bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome and Prognostic Factors in Patients with Advanced Prostate Cancer and Obstructive Uropathy
Authors: SANDHU D. P. S. , MAYOR P. E. , SAMBROOK P. A. , GEORGE N. J. R. 
Published: November 2008

Summary— a series of 51 patients with prostate cancer and obstructive uropathy, unilateral or bilateral obstruction was identified in 22 (43%) and 29 (57%) respectively. This included a non‐functioning kidney in 12 patients. In 86% of patients the T category was advanced. Bone metastases were present in 36 cases (7 1%); 19 patients (37%) had chronic retention. All patients with metastatic disease underwent hormonal manipulation and 43 underwent transurethral resection of the prostate. External beam radiotherapy, percutaneous nephrostomy and ureteric reimplantation were performed in 4,5 and 1 patient respectively. non‐function did not predict a worse prognosis in comparison with patients with unilateral hydroureteronephrosis. Raised alkaline phosphatase and prostatic acid phosphatase were of no prognostic value, while creatinine reached marginal significance. A positive bone scan and raised urea were strongly predictive of a poor outlook. It was concluded that prostate cancer and obstructive uropathy should not uniformly imply a terminal event, and interventional therapy is justified with a 25% 5‐year survival rate.Actuarial survival of all 51 patients was 57 and 25% at 2 and 5 years. Presentation with bilateral or non‐function did not predict a worse prognosis in comparison with patients with unilateral hydroureteronephrosis. Raised alkaline phosphatase and prostatic acid phosphatase were of no prognostic value, while creatinine reached marginal significance. A positive bone scan and raised urea were strongly predictive of a poor outlook. It was concluded that prostate cancer and obstructive uropathy should not uniformly imply a terminal event, and interventional therapy is justified with a 25% 5‐year survival rate.
Extracorporeal Lithotripsy of Ureteric Calculi Using the Dornier HM‐3 Lithotriptor
Authors: BENIZRI E. , AUGUSTI M. , AZOULAI G. , CHARBIT L. , CUKIER J. 
Published: November 2008

Summary Over a 5‐year period (November 1984 November 1989), we treated 356 patients with ureteric calculi; 170 were treated by extracorporeal shock wave lithotripsy (ESWL) on a Dornier HM‐3 lithotriptor. The calculi (n = 176) were uniformly distributed along the length of the ureter: 44 were just below the periureteric junction, 59 were lumbo‐iliac, 42 were in the upper bony pelvis and 32 in the lower bony pelvis. The mean diameter of the upper ureteric calculi was 10 mm and for the others it was 8 mm. Thirty‐four patients with acute obstructive pyelonephritis required pre‐ESWL drainage of the urine. X‐ray localisation required intraveneous urography during lithotripsy in 52 cases (30%). On plain X‐ray the following day 170 stones (96%) were judged to have disintegrated. The 6 patients whose stones were not fragmented received further treatment (ureterotomy (4) and ureteroscopy (2)). Five patients required additional treatment because of pain or fever (catheterisation (3) and ureterotomy (2)) and 2 patients had a second lithotripsy owing to insufficient fragmentation. Four patients were lost to follow‐up.In 153 patients (90%) the fragments were eliminated completely, 146 in the first month and the remainder before the sixth month. No serious sequelae were observed. In addition to the 5 patients who required supplementary treatment. 11 patients with pain or fever needed medical treatment. We recommend first intention in situ ESWL for all ureteric calculi.
Morphological Effects of Photodynamic Therapy on Rabbit Bladder Using Photofrin II and Photosan Intravesically and Intravenously
Authors: TAARI K. , TALJA M. , RIIHELÄ M. , RANNIKKO S. , MOKKA R. 
Published: November 2008

Summary Photodynamic therapy (PDT) has proved effective against superficial papillary bladder tumours and focal and diffuse carcinoma in situ. Effective topical administration of the sensitiser would be a welcome improvement.The morphological effects of PDT on the normal bladder were examined in 13 rabbits when 2 photosensitisers (Photofrin II and Photosan III) were applied intravesically (5 mg/kg for 1 h) and compared with intravenous administration (3 or 5 mg/kg). Four animals served as controls without a sensitiser. Intravesical red light (630 nm) from an argon dye laser was used to activate the photosensitiser, using light doses of 12 or 24 J/cm2. The animals were sacrified either 1 or 5 to 7 days after the laser treatment.Intravenous dosage induced bladder wall oedema/haemorrhage and total necrosis of the epithelium. There was no difference between the effects of the 2 sensitisers. Intravesical application induced superficial epithelial necrosis. The control animals treated with laser light alone showed slight superficial injury to the cell layer.
Detrusor Mast Cells in Refractory Idiopathic Instability
Authors: MOORE KATE H. , NICKSON P. , RICHMOND D. H. , SUTHERST J. R. , MANASSE P. R. , HELLIWELL T. R. 
Published: November 2008

Summary— The diagnosis of interstitial cystitis (IC) is not usually considered in patients with idiopathic instability. Because histamine provokes detrusor contractions in vitro, we assessed detrusor mast cell counts in 29 females with refractory instability. Raised mast cell counts (> 28/mm2 of detrusor muscle, consistent with a histological diagnosis of IC) were found in 29% of such cases. Thus cystoscopy and bladder biopsy should be considered in patients with idiopathic instability which fails to respond to anticholinergic drugs, as alternative therapy may be useful.Patients with refractory instability and normal detrusor mast cell counts often gave a history of prolonged childhood nocturnal enuresis (55% of cases); in contrast, patients with intractable instability and abnormally high mast cell counts seldom gave such a history (12%). These trends may give some insight into the aetiology of idiopathic instability—“congenital” or acquired?
The Effect of Ranitidine on Urine Mucus Concentration in Patients with Enterocystoplasty
Authors: GEORGE V. K. , GEE J. M. , WORTLEY M. I. , STOTT M. , GACHES C. G. C. , ASHKEN M. H. 
Published: November 2008

Summary— We describe the effect of ranitidine in reducing mucus in urine in 8 patients with enterocystoplasty and present a simple technique for measuring the concentration of mucus in urine. After a 10‐day course of ranitidine (300 mg daily in divided doses) the concentration of mucus had fallen significantly from an initial level of 1.38 ± 0.18 to 0.39 ± 0.04 mg/ml.Based on a Poster Demonstration at the 47th Annual Meeting of the British Association of Urological Surgeons in Glasgow, June 1991
Bladder Cancer Mortality in the Netherlands, 1955–1988
Authors: KIEMENEY L. A. L. M. , VERBEEK A. L. M. , NELEMANS P. J. , WITJES J. A. , STRAATMAN H. 
Published: November 2008

Summary— In 1955, 234 men and 116 women died from bladder cancer in the Netherlands. In 1988 the numbers were 794 and 317 respectively. After adjusting for the ageing of the Dutch population since 1955, female mortality rates per 105 person‐years appear to be very stable: 2.9 from 1955 to 1959 and 3.0 from 1985 to 1988. By contrast, an increasing trend exists in males. From 1955 to 1959 and from 1985 to 1988, bladder cancer mortality rates per 105 person‐years were 7.5 and 12.4 respectively. For men in particular, increasing mortality (and incidence) rates are seen all over the world. In many cases this increasing trend is thought to originate from a higher risk of dying from bladder cancer in successive birth cohorts rather than from a higher risk in successive calendar periods. This so‐called cohort effect is explained by changes in smoking behaviour in the male population.Statistical modelling of bladder cancer mortality data from 1955 to 1988 in the Netherlands shows that the increasing temporal trend in men can also be described as a cohort effect. The risk of dying from bladder cancer increases from the 1875 birth cohort to the 1910 birth cohort, but decreases thereafter. It is concluded that this decreasing risk for generations born after 1910 will probably result in a decreasing trend in mortality in the near future, when more and more of these “youngsters” reach the age of 70+.
Why do Most Primary Bladder Neoplasms First Appear Around the Ureteric Orifices?
Authors: STEWART L. H. , O'NEILL K. L. , McKELVEY V. J. , GILLESPIE E. S. , JOHNSTON S. R. , BIGGART J. D. , McKENNA P. G. 
Published: November 2008

Summary The majority of primary bladder neoplasms are known to arise within the mucosa around the ureteric orifices and bladder base. This may be due to the mucosa in this area being more susceptible to carcinogens than other areas of the bladder. Deficiency in the nucleotide salvage pathway enzyme thymidine kinase (TK), and especially its TK 1 isozyme, has been shown to predispose cell lines to increased mutagenesis. Total TK and TK 1 activities were measured in mucosal samples taken adjacent to the ureteric orifices and dome in 32 normal bladders and both total TK and TK 1 were shown to be significantly decreased in the mucosa adjacent to the ureteric orifices.This may explain why primary bladder neoplasms occur more commonly in this site.
Urinary Continence Following Radical Retropubic Prostatectomy
Authors: RAMON J. , LEANDRI P. , ROSSIGNOL G. , GAUTIER J.R. 
Published: November 2008

Summary Between 1983 and 1989,484 men (46–82 years old) underwent radical retropubic prostatectomy for prostate cancer. Six months after surgery, 434 patients (90%) achieved complete urinary control; stress incontinence was present in 50 patients (10%) and no patient was totally incontinent. Of the 398 patients who were followed up for more than 1 year, 377 (95%) achieved complete urinary control and 21 (5%) experienced stress incontinence.Prior open prostatectomy or transurethral resection of the prostate had no influence on the return of urinary control. Pathological stage and preservation or not of the neurovascular bundles also had no significant influence on the long‐term state of continence. Age was the only factor that adversely affected the return of urinary continence. The average interval between surgery and return of continence was shorter in patients less than 70 years old. When the impact of age was examined 1 year or more after surgery, no significant difference was noted between the age groups.Several technical considerations that contribute to these results are discussed, especially the use of a gradual approach to the apex of the prostate to facilitate exposure and haemostasis and to preserve as much of the striated urethral sphincter as possible.
Abstracts of the Proceedings of the Urological Society of Australasia, 45th Annual Scientific Meeting, Adelaide, Australia, 1992
Authors: Marshall V. R. , Sutherland P. D'A. , Millard R.J. 
Published: November 2008

The 45th Annual Scientific Meeting of the Urological Society of Australasia was held between 29 March and 2 April 1992 at the Adelaide Convention Centre, South Australia. The meeting was organised by Professor Villis Marshall, President of the Society, and a committee of local urologists. Invited guests included the R.A.C.S. Foundation Visitor Professor E. Tanagho from San Francisco, together with Professor Donald Coffey from Baltimore, Professor Urs Studer from Berne and Professor John Blandy from London.The Harry Harris Memorial Oration was given by Professor Donald Coffey on the subject “Science, creativity and human destiny”. The Keith Kirkland Prize was won by R. Thomas for his presentation on “Oral N‐acetyl cysteine in urinary tract mucolysis”. The Alban Gee prize for the best poster was won by P. K. Grover for his poster on the promotion of calcium oxalate crystallisation by urate: epitaxy is not its cause.Each of the invited guests gave keynote presentations on his work. The meeting again encompassed sections on C.M.E. and the entire membership agreed to undertake a multiple choice “Practice profile” examination during the meeting. This will be repeated after 2–3 years to assess whether a selection of C.M.E. measures can alter “practice profiles” and the urological knowledgebase of members.The 46th Annual Scientific Meeting of the Society will be held between 28 February and 5 March 1993 at the Sheraton Hotel, Hobart, Tasmania.
Metabolic Complications of the Urinary Intestinal Diversion: lleo‐caecal Bladder Compared with Ileal Conduit
Authors: OLIVO G. , BIASIOLI S. , BONCIARELLI M. , NOTO L. 
Published: November 2008

Summary— Five patients with an ileal conduit and 5 with an ileo‐caecal bladder substitute have been studied metabolically. All had undergone cystectomy for infiltrating carcinoma and they formed 2 homogeneous groups in terms of age and follow‐up.Function in both groups was within normal limits but closer examination of patients with an ileo‐caecal bladder revealed mild functional damage as shown by reduced creatinine secretion, a lower level of bicarbonate and lower urinary acid valency secretion.It was concluded that the ileal conduit is more satisfactory from a metabolic point of view than the ileo‐caecal bladder, which requires closer follow‐up and treatment with bicarbonates if necessary.
PAEDIATRIC UROLOGY: The Failed Exstrophy Closure: Strategy for Management
Authors: GEARHART J. P. , PEPPAS D. S. , JEFFS R. D. 
Published: November 2008

Summary— In the last 7 years, 29 boys and 11 girls have been referred with failure of their exstrophy closure; 38 patients had classic bladder exstrophy and 2 had cloacal exstrophy. Reclosure was performed for complete bladder dehiscence in 28 cases and for significant bladder prolapse in 10. Two patients underwent revision of the posterior urethra after primary closure due to a severe urethral stricture secondary to the use of para‐exstrophy skin flaps. Six patients underwent posterior iliac osteotomy at the time of initial bladder closure and in 34 no osteotomy was performed. Thirty‐seven patients underwent either posterior iliac osteotomy (15) or anterior innominate osteotomy (22). Epispadias repair together with reclosure of bladder exstrophy was done in 20 boys.The upper tract has remained normal in all patients. Fourteen have undergone subsequent bladder neck reconstruction. Seven patients have undergone simultaneous bladder neck reconstruction and augmentation cystoplasty and 1 has undergone augmentation cystoplasty and Mitrofanoff procedure; all are dry on intermittent self‐catheterisation.The failed exstrophy reconstruction represents a formidable dilemma. However, a well planned reconstruction including osteotomy (even if previously performed), reclosure with or without epispadias repair or revision of the urethra can be performed with an excellent chance of proceeding with staged reconstruction.
Primary Retroperitoneal Lymph Node Dissection in Clinical Stage A Non‐seminomatous Germ Cell Testis Cancer Review of the Indiana University Experience 1965–1989
Authors: DONOHUE J. P. , THORNHILL J. A. , FOSTER R. S. , ROWLAND R. G. , BIHRLE R. 
Published: November 2008

Summary— The results of primary retroperitoneal lymph node dissection (RPLND) in 464 patients with clinical stage A non‐seminomatous germ cell (NSGC) testis cancer treated over 25 years (1965–1989) were reviewed. The results were analysed in clinical terms and subdivided into early (1965–1978) and contemporary (1979–1989) groups in order to be comparable with series using radiotherapy or surveillance. Between 1965 and 1978 (86 clinical stage A patients) the overall relapse rate of 15% (n = 13) was similar to that of radiotherapy series but survival (97.7% after RPLND) was superior to that achieved with irradiation (87%). From 1979 to 1989, 378 clinical stage A patients had primary RPLND and 30% of them (n = 112) had cancerous nodes. The relapse rate for pathological stage A (n = 266) was 12% and 2 patients died. The relapse rate in pathological stage B patients without adjuvant chemotherapy was 34%. No relapse was seen among 48 pathological stage B patients who received post‐operative adjuvant chemotherapy. The death rate was 0.8% among 378 clinical stage A RPLND patients.While not statistically significantly different from death rates reported in current surveillance series, these consistent results spanning 2 eras (before and after cisplatin) over 25 years suggest a sound basis for the surgical approach. The anatomical and medical principles in oncology, which have supported this approach, still remain cogent today. Now that nerve‐sparing techniques have been developed, the only long‐term morbidity of RPLND (anejaculation) has been avoided. It would seem appropriate to include nerve‐sparing RPLND techniques in the management of clinical stage A disease.
Female Genito‐urethroplasty and Submucosal Periurethral Collagen Injection as Adjunctive Procedures for Continence in the Exstrophy‐epispadias Complex Preliminary Results
Authors: CAIONE P. , CAPOZZA NICOLA , LAIS A. , CRETI G. , DE GENNARO M. 
Published: November 2008

Summary— Continence is the main goal in the treatment of patients with bladder exstrophy and prognosis is necessarily long‐term. Over an 8‐year period, 44 patients presented with bladder exstrophy and/or incontinent epispadias. Twenty‐five bladder closures (7 secondary), 23 male urethroplasties, 19 bladder neck (BN) reconstructions and 6 bladder augmentations were performed in these patients. In 18 children 2 additional procedures were employed in the last 3 years: female genito‐urethroplasty (15) and submucosal periurethral collagen injection (11). Eight children underwent both procedures.Genito‐urethroplasty and collagen injection were performed before BN reconstruction in 6 and 5 cases respectively, in order to increase bladder outlet resistance. The submucosal injection was performed at 3, 9 and 12 o'clock in the BN or sphincteric urethra, using 0.75 to 2.5 ml of cross‐linked bovine collagen. Continence in the children who underwent the complete staged reconstruction was good in 58%, fair in 32% and poor in 11%. Following female genito‐urethroplasty and periurethral collagen injection, bladder capacities increased by 25%.These complementary procedures are effective in increasing outlet resistance and bladder capacity in patients with exstrophy and/or epispadias; they may improve continence and lessen the need for further bladder augmentation.
Ultrasonically Determined Patterns of Enlargement in Benign Prostatic Hyperplasia
Authors: COLLINS G. N. , LEE R. J. , RUSSELL E. BARBARA , RAAB G. M. , HEHIR M. 
Published: November 2008

Summary— A series of 430 men aged 40 to 79 years underwent transrectal ultrasonography (TRUS) as part of a community survey of benign prostatic hyperplasia (BPH). We describe a reproducible method of prostate volume estimation and discuss the implications of prostate dimension changes in BPH.The mean prostate and adenoma volumes for the group were 32 ml (SD 14) and 15 ml (SD 11) respectively. The antero‐posterior dimension of the prostate (APD) had the strongest correlation with gland volume compared with the transverse dimension (TD) and length (L). The mean ratio of adenoma volume to prostate volume was 0.45 (SD 0.13) and this increased with increasing gland volume. There was a modest correlation between the ratio and prostate volume.BPH is characterised by a proportionally greater increase in the APD compared with L and TD and by an increasing adenoma/prostate ratio. TRUS is useful in assessing the type and extent of adenoma and prostate enlargement in BPH.
Transrectal Ultrasound Examination of the Prostate: Complications and Acceptance by Patients
Authors: AUS G. , HERMANSSON C. G. , HUGOSSON J. , PEDERSEN K. V. 
Published: November 2008

Summary— Transrectal ultrasound scan (TRUS) of the prostate was performed on 511 patients, 391 of whom also underwent between 1 and 5 transrectal 1.2 mm core biopsies. The infection rate in the whole group was 4.1%; 32% of the patients were given antibiotic prophylaxis with norfloxacin 400 mg twice daily for 1 week and in this group the infection rate was 0.8%. In the remaining patients, who received 400 mg norfloxacin at the time of biopsy and another 400 mg the same evening, the infection rate was 5.6%. The only risk factor identified for post–biopsy infection was steroid medication.Only minor discomfort (or none at all) was reported by 95% of patients during the examination procedure. If TRUS was combined with core biopsy 92% reported either minor or no discomfort. Of 78 patients who experienced both finger‐guided fine needle aspiration biopsy and TRUS‐guided core biopsy 82% preferred the latter procedure.TRUS and core biopsy proved acceptable to most patients. Antibiotic treatment with 2 tablets of norfloxacin failed to prevent infection.
Laser Lithotripsy with the Candela MDL‐2000 Laser Tripter
Authors: MacDERMOTT J. P. , GROVE J. , CLARK P. B. 
Published: November 2008

Summary— The Yorkshire Lithotriptor Centre acquired a Candela MDL‐2000 Laser Tripter and a 7.2F Miniscope in February 1990. We present the results obtained in the first 200 patients referred for treatment of ureteric stones or stone fragments.Of 175 patients who were evaluable, 58 had upper ureteric stones, 41 mid‐ureteric and 76 lower ureteric stones. Successful laser fragmentation was achieved in 77% of cases and a further 10% were rendered stone‐free by the push‐bang technique. Ureterolithotomy was required in 9% and the major complication rate was 4%. Ureteric dilatation was not used. Maximum laser energy was required to break 19% of the stones, but no stone was encountered which could not be broken.Laser lithotripsy with this system is highly effective at all levels of the ureter; it is safe and it complements ultrasound‐guided extracorporeal lithotripsy.
Increased Fractional Excretion of Sulphate in Stone Formers
Authors: PUCHE R. C. , VACCARO D. , SANCHEZ A. , GONZALEZ A. , SARANO H. D. 
Published: November 2008

Summary— This study was performed to determine urinary sulphate excretion in patients with renal stone disease. Stone formers showed a significantly higher fractional excretion of sulphate than control subjects; 80% of stone formers had fractional excretions > 0.26. No significant relationship was established between increased urinary sulphate excretion and any identifiable metabolic disorder, or the recurrence rate of stone episodes.The increase in fractional excretion of sulphate appears to be a more prevalent tubular defect among stone formers than has hitherto been reported.
The Role of the Radionuclide Renal Study in the Management of Renal Colic
Authors: GUTMAN M. , BRAF Z. , KAVER I. , SALTZMANN S. , BARON J. M. 
Published: November 2008

Summary— If renal colic is suspected in the patient presenting with acute flank or lower abdominal pain it must be established whether or not the affected kidney is obstructed and whether there is functional impairment that may require urological intervention.The radionuclide renal study developed in this hospital and used routinely for over 10 years can reveal obstruction when the results of commonly used tests are negative. It also provides information on renal function, morphology and blood flow. It is a cost‐effective, safe and reliable procedure for the initial investigation of patients presenting with suspected renal colic.
Bladder Z‐plasty for the Repair of Ureteric Injuries Experimental Study in Sheep
Authors: CORMIO L. , CROVACE A. , LACALANDRA G. , BELLO A. DI , SELVAGGI F. P. 
Published: November 2008

Summary— There is general acceptance that the best substitute for a damaged distal ureter is an elongated bladder and that the bladder psoas hitch is the most reliable procedure. Nevertheless, it is not always sufficient to bridge a long ureteric gap.In order to obtain an equally safe but wider bladder elongation than the psoas hitch can provide, we have previously studied the effect of several Z‐shaped incisions on isolated pig bladders. The aim of the present study was to verify, in vivo, the efficacy and safety of the new technique. Five sheep underwent the psoas hitch procedure and 6 the Z‐plasty procedure. The results showed that Z‐plasty provides an equally safe but longer bladder elongation than the psoas hitch procedure.