had severe or persistent oligozoospermia. Amongst the 23 azoospermic cases, the vasa were found to be blocked in 12; following repeat vaso‐vasostomy, normal sperm counts were produced in 10 patients; 8 of these patients followed up for 6 months or more successfully impregnated their wives. In four cases there was a secondary epididymal block: following epididymo‐vasostomy, three of four patients obtained normal sperm counts and two wives became pregnant. In seven patients there was a very high antisperm antibody titre (> 1024 by tray agglutination test) and despite reparative surgery and prednisolone therapy, no pregnancies were obtained. The overall pregnancy rate for this group was 7 of 19 (37%).Amongst nine oligozoospermic cases, unilateral obstruction was found in eight. The block was found in the vas in five and in the epididymis in two, and in two there were very high antisperm antibody titres. After reconstructive surgery, four patients had normal sperm counts and one pregnancy has been obtained
Pre‐natal Diagnosis: How Useful is it?*
Authors: THOMAS D. F. M. , IRVING H. C. , ARTHUR R. J. 
Published: November 2008

Summary— Dilatation of the fetal urinary tract can now be detected by ultrasound imaging in pregnancy. Forty‐six cases of prenatally diagnosed dilatation were analysed to assess the contribution of this information to subsequent urological management.Positive pre‐natal scans proved accurate. Dilatation was confirmed by neonatal ultrasound imaging or by autopsy in 24 of 25 consecutive inborn neonates and two aborted fetuses.Forty‐four live births were studied. Twelve neonates had physical signs at birth which rendered the pre‐natal diagnosis unnecessary. In 32 neonates (73%) the urinary tract anomaly was identified solely as a result of pre‐natal imaging and would otherwise have remained undetected. However, in seven neonates the information was of doubtful value (mild unilateral dilatation), in 16 it was of probable value (confirmed unilateral PUJ obstruction, multicystic kidney, etc.) and in only nine neonates (20%) was it of definite value (treatable conditions affecting both kidneys or a solitary kidney, e.g. urethral valves, PUJ obstruction in a solitary kidney, etc.).Prenatally detected bilateral dilatation (18 infants) carried a poor prognosis—33% mortality and 56% incidence of coexistent abnormalities. No infants in our series had undergone intra‐uterine drainage, but the numbers of survivors and their renal function was comparable to the published results for fetal intervention.
Renal Metastases from Carcinoma of the Lung
Authors: BECKER W. E. , SCHELLHAMMER P. F. 
Published: November 2008

Summary— Five cases of clinically manifest solitary and bilateral renal lesions metastatic from the lung are presented. These cases are unusual in that renal metastases are usually silent lesions discovered at autopsy. Review of the autopsy data from this hospital identified renal metastases in 19% of patients who died from carcinoma of the lung. This incidence parallels that of other series.A solid renal lesion which is identified in a patient with a history of pulmonary carcinoma should raise the suspicion of renal metastases, especially if computed tomography of the mass demonstrates relative homogeneity and minimal enhancement. More frequent use of the abdominal CT scan in staging patients with lung cancer will render metastatic carcinoma from lung to kidney a more frequent ante mortem diagnosis
The Use of Transabdominal Ultrasound in the Detection of Early Bladder Tumours
Authors: MALONE P. R. , WESTON‐UNDERWOOD J. , ARON P. M. , WILKINSON K. W. , JOSEPH A. E. A. , RIDDLE P. R. 
Published: November 2008

Summary— We have studied the accuracy of transabdominal ultrasound (TAUS) in the diagnosis of early superficial bladder carcinoma. One hundred and twenty‐six patients returning for check cystoscopy were scanned pre‐operatively with the Technicare Autosector Scanner and the results compared with the endoscopic findings.Forty‐four patients (37%) had a tumour recurrence. TAUS demonstrated a lesion in 50% of these with a false positive rate of 11 %. The diagnostic accuracy was proportional to the tumour size (82% of patients with tumours above 5 mm were detected compared with 38% below 5 mm), but was not affected by grade, stage or position in the bladder.TAUS may prove a useful adjunct to cytology as a screening test for bladder cancer.
A New Hormonal Therapy for Prostatic Cancer: Long‐term Clinical and Hormonal Response
Authors: AHMED S. R. , GRANT J. B. F. , SHALET S. M. , HOWELL A. , COSTELLO C. B. , WEATHERSON T. , BLACKLOCK N. J. 
Published: November 2008

Summary— Twenty‐four patients with advanced prostatic cancer were treated with daily injections of the LHRH analogue ICI 118630 (Zoladex) for up to 21/2 years. Successful long‐term suppression of LH (luteinising hormone) and testosterone was observed without any escape of testosterone. Immunoreactive LH concentrations rose significantly following the daily injection of LHRH analogue but there was no corresponding rise in testosterone concentrations, suggesting altered bioactivity of the LH.A long‐term clinical response was obtained in 10 patients (41.6%) and the median duration of response in these patients was 25 months. Eight of the 10 had well to moderately differentiated tumours. The actuarial median survival of all patients was 22 months.
Predictive Value of99m Tc‐DTPA Renography Studies under Conditions of Maximal Diuresis for the Functional Outcome of Reconstructive Surgery in Children with Obstructive Uropathy
Authors: SUKHAI R. N. , KOOY P. P. M. , WOLFF E. D. , SCHOLTMEIJER R. J. 
Published: November 2008

Summary—
Renographic studies under standardised conditions of maximal diuresis provoked by infusion of hypotonic saline and frusemide were made on 51 patients with 54 dilated upper urinary tract systems in order to distinguish obstructed from non‐obstructed systems.Of the 23 systems judged on clinical and radiological grounds to be obstructed only 12 were in fact obstructed following infusion of hypotonic saline and frusemide. In 10 of these systems (1 0 patients) an Anderson‐Hynes pyeloplasty was carried out. All systems showed improved renal function after operation and the renographic pattern became non‐obstructed.