bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low Dose Bleomycin with Etoposide and Cisplatin for Metastatic Testicular Teratoma
Authors: COLEMAN R. E. , WHILLIS D. , HOWARD G. C. W. , TAYLOR R. E. , CORNBLEET M. A. 
Published: December 2008

Summary Thirty‐nine men with metastatic testicular teratoma were treated with a combination of bleomycin, etoposide and cisplatin (BEP). Unlike the usual regimen of these 3 agents, bleomycin and cisplatin were given on day 1 only of the cycle, with etoposide for 3 days. Thirty patients (77%) are alive and disease‐free after a median follow‐up of 31 months—24/25 (96%) with disease confined to lymph nodes but only 6/14 (43%) patients with lung involvement.Modified BEP chemotherapy is a well tolerated alternative to standard BEP chemotherapy for small volume nodal disease; it minimises in‐patient time, hospital visits and the risk of bleomycin lung toxicity. However, omission of the weekly doses of bleomycin and shortening of the administration schedule of cisplatin and etoposide may be detrimental in patients with more extensive disease, for whom more intensive therapy may be necessary.
Endoscopic Implantation of Collagen (GAX) for the Treatment of Urinary Incontinence
Authors: KIESWETTER H. , FISCHER M. , WÖBER L. , FLAMM J. 
Published: December 2008

Summary— Sixteen women whose ages ranged from 42 to 73 years (mean 57) and 2 men, aged 76 and 80 years respectively, were treated for urinary stress incontinence with transurethral implantation of submucosal glutaraldehyde cross‐linked collagen (GAX); 15 females had had several continence operations previously and 1 female was totally incontinent following low anterior resection of the sigmoid colon for cancer. All but 2 patients received 8 ml GAX in a single operative session under general anaesthesia. Before implantation, patients underwent urodynamic evaluation, cystoscopy, urinary stress test and the two‐thirds capacity pad weighing test. Post‐operative evaluations were carried out after 3, 6 and 9 months and included urinary flow rate, urine analysis, residual urine determination and the two‐thirds pad weighing test. The results were encouraging.After 3 months, 8/18 patients were cured, 7/18 had improved and 3/18 had failed to respond. Nine months post‐operatively, 7 patients were still continent, 8 had improved and 3 remained unchanged. One of the improved group had a reinjection 18 months post‐operatively and has been continent since then.We feel that GAX collagen injection is a safe and easy method for the treatment of urinary stress incontinence; it has no observable or measurable morbidity.
Is Injected Polytetrafluoroethylene (Polytef) Carcinogenic?
Authors: DEWAN P. A. 
Published: December 2008

Summary— Injectable polytetrafluoroethylene (Polytef) has been used in many patients for vocal cord augmentation and for the management of urinary incontinence since the early 1960s and noninjectable forms have been used for sutures, hernia repair, replacement of the stapes, hip prostheses, cardiac valves and vascular grafts.Since 1984, many children have been treated with subureteric Polytef injection for the management of vesicoureteric reflux. Its use in young patients has heightened the concern about particle migration and carcinogenesis, particularly in view of the fact that the substance may be in the patient for decades.The available evidence does not confirm a significant carcinogenic effect in humans; rather it suggests that, if there is a risk, it is extremely low. However, human specimens, taken decades after the implantation of Polytef, and long‐term, non‐rodent animal experiments are needed to substantiate the probable safety of Polytef in children.
DNA Analysis in Predicting Survival of Irradiated Patients with Transitional Cell Carcinoma of Bladder
Authors: WIJKSTRÖM H. , NILSSON B. , TRIBUKAIT B. 
Published: December 2008

Summary— A total of 115 patients with invasive transitional cell carcinoma of the bladder underwent radical radiotherapy between 1975 and 1986 and were followed up until the end of 1990. Apart from routine clinical observations, flow cytometric DNA measurements made on fresh tumour material were available for analysis. Actuarial cancer‐free survival controlling for response to treatment was analysed with the log‐rank test, bivariate and multivariate analyses using Cox's stepwise regression model on probable prognostic factors.The overall actuarial 5‐year cancer‐free survival rate was 30%. Survival was significantly correlated with response to treatment: 59% for patients with complete regression and 5% for those with residual tumour.Prognostic factors that significantly correlated with death from cancer were advanced stage, large size, incomplete resection, ureteric obstruction, anaemia, carcinoma in situ grade 3 and occurrence of more than one aneuploid cell population. However, only 3 of these factors were of independent power in the multivariate analysis: stage, size and carcinoma in situ.Of 21 patients with a history of primary or secondary carcinoma in situ, 19 died from cancer during follow‐up: 18 of the 21 patients had tumours that were aneuploid with more than one aneuploid cell population.It is concluded that curative radiotherapy can be successful only in patients with less advanced tumours assessed according to clinical stage and size, aneuploid tumours with not more than one aneuploid cell line, no carcinoma in situ, no ureteric obstruction, and in whom a complete transurethral resection of the exophytic tumour is possible.
The F‐15 Diuresis Renogram in Suspected Obstruction of the Upper Urinary Tract
Authors: UPSDELL S. M. , TESTA H. J. , LAWSON R. S. 
Published: December 2008

SummaryThe results are presented of the first long‐term follow‐up study of patients with suspected obstruction of the upper urinary tract investigated by a modified form of diuresis renography (F‐15 renography). The incidence of equivocal results from diuresis renography is significantly reduced by the use of the F‐15 renogram.F‐15 renography provides a reliable assessment of the upper urinary tract in patients with suspected obstruction and is recommended in the investigation of equivocal upper urinary tract dilatation.
Bladder Cancer: Inter‐relationships between Chemotherapy and Radiotherapy
Authors: WAXMAN J. , BARTON C. , BIRULS R. , JAMES N. , HARRISON M. , ROGERS H. , MEE D. , SIKORA K. , COLBECK R. , ABEL P. , WILLIAMS GORDON 
Published: December 2008

SummaryThere has been increasing interest in the role of chemotherapy as primary treatments for patients with urothelial cancer and because of the poor prognosis of locally advanced tumours with conventional treatment, trials have been initiated comparing radiotherapy with chemotherapy as primary therapies. In this context it is important to assess the relationship between the responses to chemotherapy and radiotherapy, and this we have examined in 64 patients treated with MVMJ (methotrexate, vinblastine, mitozantrone and carboplatin).Either a complete or a partial response was found in 29 of the 64 patients, 15 had stable disease and 13 had progression of disease. Seven patients died within the first treatment month. The survival of the responding patients ranged from 114 to 1184 days.Six of 15 patients who had had pelvic irradiation prior to chemotherapy responded to MVMJ, the maximum duration of response being more than 3 years.Twenty‐two patients had radiotherapy following their chemotherapy. One of 13 patients not responding to MVMJ had a transient response to radical radiotherapy. Only 1 of 9 patients responding to chemotherapy and then relapsing responded to subsequent radical radiotherapy.Patients with metastatic disease or with recurrent disease after radiotherapy have a worthwhile chance of responding to chemotherapy and achieve durable remissions. In contrast, radiotherapy appears relatively ineffective in patients whose disease progresses or relapses after chemotherapy given as primary treatment with curative intent.
Recurrent Infection Stones with Apparently Negative Cultures. The Case for Blind Antibacterial Treatment
Authors: ROSE G. A. , ROSENBAUM T. P. 
Published: December 2008

SummaryInfection stones in the urinary tract are always associated with infection with a urease‐producing, urea‐splitting organism. The most common of these organisms are easy to culture and identify and can be treated early either with an appropriate antibiotic or with an anti‐urease agent. Ureaplasma urealyticum and Corynebacterium urealyticum are urease‐producing organisms which are difficult to grow; their presence and effects frequently go undetected and untreated. Other organisms, as yet unknown, may also be involved in the same process.We report the first series of 8 patients with recurrent infection‐type stones likely to have been caused by a “hard to grow” organism. Five patients never had a positive culture; in 2 patients 1 of 10 urine cultures grew a coagulase‐negative Staphylococcus and in 1 patient the same organism was grown from a stone but never in the urine.The clinical course of all of these patients was significantly improved after blind treatment with antibiotics and in one case with an anti‐urease agent.
Urinary Tract Metastasis from Renal Carcinoma
Authors: GELISTER J. S. K. , FALZON M. , CRAWFORD R. , CHAPPLE C. R. , HENDRY W. F. 
Published: December 2008

SummaryFive patients with urinary tract metastases from renal carcinoma are presented. In 4, urinary tract metastasis occurred in the absence of spread elsewhere. The initial presentation in 1 patient was ureteric obstruction; 3 others re‐presented with haematuria and the fifth patient was diagnosed post mortem. Metastatic sites included ipsilateral ureter, contralateral ureter, ureteric stump, bladder and prostatic fossa.After previous nephrectomy for renal carcinoma, urinary metastases, although rare, should be considered and investigation of unexplained haematuria should include the ureteric stump. Useful palliation and possibly cure can be achieved by resection of these lesions.
Calcium Balance, Growth and Skeletal Mineralisation in Patients with Cystoplasties
Authors: MUNDY A. R. , NURSE DIANE E. 
Published: December 2008

SummaryTwelve adult female patients and 16 children who had undergone augmentation cystoplasty at least 2 years previously were studied to assess calcium balance and skeletal mineralisation.The serum and 24‐h urinary calcium levels were measured and arterial blood gas analysis was performed in all patients. In children, skeletal mineralisation was assessed by serial study of their growth charts, comparing their growth centiles before and after cystoplasty. In adults, skeletal mineralisation was assessed by dual photon absorptiometry (DPA).As previously reported, all patients had a metabolic acidosis, usually with respiratory compensation. Serum and 24‐h urinary calcium levels were all within the normal range. Growth charts of the 6 children with colocystoplasties showed an average of 20% reduction in growth potential in 3 of them. Growth charts in the 10 children with ileocystoplasties did not show any change in growth pattern. DPA bone scans in adults were all normal.These results suggest that if calcium is mobilised from bone in patients with a cystoplasty as a result of the metabolic acidosis, then it is reabsorbed from the bladder by the gut segment after an ileocystoplasty; colonic segments are less efficient than ileal segments, however, so that after a colocystoplasty skeletal demineralisation or a reduction in growth potential is more likely.
Urinary Flow Rate in Benign Prostatic Hypertrophy in Relation to the Degree of Obstruction of the Vesical Outlet
Authors: CUCCHI A. 
Published: December 2008

SummaryForty men with bladder outflow obstruction from benign prostatic hypertrophy were investigated urodynamically by medium‐fill water cystometry and pressure flow study. The most obstructed patients proved to be unstable. A positive link was found between the degree of obstruction, as assessed by the opening pressure (i. e. the detrusor pressure needed to start micturition), and the maximum mechanical power generated by the contracting bladder during voiding. What seems most striking, is that neither detrusor contraction velocity nor the urine flow rate fully mirrored the degree of obstruction–i. e. the opening pressure and the maximum contraction speed did not show a negative correlation, but rather a weak (though insignificant) positive link, and the flow rate decreased only slightly (not significantly) when obstruction increased. Such a surprising observation could be explained by the fact that prostatic obstruction produces both collagen infiltration into the bladder muscle (this affecting the spread of the depolarisation wave) and, at the same time, denervation supersensitivity. The latter actually yields a decrease in electrical resistance between the detrusor smooth muscle cells (and thereby an enhanced synchronisation of the detrusor contraction), which might be only partly cancelled by the effects of collagenosis.
Squamous Metaplasia in the Penile Urethra due to Oestrogen Therapy
Authors: RUSSELL G. A. , CROWLEY T. , DALRYMPLE J. O. 
Published: December 2008

SummaryHistological examination was performed on the anterior penile urethra from 21 asymptomatic trans‐sexual patients taking oestrogens prior to surgery. Squamous metaplasia was present in 15 of these patients and in 1 man taking progesterones. Immunohistochemical staining for oestrogen receptors in the urethra was negative. Severe squamous metaplasia was associated with patchy chronic inflammatory cell infiltration but this was also present in normal controls. The lack of recognised complications of squamous metaplasia at this site suggests that it is an incidental observation in men taking oestrogens.
Comparison of DMSA Scintigraphy with Intravenous Urography for the Detection of Renal Scarring and its Correlation with Vesicoureteric Reflux
Authors: ELISON B. S. , TAYLOR D. , Van der WALL H. , PEREIRA J. K. , CAHILL S. , ROSENBERG A. R. , FARNSWORTH R. H. , MURRAY I. P. C. 
Published: December 2008

SummaryA series of 208 patients was prospectively assessed for reflux nephropathy by intravenous urography (IVU) and 99mTc‐dimercaptosuccinate (DMSA) scintigraphy. All patients were studied at least 3 months after their most recent urinary tract infection and micturating cystourethrography (MCU) was performed prior to the scintigraphic studies. DMSA scintigraphy detected significantly more cortical abnormalities than did IVU. There was also a correlation between cortical abnormalities in the DMSA studies and the degree of reflux on MCU.The validity of DMSA as a cortical imaging agent is evaluated and the histological evidence for its efficacy derived from the animal model is reviewed, lending weight to its establishment as the “gold standard” for renal cortical scarring.
Extracorporeal Shock Wave Lithotripsy for Renal Calculi in Children
Authors: MISHRIKI S. F. , WILLS M. I. , MUKHERJEE A. , FRANK J. D. , FENELEY R. C. L. 
Published: December 2008

SummaryFifteen children (8 male and 7 female) with an age range of 18 months to 15 years were treated with extracorporeal shock wave lithotripsy (ESWL) using the Siemens Lithostar. Two children had a history of metabolic stone disease and 1 child had previously undergone open stone surgery. Four children were treated with a ureteric stent in place and 1 nephrostomy was inserted before treatment. All children were treated under general anaesthesia and all of the stones treated were confined to the kidney and ranged in size from 5 mm to a complete staghorn.The number of treatments ranged from 1 to 6 and generator voltage ranged from 16 to 19 kV with a maximum number of 30,000 shocks to a complete staghorn. Complications were minimal, with 3 children presenting with colic, 1 child requiring a stent and none requiring a nephrostomy after treatment. The overall stone clearance rate at 3 months was 65%.ESWL provides an effective treatment for selected calculi in children. In the short term, complications are minimal but the long‐term effects on children need to be monitored.
Surgery for Hypospadias Fistula
Authors: EARDLEY I. , WHITAKER R. H. 
Published: December 2008

SummaryThe results of 12 years' experience in the surgical treatment of hypospadias fistula are presented. Overall, there was a success rate of approximately 50% for each attempt at surgical closure of a fistula. The chances of success were not significantly influenced by the number of previous surgical procedures. The best results were obtained with fistulae on the shaft of the penis which were closed with mucosal inversion and advancement of a skin flap over the fistula.
Complications of Clam Enterocystoplasty with Particular Reference to Urinary Tract Infection
Authors: FENN N. , CONN I. G. , GERMAN K. A. , STEPHENSON T. P. 
Published: December 2008

Summary— A study was carried out on 112 patients who had undergone a clam procedure. Followup extended from 15 months to 8 years. The efficacy of the operation in achieving and maintaining continence in patients with instability and hyper‐reflexia was confirmed (93% in the neuropathic group, 91% in the congenital instability group and 78% in the idiopathic group).Complications were common and included inability to void (requiring self‐catheterisation), haematuria, mucus production and recurrent urinary tract infection. Complete bacteriological data were obtained on 80 patients; 30% were infected pre‐operatively (all but 4 in the neuropathic group) but 66% had bacteriuria at the time of assessment after surgery. Subjectively, 17 patients (24%) who “never” got infected had bacteriuria, as did 29 (63%) of those who were “occasionally” infected. Objectively, 84% of patients on intermittent self‐catheterisation (ISC) had positive cultures, but even in those voiding spontaneously bacteriuria was present in 60%.Careful follow‐up of these patients is mandatory and a more rigorous approach to eradication of infection and subsequent prophylaxis has been instituted.
A Self‐administered Patient Questionnaire in the Assessment of Symptoms before and after Prostatectomy
Authors: BARDSLEY M. J. , VENNING PAM M. , CHAM C. W. , HASAN T. , NEAL D. E. 
Published: December 2008

Summary— A self‐administered patient questionnaire was developed to assess the severity of key symptoms before and after transurethral prostatectomy (TURP). This questionnaire was validated by comparison with a standard assessment performed by the doctor. Complete data were obtained on 39 men studied before and 3 months after prostatectomy.Close associations were found between the scores resulting from the assessments performed by the patient and those carried out by the doctor. These associations were found for individual scores and for aggregate scores for obstructive and irritative symptoms before and after operation.Symptom scores after operation were significantly related to the patients' overall assessment of whether the operation had been a success–a low score being associated with a satisfactory outcome. It is suggested that self‐administered symptom questionnaires can give a reliable picture of the outcome of prostatectomy and might be useful in developing audit systems.
Anti‐reflux Surgery by Injection of Teflon Paste
Authors: KONDO A. , YOSHIKAWA Y. , NAGAI T. , SAITO M. 
Published: December 2008

Summary— Over a 3‐year period, 55 refluxing ureters in 36 patients were treated by the endoscopic injection of Teflon paste. Although reflux was corrected immediately in 54 ureters (98%), reflux recurred 3 to 4 months later in 18 ureters. Reinjection was carried out once in 5 ureters and twice in 1. The success rate was 71% in primary reflux and 53% in secondary reflux.Significant side effects were encountered post‐operatively in 3 patients: vesicoureteric junction obstruction in 2 and urethral stricture in 1. We recommend that the results of surgery should not be evaluated until at least 3 to 4 months after operation. A review of the literature shows that the overall success rate was 92% in 367 ureters with primary reflux and 70% in 181 ureters with secondary reflux. Because of the uncertain outcome of surgery and the possibility of adverse side effects, one should be cautious when considering this form of treatment in young children.
Reconstruction of the Lower Urinary Tract for Neurogenic Bladder: Lessons from the Adolescent Age Group
Authors: WOODHOUSE C. R. J. 
Published: December 2008

Summary— Of 42 adolescents with neurogenic bladder who presented for lower urinary tract reconstruction, 4 patients with severe spina bifida were unfit for major surgery.Five patients had a simple undiversion; 4 of these had a poor outcome because of unpredicted sphincter incontinence (1 patient) or instability (3).A total of 26 patients had an enterocystoplasty. All 7 patients who had a substitution cystoplasty had a good result, as did 3 males with a clam cystoplasty. Nine of 16 females had a poor result from a clam procedure. In 3 the problem lay with self‐catheterisation difficulties. One each had persistent hyper‐reflexia and sphincter incontinence. Four had hyper‐reflexia on sexual intercourse.Overall, 42% of females had problems from the retained bladder segment.Seven patients had continent urinary diversions. The results were good, although 2 Kock nipples required revision.Surgery was well tolerated. There was a 21% re‐operation rate for complications.Pre‐operative investigation correctly predicted sphincter competence and the need for self‐catheterisation in 79 and 86% respectively.
Contralateral Testicular Blood Flow in Unilateral Testicular Torsion Measured by the 133Xe Clearance Technique
Authors: MELIKOGLU M. , GUNTEKIN E. , ERKILIC M. , KARAVELI S. 
Published: December 2008

Summary— Contralateral testicular blood flow was measured by the intratesticular injection of 133Xe in 9 controls (Group 1) and in 34 adult male albino rats with experimentally induced left testicular torsion. In Group 2 (n = 9) testicular torsion was maintained for 3 h; in Group 3 (n = 7) torsion was maintained for 9 h and in Group 4 (n = 10) for 15 days. In Group 5 (n= 16) torsion was maintained for 9 h in 8 rats and the sera were given to 8 normal animals.In Groups 3, 4 and 5 there was a significant increase in contralateral testicular blood flow on the fifteenth day. This increase may be the cause of contralateral testicular damage in prolonged unilateral testicular torsion.
Complete Resolution of a Large Seminal Vesicle Cyst–Evidence for an Obstructive Aetiology
Authors: CONN I. G. , PEELING W. B. , CLEMENTS R. 
Published: December 2008

Summary— Seminal vesicle cysts may arise from inflammation or obstruction of the seminal vesicle or from embryological remnants such as the müllerian duct. Surgical removal has been proposed as the treatment of choice.A 19‐year‐old boy presented with abdominal pain and constipation. Investigations revealed a 14‐cm multiloculated cyst arising from the right seminal vesicle and a small stone lodged at the orifice of the ipsilateral ejaculatory duct. Following endoscopic removal of the stone the mass decreased in size considerably and 2 months later transrectal ultrasound and magnetic resonance imaging showed normal seminal vesicles and no evidence of the cyst.This case strongly supports an obstructive aetiology for this cyst and we would suggest that, in similar cases, full assessment of the ejaculatory apparatus should be carried out to exclude an obstructive cause before embarking on major surgery.