bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of thoracotomy in managing postchemotherapy residual thoracic masses in patients with nonseminomatous germ cell tumours
Authors: McGuire M.S. , Rabbani F. , Mohseni H. , Bains M. , Motzer R. , Sheinfeld J. 
Published: December 2004

The role of thoracotomy in patients with metastatic testicular cancer is explored by the group from Memorial Sloan‐Kettering Cancer Center. This is a controversial area, and they evaluate the outcome and establish prognostic variables in patients having this procedure after chemotherapy. They found it to be therapeutic for most patients with teratoma, and many with residual viable cancer. The group from the University of Miami evaluated the use of cell‐saver in patients undergoing radical prostatectomy and reassure the reader that its use does not influence the recurrence of cancer. In another interesting study from Hamburg, the authors show that there are important differences in the biopsy features between prostate cancers located in the transition and peripheral zones. In a detailed study, authors from Poitiers show in a case‐control study that obesity was not significantly associated with prostate cancer when compared to controls with BPH, but obese men had a higher risk of having prostate cancer. ObjectiveTo evaluate the clinical outcome and identify prognostic variables in patients with nonseminomatous germ cell tumours undergoing postchemotherapy thoracotomy for residual masses, as the role of this procedure is controversial.Patients and methodsOf 385 patients who underwent postchemotherapy retroperitoneal lymph node dissections between 1988 and 1998, 105 also had 130 thoracotomies. The clinical presentation, chemotherapy regimens, marker status, primary tumour histology, pathology of all resected masses, and clinical outcome of these 105 patients were analysed.ResultsThe overall discordance rate for synchronous thoracic and retroperitoneal masses was 28%; that for asynchronous thoracic and retroperitoneal masses was 57%. Independent prognostic factors for residual thoracic teratoma or cancer were teratoma (mature or immature) in the primary tumour or retroperitoneal teratoma or cancer. Although three of 12 patients with residual thoracic cancer remained with no evidence of disease, residual thoracic cancer is an independent prognostic factor (P < 0.001) against disease‐free survival.ConclusionPostchemotherapy thoracotomy yields important prognostic information, and is therapeutic for most patients with teratoma and a subset with residual viable cancer. The prognostic criteria predictive of fibrosis are not sufficiently accurate to omit resection of residual thoracic masses.
Obesity in relation to prostate cancer risk: comparison with a population having benign prostatic hyperplasia
Authors: Irani J. , Lefebvre O. , Murat F. , Dahmani L. , Doré B. 
Published: December 2004

ObjectiveTo analyse the relationship between obesity and prostate cancer, when compared with men with benign prostatic hyperplasia (BPH).Patients and methodsThe records were reviewed of consecutive patients with histologically confirmed prostate cancer admitted for prostate surgery between January 1993 and February 1999. Controls were selected from patients who were hospitalized at the same time for the surgical treatment of BPH. One control was matched to each case by age. Obesity was defined as a body mass index (BMI) of> 29 kg/m2.ResultsThe study included 194 cases and 194 controls; their median (range) age at operation was 69.5 (50–88) years in both groups, and the BMI 26.1 (16.6–38.1) kg/m2 in the cancer and 25.7 (15.1–36.8) kg/m2 in the BPH group. The difference between the groups was not significant (P = 0.06). Obesity was significantly associated with prostate cancer, with an odds ratio (95% confidence interval) of 2.47 (1.41–4.34). Cases with advanced disease had a higher BMI than those with localized disease, but when age was considered the difference was not significant.ConclusionIn general the BMI was not significantly associated with prostate cancer when compared with men having BPH. However, obese men had 2.5 times the risk of having prostate cancer.
Medical therapy of oligoasthenospermia associated with left varicocele
Authors: Cavallini G. , Biagiotti G. , Ferraretti A.P. , Gianaroli L. , Vitali G. 
Published: December 2004

The authors from Ferrara show that a NSAID has a role in patients who have oligoasthenospermia associated with a left‐sided varicocele, although not in every case. Peyronie's disease is discussed in two papers; in the first of these, the authors make the case for histopathological diagnosis by drawing the reader's attention to the possible presence of penile epithelioid sarcoma. In the second paper, attention is drawn to the possibility of using a combination of vitamin E and colchicine in the early stages of the condition. ObjectiveTo ascertain whether a nonsteroidal anti‐inflammatory drug (cinnoxicam) or surgical varicocelectomy are suitable therapies for oligoasthenospermia associated with varicocele.Patients and methodsPatients who were oligoasthenospermic and had a varicocele were blindly randomized into three groups and the varicocele graded using echo‐colour Doppler ultrasonography. In group 1, seven men had grade V, four grade IV and 30 grade III varicoceles; in group 2 eight had grade V, 10 grade IV and 43 grade III; in group 3 six had grade V, eight grade IV and 40 grade III. Group 1 underwent surgery, group 2 received cinnoxicam (one 30 mg suppository every 4 days for 12 months) and group 3 received a placebo (one glycerine suppository every 4 days for 12 months). Sperm was analysed at intervals to follow the response in the three groups, and any side‐effects considered.ResultsSurgery significantly increased sperm values in men with grade III–V varicocele within 4 months, the highest values being obtained at 8 and 12 months. Cinnoxicam significantly improved sperm quality after 2 months in men with grade III varicocele, but the results were best at 4 months and stable at 12 months; stopping therapy caused a decline to the baseline values. Cinnoxicam did not change the sperm quality of men with grade IV or V varicocele. The placebo was inactive, and there were no side‐effects of active treatment.ConclusionsCinnoxicam is a safe and reliable therapeutic option for men with oligoasthenospermia associated with a grade III varicocele, but surgery is better for those with grade II, IV and V.
Neural control of the urethra and development of pharmacotherapy for stress urinary incontinence
Authors: Fraser M.O. , Chancellor M.B. 
Published: December 2004

SUMMARYThis review discusses the control of the urethra by the central nervous system, emphasizing the importance of nervous system control and the role of serotonin and noradrenaline in storage, micturition and sphincter reflexes. The concept of pharmacological neuromodulation and the use of pharmacological therapy as first‐line therapy for stress urinary incontinence (SUI) is presented. Coordination between the urinary bladder and urethra is mediated by many reflex pathways organized in the brain and spinal cord. During bladder filling, activation of mechanoreceptor afferent nerves in the bladder wall triggers firing in the cholinergic efferent pathways to the external urethral sphincter and in sympathetic adrenergic pathways to the urethral smooth muscle. These storage reflexes depend on interneuronal circuitry in the spinal cord and are modulated by descending pathways. It would therefore seem that neurotransmission in the central nervous system and periphery may be important in SUI, and moreover that pharmacological agents affecting these neurotransmitter pathways may be used to treat SUI. The central and peripheral mechanisms of action of duloxetine affect serotonin and noradrenaline neurotransmission in ways that may ameliorate the symptoms of SUI.
Selenium supplementation, baseline plasma selenium status and incidence of prostate cancer: an analysis of the complete treatment period of the Nutritional Prevention of Cancer Trial
Authors: Duffield‐Lillico A.J. , Dalkin B.L. , Reid M.E. , Turnbull B.W. , Slate E.H. , Jacobs E.T. , Marshall J.R. , Clark L.C. ,   for the Nutritional Prevention of Cancer Study Group
Published: December 2004

OBJECTIVETo present the results (to January 1996, the end of blinded treatment) of the Nutritional Prevention of Cancer (NPC) Trial, a randomized trial of selenium (200 µg daily) designed to test the hypothesis that selenium supplementation (SS) could reduce the risk of recurrent nonmelanoma skin cancer among 1312 residents of the Eastern USA.MATERIALS AND METHODSOriginal secondary analyses of the NPC to 1993 showed striking inverse associations between SS and prostate cancer incidence. A subsequent report revealed that this effect was accentuated among men with the lowest baseline plasma selenium concentrations. The effects of treatment overall and within subgroups of baseline prostate‐specific antigen (PSA) and plasma selenium concentrations were examined using incidence rate ratios and Cox proportional hazards models.RESULTSSS continued to significantly reduce the overall incidence (relative risk and 95% confidence interval) of prostate cancer (0.51, 0.29–0.87). The protective effect of SS appeared to be confined to those with a baseline PSA level of ≤ 4 ng/mL (0.35, 0.13–0.87), although the interaction of baseline PSA and treatment was not statistically significant. Participants with baseline plasma selenium concentrations only in the lowest two tertiles (< 123.2 ng/mL) had significant reductions in prostate cancer incidence. A significant interaction between baseline plasma selenium and treatment was detected.CONCLUSIONTo the end of the blinded treatment the NPC trial continued to show a significant protective effect of SS on the overall incidence of prostate cancer, although the effect was restricted to those with lower baseline PSA and plasma selenium concentrations.
Assessment of an electronic daily diary in patients with overactive bladder
Authors: Quinn P. , Goka J. , Richardson H. 
Published: December 2004

OBJECTIVETo assess the effectiveness of a portable electronic diary as a data collection device for overactive bladder symptoms, and to evaluate its level of patient acceptability compared with a conventional paper‐based voiding diary.PATIENTS AND METHODSPatients were identified through USA and UK hospital incontinence clinics. Patients were trained in the use of paper and electronic diaries before randomization, to complete either diary for 7 days. The diaries were then collected and, after a further training session, patients completed the other diary type for 7 days.RESULTSIn all, 35 patients were recruited into the trial; overall, patients using the paper diaries (35) and electronic diaries (33) recorded similar data for the median number of incontinent episodes per week (8.2 and 7.0, respectively) and for the median number of significant leaks per day (0.4 and 0.5, respectively). However, the number of daily micturitions was slightly lower for the electronic than for the paper diary (7.3 vs 8.5, respectively). The frequency of urgency recorded in the electronic diary was higher than that recorded in the paper diary (5.8 vs 4.7). As 94% of patients found the electronic diary easy to use, and the electronic diary reflects real‐time data entries, the electronic diary data may provide a more accurate reflection of patient symptoms.CONCLUSIONWe confirmed that the electronic diary is a novel method of collecting clinically relevant symptom data from patients with an overactive bladder. In addition, the ease‐of‐use ratings support the use of the electronic diary as a superior alternative to paper diaries, providing real‐time data which can be rapidly analysed, and thus allowing a speedy review of data during ongoing clinical studies.
Desmopressin in elderly patients with nocturia: short‐term safety and effects on urine output, sleep and voiding patterns
Authors: Rembratt A. , Norgaard J.P. , Andersson K‐E. 
Published: December 2004

OBJECTIVETo investigate the short‐term safety of desmopressin in elderly patients with nocturia, with special focus on the risk of hyponatraemia, and to assess the short‐term effects on urine output, sleep and voiding patterns.PATIENTS AND METHODSPatients (72) were recruited from a study using frequency‐volume charts, which in turn was preceded by a questionnaire study. Each patient took one 0.2 mg desmopressin tablet at bedtime for three consecutive nights and kept a frequency‐volume chart. Serum sodium was assessed in the morning after the first and the third dose. Patients with a mean serum sodium level during treatment deviating more than five units from baseline were considered sensitive to change in serum sodium. Potential predictors for sodium sensitivity and response were investigated with logistic and multiple regression.RESULTSAll 72 enrolled patients completed the trial; no serious adverse events occurred and no adverse events of severe intensity were recorded. Six patients were sensitive to change in serum sodium. The risk (odds ratio, 95% confidence interval) increased with increasing age (1.3, 1.1–1.6), concomitant cardiac disease (10.0, 0.9–105.8) and increasing baseline 24‐h urine output (1.2, 1.0–1.5). Patients sensitive to change in serum sodium were pharmacological responders and desmopressin had a greater effect on their 24‐h diuresis, indicating that the drug effect was not limited to the night only.CONCLUSIONDesmopressin was well tolerated in elderly patients with nocturia, but the results suggest that serum sodium should be measured before and after a few days of treatment.
Infertility despite surgery for cryptorchidism in childhood can be classified by patients with normal or elevated follicle‐stimulating hormone and identified at orchidopexy
Authors: Cortes D. , Thorup J. , Lindenberg S. , Visfeldt J. 
Published: December 2004

OBJECTIVETo analyse infertility despite orchidopexy in childhood.PATIENTS AND METHODSThe study comprised patients with cryptorchidism (70 bilateral and 65 unilateral) who had a simultaneous biopsy taken at orchidopexy in childhood, and in adulthood had analyses of semen and FSH. In adulthood 42 formerly bilateral cryptorchid boys had repeat testicular biopsies taken. Infertility was suspected in men with < 5 million sperm/mL in the best sample of semen and concomitant poor sperm motility, and who were classified by follicle‐stimulating hormone (FSH) values. At orchidopexy the number of spermatogonia/tubule and the germ cell differentiation were measured. In adulthood the percentage of tubules with complete spermatogenesis, spermatogenic arrest and Sertoli‐cell only status was assessed.RESULTSInfertility was suspected in 38 of 70 (54%) of formerly bilateral and six of 65 (9%) formerly unilateral cryptorchid patients. High FSH values were expected in these suspected infertile patients, but 15 of 38 (59%) formerly bilateral and five of six formerly unilateral cryptorchid patients had normal FSH values. These patients were identified in childhood at orchidopexy; those with bilateral cryptorchidism generally presented with germ cells, but the mean number of spermatogonia per tubule was < 30% of the lowest normal value, and the germ cells were seldom normally differentiated, whereas those with unilateral cryptorchidism generally lacked germ cells in the biopsies. No patients had a decreased FSH value.CONCLUSIONDespite surgery for cryptorchidism, infertility was probable in a third (44 of 135) of the patients. We expected high FSH values in these patients, but in 45% (20/44) the FSH values were normal. These patients may have relative FSH deficiency. At orchidopexy these patients were identified to be bilaterally cryptorchid with few germ cells and those unilaterally cryptorchid had none in the biopsy. After orchidopexy in childhood, additional hormonal treatment, e.g. recombinant FSH or buserelin, may be indicated in these patients.
Detection of bladder dysplasia using 5‐aminolaevulinic acid‐induced porphyrin fluorescence
Authors: Landry J.L. , Gelet A. , Bouvier R. , Dubernard J.M. , Martin X. , Colombel M. 
Published: December 2004

OBJECTIVETo report results of a clinical investigation on the detection of bladder dysplasia and in situ carcinoma by using fluorescence induced by 5‐aminolaevulinic acid (ALA).PATIENTS AND METHODSThe study included 50 patients with a primary bladder lesion, who had a bladder instillation of 50 mL of 3% ALA solution ≥ 1 h before transurethral resection of the tumour. Random biopsies were taken using white‐light cystoscopy, then using blue light to induce fluorescence; positive zones were noted and biopsied. The primary lesion was then resected. The frequency of dysplasia detected by ALA‐induced fluorescence was evaluated, as was the risk of recurrence with a follow‐up of ≥ 2 years.RESULTSIn all patients the tumours were positive; in 21 fluorescence distant from the tumour was detected. The pathological report of the biopsies showed 11 cases of dysplasia, six of carcinoma in situ and four of inflammatory lesions. In 29 patients there was no fluorescence and quadrant biopsies were normal in all but three with moderate dysplasia. Within the minimum follow‐up patients with bladder dysplasia detected by ALA‐induced fluorescence had a higher risk of recurrence.CONCLUSIONALA‐induced fluorescence of the bladder significantly enhanced the detection of dysplasia and in situ carcinoma. However, this technique requires further investigation using well‐characterized instrumentation and study protocols to determine any effect on treatment choice.
Intermediate effects of the ileocaecal urinary reservoir (Charleston pouch 1) on serum vitamin B12 concentrations: can vitamin B12 deficiency be prevented?
Authors: Yakout H. , Bissada N.K. 
Published: December 2004

OBJECTIVETo assess the long‐term effects of a form of ileocolic urinary reservoir (Charleston Pouch 1) on vitamin B12 serum levels, as vitamin B12 deficiency may be an important long‐term risk after urinary diversion by this method.PATIENTS AND METHODSThe study included 60 patients (mean age 52 years, range 27–77; 33 men and 27 women) who had a follow‐up of ≥ 36 months (36–132 months) after the construction of an ileocaecal urinary reservoir. Vitamin B12 serum levels were determined at the time of diversion and again when the patients were evaluated every 6 months.RESULTSFifty‐eight patients had a normal serum vitamin B12 concentration before surgery (two patients were excluded from the study because they had low levels); the mean level was 464 pg/mL (normal range 247–1000). At 6 and 12 months, the mean vitamin B12 levels were 367.5 and 468.5 pg/mL; at 1.5, 2, 3, 4, 5, 6, 7, 8, 10 and 11 years, the mean levels were 305, 495.5, 436.5, 379.5, 423.5, 393, 529.5, 631, 333.5 and 340 pg/mL, respectively.CONCLUSIONIleocaecal urinary reservoirs have no adverse effects on serum vitamin B12 levels for up to 10 years after surgery. Patients with vitamin B12 deficiency must be identified and given adequate parenteral doses for life. Because body stores of vitamin B12 may not be depleted for many years, problems with B12 may be masked for a long time. We recommend that vitamin B12 levels be obtained annually, that a modest supplement twice yearly (by injection) may be beneficial and that serum vitamin B12 must be sampled before giving vitamin B12 injections, to avoid false results.
Self‐expanding stent insertion for urethral strictures: a 10‐year follow‐up
Authors: De Vocht T.F. , Van Venrooij G.E.P.M. , Boon T.A. 
Published: December 2004

OBJECTIVETo evaluate the safety and efficacy of the Urolume??? endourethral self‐expandable metallic stent (American Medical Systems, MI, USA) in treating urethral strictures, based on a follow‐up of> 10 years.PATIENTS AND METHODSBetween November 1989 and June 1990, the Urolume stent was inserted into 15 patients (aged 25–77 years) who had recurrent urethral strictures. The mean duration of stricture before stent insertion was 10.9 years. The patients (all men) were followed using a questionnaire and uroflowmetry, and if necessary, retrograde cysto‐urethrography and/or urethroscopy and/or X‐ray urodynamics.RESULTSTwo failures were caused by excessive tissue proliferation in the stent, which ended in stent removal or a suprapubic catheter. Another two stents were removed because of discomfort or pain. Two patients developed stenosis in the stent after 7 and 9 years. In the final evaluation only two of the 15 patients were satisfied with their stent. The mean maximum urinary flow rate at the last follow‐up was 15 mL/s, and half the patients noted ‘stent’ incontinence. Lower urinary tract infections, urge and stress incontinence, and discomfort with ejaculation, were all symptoms perceived at the last follow‐up.CONCLUSIONThe long‐term results of the Urolume stent in this study weaken the optimistic early results. Only two of the 15 patients were satisfied with their stent.
Neonatal scrotal haematoma: mimicker of neonatal testicular torsion
Authors: Diamond D.A. , Borer J.G. , Peters C.A. , Cilento B.G. , Sorcini A. , Kaefer M. , Paltiel H.J. 
Published: December 2004

OBJECTIVETo describe the clinical features of neonatal scrotal haematoma and distinguish them from those of neonatal testicular torsion.PATIENTS AND METHODSFive neonates presenting with an acute scrotum and initial diagnosis of neonatal testicular torsion were found to have neonatal scrotal haematoma. In one case the diagnosis was surgical and in four subsequent cases the diagnosis was by colour Doppler ultrasonography, and surgery was avoided. Four of the five children had risk factors associated with neonatal scrotal haematoma, including bleeding diathesis, birth trauma and high birth weight.CONCLUSIONSThe importance of including haematoma in the differential diagnosis of the acute neonatal scrotum is emphasized, as is the value of contemporary Doppler ultrasonography in making this diagnosis.
Nitric oxide synthase gene transfer for erectile dysfunction in a rat model
Authors: Chancellor M.B. , Tirney S. , Mattes C.E. , Tzeng E. , Birder L.A. , Kanai A.J. , De Groat W.C. , Huard J. , Yoshimura N. 
Published: December 2004

OBJECTIVETo determine whether over‐expression of nitric oxide synthase (NOS) in the corpus cavernosum of the penis improves erectile function, as NO is an important transmitter for genitourinary tract function, mediating smooth muscle relaxation and being essential for penile erection.MATERIALS AND METHODSThe inducible form of the enzyme NOS (iNOS) was introduced into the corpus cavernosum of adult Sprague‐Dawley rats (250–300 g) by injecting a solution of plasmid, adenovirus or adenovirus‐transduced myoblast cells (adeno‐myoblasts). Plasmid, adenovirus and adeno‐myoblasts encoding the expression of the β‐galactosidase reporter gene were also injected into rats.RESULTSThroughout the corpora cavernosum there was expression of β‐galactosidase after injecting each of the three solutions. Maximum staining was greatest for adeno‐myoblast, then adenovirus and then plasmid. The mean (sd) basal intracavernosal pressure (ICP) of iNOS‐treated animals (adenovirus and adeno‐myoblast) increased to 55 (23) cmH2O, compared with naive animals with a basal ICP of 5 (6) cmH2O (P = 0.001). Stimulating the cavernosal nerve (15 Hz, 1.5 ms, 10–40 V, 1 min) resulted in a doubling of the ICP (adenovirus and adeno‐myoblast) from the basal level of the iNOS‐treated animals. Direct in situ measurement of NO showed the release of 1–1.3 µmol/L in the adeno‐myoblast penis.CONCLUSIONMyoblast‐mediated gene therapy was more successful for delivering iNOS into the corpus cavernosum than direct adenovirus injection or plasmid transfection. Surprisingly, implanting muscle cells into the penis is not only feasible but also beneficial. Gene therapy for NOS may open new avenues of treatment for erectile dysfunction. Control of NOS expression would be necessary to prevent priapism.