bluuebunny/crossref_metadata_2025_split huggingface dataset:
5‐aminolaevulinic acid‐induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer
Authors: Babjuk Marko , Soukup Viktor , Petrík Radko , Jirsa Milan , Dvorácek Jan 
Published: September 2005

OBJECTIVETo assess the influence of 5‐aminolaevulinic acid‐induced fluorescence cystoscopy (FC) during transurethral resection (TUR) on the recurrence rate and the length of tumour‐free interval in stage Ta/T1 transitional cell carcinoma (TCC) of the urinary bladder.PATIENTS AND METHODSIn all, 122 patients with primary or recurrent stage Ta/T1 bladder TCC treated with TUR were enrolled in a prospective randomized study. In group A the TUR was performed with standard white‐light endoscopy, and in group B with FC. The patients were followed using standard cystoscopy and urinary cytology. The recurrence‐free interval was evaluated in whole groups, for single and multiple, and for primary and recurrent tumours separately.RESULTSAt the time of the first cystoscopy (10–15 weeks after TUR) tumour recurrence was detected in 23 of 62 patients (37%) in group A, but only in five of 60 patients (8%) in group B. The recurrence‐free survival rates in group A were 39% and 28% after 12 and 24 months, compared to 66% and 40% respectively in group B (P = 0.008, log‐rank test). In separate analyses, the recurrence‐free survival rates were significantly higher using FC in multiple (P = 0.001) and in recurrent (P = 0.02) tumours. In solitary and primary tumours the median time to recurrence was also longer in group B, but the difference was not statistically significant.CONCLUSION5‐aminolaevulinic acid‐induced FC during TUR reduces the recurrence rate in stage Ta/T1 bladder TCC. The most significant benefit is in patients with multiple and recurrent tumours.
Plasma osteopontin levels are predictive of disease stage in patients with transitional cell carcinoma of the bladder
Authors: Ang Celina , Chambers Ann F. , Tuck Alan B. , Winquist Eric , Izawa Jonathan I. 
Published: September 2005

OBJECTIVETo measure plasma levels of osteopontin in patients with transitional cell carcinoma (TCC) of the bladder, and to determine if osteopontin levels relate to disease stage.PATIENTS AND METHODSBlood samples were collected from 72 consecutive patients with TCC. Clinical data were obtained from medical record reviews. Patients were divided into subgroups based on disease status (active vs inactive) and clinical and pathological stage of TCC (tumour, nodes and metastases staging system). Osteopontin levels were measured using an enzyme‐linked immunosorbent assay.RESULTSPlasma osteopontin levels were higher in patients with active TCC than in controls (P = 0.035). Plasma osteopontin levels were not significantly different between patients with active and inactive TCC, but were higher in patients with metastases than in patients with active, clinically organ‐confined TCC (P = 0.021).CONCLUSIONSPlasma osteopontin levels increase with tumour stage in TCC of the bladder. These findings suggest that larger, more extended studies on plasma osteopontin levels in patients with TCC are warranted.
Laparoscopic vs open partial nephrectomy in consecutive patients: the Cornell experience
Authors: Schiff Jonathan D. , Palese Michael , Vaughan E. Darracott , Sosa R. Ernest , Coll Diedre , Del Pizzo Joseph J. 
Published: September 2005

OBJECTIVETo compare a contemporary series of laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN) at one institution, to evaluate the size and types of tumour in each group and the early outcome after each procedure, as LPN is replacing open radical nephrectomy as the standard of care for uncomplicated renal tumours but partial nephrectomy remains significantly more difficult laparoscopically, especially if the goal is to duplicate the open surgical technique.PATIENTS AND METHODSWe retrospectively analysed the records of all patients who underwent partial nephrectomy at our institution from January 2000 to April 2004, identifying 66 who had LPN and compared them with 59 who had OPN (mean age at LPN and OPN, 62.1 and 64.2 years, respectively; 70% men in each group). Variables analysed included operative time, blood loss, creatinine levels before and after partial nephrectomy, time to resuming clear liquids and regular diet, length of stay, tumour size, tumour pathological type and complications. Groups were compared using Student's t‐test, with P < 0.05 taken to indicate significance.RESULTSOf those having LPN, 59% had right‐sided tumours, vs 53% in the OPN group; the respective mean tumour size was 2.2 and 3.4 cm, the mean operative duration 144 and 239 min (both P < 0.001), and the mean estimated blood loss 236 and 363 mL (P = 0.09). Seven patients in the OPN group had obligatory partial nephrectomy for either a solitary kidney (two) or azotaemia (five). No patient in the LPN group required an obligatory partial nephrectomy. Serum creatinine levels were measured before and 1 and 2 days after surgery, and were 88, 88 and 97 µmol/L for the LPN group, and 97, 106 and 106 µmol/L for the OPN group. Clear fluids were started a mean of 41 h after surgery, a regular diet resumed 76 h after and discharge was 129 h after surgery in the OPN group; the respective values for the LPN group were 24 h (P = 0.01), 49 h (P = 0.2) and 82 h (P < 0.001). Complications were similar in both groups but the pathological subtypes differed.CONCLUSIONSLPN offers early functional advantages over OPN in terms of earlier resumption of diet and slightly earlier discharge. However, the two groups of patients were clearly not evenly matched for size nor pathological subtypes, with larger, malignant subtypes more predominant in the OPN group. These results suggest that while LPN is a safe, effective treatment for small renal tumours, obligatory partial nephrectomy or large tumours continue to be performed using open techniques with good results.
Resection of the abdominal inferior vena cava for complicated renal cell carcinoma with tumour thrombus
Authors: Ciancio Gaetano , Soloway Mark 
Published: September 2005

OBJECTIVETo describe our experience of excising the inferior vena cava (IVC) without a graft; en bloc resection of a renal cell carcinoma (RCC) with the renal vein and vena cava tumour thrombus and a segment of the entire abdominal IVC is technically feasible, but traditionally, after resection, attempts are made to restore continuity with the use of synthetic or homologous venous grafts.PATIENTS AND METHODSBetween May 1997 and September 2004, 60 patients (mean age 62 years) underwent surgical resection of a renal tumour with a thrombus extending into the IVC. To resect the entire evident tumour, excision of the affected portion of the IVC was required in three patients (5%); the IVC was not reconstructed.RESULTSThe three patients were aged 38, 39 and 74 years; the mean operative duration was 5.88 h, the mean (range) estimated blood loss was 833 (500–1000) mL, the mean number of blood units transfused was 3.3 (0–7) units, and the mean follow‐up was 24 months. The course after surgery was uneventful; specifically, none of the patients had a venous thrombosis or a pulmonary embolus.CONCLUSIONSRCC has a propensity to invade the renal vein and IVC. Occasionally the thrombus invades the wall of the IVC and complete removal requires excision of a circumferential portion of the IVC; this can be done safely without a graft.
Low Urinary Tract. Lower urinary tract symptoms in men: self‐perceptions and the concept of bother
Authors: Gannon Kenneth , Glover Lesley , O'Neill Marie , Emberton Mark 
Published: September 2005

An interesting study from the UK explores the meaning men attach to their experiences of having LUTS and to understand the meaning of the word bother in this context. Their findings are very helpful to clinicians, and perhaps to people constructing clinical trials in the future. A second report assesses the bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. The author concluded from their study that when determining the most appropriate management strategy doctors should consider the experience of being incontinent as being unique to each individual.OBJECTIVETo explore the meaning that men attach to their experiences of having lower urinary tract symptoms (LUTS) and to understand ‘bother’ in the context of those meanings.PATIENTS AND METHODSSixteen men with symptoms suggestive of LUTS and/or an enlarged prostate were recruited from the outpatient urology clinic of a London teaching hospital. They were assessed before or shortly after their first appointment, during which demographic information, including age, occupation, marital status and ethnicity, was obtained and an individualized repertory grid was completed. Each man also completed the International Prostate Symptom Score, which included an item measuring overall bother, and the Hospital Anxiety and Depression Scale.RESULTSMost participants held very negative views about what it meant to have prostate problems and viewed them as being associated with old age. Nevertheless, they also had reasonably high levels of self‐esteem. However, there was evidence that these had been higher before they had prostate problems, and that self‐esteem might decline over time. Bother was related to symptom scores and to anxiety. Also, a perception that other people, particularly their partner, saw them in a more negative light because of their symptoms was associated with higher levels of bother.CONCLUSIONSThe findings suggest that men attempt to preserve a sense of a relatively youthful and intact ‘self’ in the face of advancing years and a progressive disease that was viewed as being associated with old age. Overall, these men had a reasonably secure self‐image and they deployed a range of cognitive strategies to maintain this. Bother appears to be a combination of symptom severity, psychological distress, negative evaluations of the condition and beliefs about the reactions of others. Reducing anxiety and challenging negative stereotypes and expectations that others would view them negatively if their problems were known might reduce bother. Attending to these factors could enable watchful waiting to be optimized by reducing bother. Trials to evaluate interventions drawing on these principles would be valuable.
Loupe‐assisted vs microsurgical technique for modified one‐layer vasovasostomy: is the microsurgery really better?
Authors: Hsieh Ming‐Li , Huang Hsin Chieh , Chen Yu , Huang Shih Tsung , Chang Phei Lang 
Published: September 2005

OBJECTIVESTo compare the outcome of loupe‐assisted, modified one‐layer vasovasostomy (MOLV) and conventional microsurgical MOLV for vasectomy reversal.PATIENTS AND METHODSWe retrospectively analysed data for 74 patients who had a MOLV between 1993 and 2003; 42 had the standard microsurgical (×10–16) MOLV (group 1, mean age 40.5 years, sd 6.3, range 30–58) and 32 a loupe‐assisted (× 3) MOLV (group 2, mean age 41.3 years, sd 6, range 28–64). With general anaesthesia, each operation was performed as an outpatient procedure or with hospitalization for one night after surgery. The patients’ characteristics, patency rate, paternity rate, and operative duration were compared.RESULTSThe mean (sd, range) duration of obstruction was 8.1 (5.0, 0.33–25) years in group 1 and 9.2 (4.8, 0.33–27) years in group 2. The postoperative patency and pregnancy rates were 91% and 43% for group 1 and 89% and 39% for group 2. There were no complications during or after surgery in either group, but the surgery was significantly faster for group 2.CONCLUSIONSThere was no significant difference in the patency and paternity rates between loupe‐assisted and microsurgical MOLV. The surgery was significantly faster with the loupe‐assisted method. Because of the shorter operation duration and less expensive instruments required that should reduce the cost, the loupe‐assisted MOLV should be considered as the best choice for simple vasectomy reversal.
Renal autotransplantation for managing a short upper ureter or after ex vivo complex renovascular reconstruction
Authors: Webster J. Christopher , Lemoine Jason , Seigne John , Lockhart Jorge , Bowers Victor 
Published: September 2005

Several topics related to the upper urinary tract are covered this month. Renal autotransplantation for managing a short upper ureter or after ex vivo complex renovascular reconstruction is described by authors from Florida. Percutaneous nephrolithotomy and various technical aspects associated with it are presented by authors from Germany and India.OBJECTIVETo report our contemporary experience with renal autotransplantation (AT), an established treatment for managing patients with a shortened ureter or renovascular disease, as despite its historical importance, AT remains an underused technique by urologists.PATIENTS AND METHODSAll patients undergoing AT between 1997 and 2002 for a short ureter after ureteric injury and for renovascular disease were assessed by creatinine level and blood pressure before and after surgery, and antihypertensive drug use and complications.RESULTSEleven patients had AT for renovascular disease and four for ureteric injury. There was no statistical difference in creatinine levels or blood pressure before and after surgery in either group. Eight patients treated with AT for renovascular disease required less antihypertensive medication after surgery. Minor complications occurred in both groups and included a suture abscess, chronic wound pain, and transient acute tubular necrosis. One patient in the ureteric injury group required a transplant nephrectomy after renal vein thrombosis, and one in the renovascular group died from multi‐organ system failure.CONCLUSIONAT remains a treatment option for patients with a short ureter after ureteric injury and in those with renovascular disease. Patients had stable renal function and blood pressure after surgery. Most patients treated for renovascular disease required less medication after AT. The procedure is associated with both minor and major complications, which must be considered before surgery.
Tubeless percutaneous nephrolithotomy: a prospective feasibility study and review of previous reports
Authors: Shah Hemendra N. , Kausik Vikram B. , Hegde Sunil S. , Shah Jignesh N. , Bansal Manish B. 
Published: September 2005

OBJECTIVETo evaluate the status of tubeless percutaneous nephrolithotomy (PCNL) in managing renal and upper ureteric calculi, from initial experience and a review of previous reports.PATIENTS AND METHODSFrom September 2004 to December 2004, 46 patients were scheduled for tubeless PCNL in a prospective study. Patients with solitary kidney, or undergoing bilateral simultaneous PCNL or requiring a supracostal access were also enrolled. Patients needing more than three percutaneous access tracts, or with significant bleeding or a significant residual stone burden necessitating a staged second‐look nephroscopy were excluded. At the end of the procedure, a JJ ureteric stent was placed antegradely and a nephrostomy tube avoided. The patients’ demographic data, the outcomes during and after surgery, complications, success rate, and stent‐related morbidity were analysed. Previous reports were reviewed to evaluate the current status of tubeless PCNL.RESULTSOf the 46 patients initially considered only 40 (45 renal units) were assessed. The mean stone size in these patients was 33 mm and 23 patients had multiple stones. Three patients had a serum creatinine level of >2 mg/dL (>177 µmol/L). Five patients had successful bilateral simultaneous tubeless PCNL. In all, 51 tracts were required in 45 renal units, 30 of which were supracostal. The mean decrease in haemoglobin was 1.2 g/dL and two patients required a blood transfusion after PCNL. There was no urine leakage or formation of urinoma after surgery, and no major chest complications in patients requiring a supracostal access tract, except for one with hydrothorax, managed conservatively. The mean hospital stay was 26 h and analgesic requirement 40.6 mg of diclofenac. Stones were completely cleared in 87% of renal units and 9% had residual fragments of < 5 mm. Two patients required extracorporeal lithotripsy for residual calculi. In all, 30% of patients had bothersome stent‐related symptoms and 60% needed analgesics and/or antispasmodics to treat them.CONCLUSIONTubeless PCNL was safe and effective even in patients with a solitary kidney, or with three renal access tracts or supracostal access, or with deranged renal values and in those requiring bilateral simultaneous PCNL. The literature review suggested a need for prospective, randomized studies to evaluate the role of fibrin sealant and/or cauterization of the nephrostomy tract in tubeless PCNL.
Expression of a recombinant vector of a mutant human telomerase reverse transcriptase gene in human bladder cancer cell line T24, and its clinical significance
Authors: Fu Wei‐Jun , Hong Bao‐Fa , Huang Jun‐Jian , Xu Bing , Gao Jiang‐Ping , Wang Xiao‐Xiong , Huang Cui‐Feng 
Published: September 2005

OBJECTIVETo construct a mutant enhanced green fluorescence protein (pEGFP) human telomerase reverse transcriptase (hTERT) gene expression vector (pEGFP‐hTERT), to observe its expression in transfected human bladder cancer cell line T24 and its role in the molecular regulatory mechanisms of telomerase, and to provide a new target gene for bladder cancer therapy.MATERIALS AND METHODSPolymerase chain reaction (PCR) amplification was performed using primers based on the gene sequence of hTERT. The PCR product was cloned into plasmid pGEMT‐T Easy and the sequence of mutant hTERT gene analysed. A recombinant mutant hTERT vector (pEGFP‐hTERT) was constructed at the EcoR I and Sal I sites of the pEGFP‐C1 vector. After transfecting the fusion gene into T24 cells by the method of calcium phosphate‐DNA co‐precipitation, we detected steady expression of the GFP‐hTERT fusion protein by fluorescent‐light microscopy. Changes in the proliferation of T24 cells were detected by light microscopy, and β‐galactosidase staining correlated with senescence.RESULTSIdentification of pEGFP‐hTERT by enzyme digestion showed that the mutant hTERT fragment had been cloned into EcoR I and Sal I sites of the pEGFP‐C1 vector. Steady expression of GFP‐hTERT fusion protein was located in the nucleus of transfected cells. Positive expression senescence‐associated β‐galactosidase staining in transfected cells increased gradually with extended cultured time, and their growth was suppressed.CONCLUSIONThe recombinant mutant vector (pEGFP‐hTERT) was successfully constructed and expressed steadily in T24 cells. The mutant‐type hTERT gene suppresses the proliferation of T24 cells by a competitive effect on telomerase activity. This suggests that the hTERT gene might be a suitable gene target for bladder cancer therapy.
Expression of the secreted form of clusterin protein in renal cell carcinoma as a predictor of disease extension
Authors: Kurahashi Toshifumi , Muramaki Mototsugu , Yamanaka Kazuki , Hara Isao , Miyake Hideaki 
Published: September 2005

OBJECTIVESTo evaluate the significance of clusterin expression in surgically resected renal cell carcinoma (RCC) specimens.PATIENTS AND METHODSNormal kidney and RCC specimens were obtained from 131 patients who had radical surgery. The expression of clusterin protein was analysed by immunohistochemical staining with an antibody recognizing all isoforms of clusterin. Cell proliferative activities and apoptotic features in these specimens were investigated using Ki‐67 immunostaining and the terminal deoxynucleotidyl transferase mediated dUTP nick‐end labelling assay, respectively. Findings were evaluated in relation to several clinicopathological factors.RESULTSThere were various levels of clusterin expression in 128 of the 131 RCC specimens, while 37 of 131 normal kidney tissues (28.2%) had no clusterin staining. Clusterin protein was present in the cytoplasm of both normal and cancer cells, but there was no nuclear staining identified in either type of cell. The expression level of clusterin protein in RCC tissues was significantly related to tumour stage and grade, but not to age, gender or histological cell type. Cell proliferative activity in RCC specimens was significantly associated with clusterin expression, while the apoptotic index was inversely related to clusterin expression. Furthermore, recurrence‐free survival in patients with strong clusterin expression was significantly lower than that in those with weak expression.CONCLUSIONSThese findings suggest that the secreted form of clusterin may be involved in the progression of RCC, and that overexpression of clusterin could be a useful prognostic variable after radical surgery in patients with RCC.
Urine cytology after flexible cystoscopy
Authors: Herr Harry W. , Regan Marisa 
Published: September 2005

OBJECTIVETo correlate urine cytology findings before and after flexible cystoscopy.PATIENTS AND METHODSA total of 153 patients undergoing surveillance for bladder tumour provided voided urine for cytology before and immediately after flexible cystoscopy.RESULTSOf the 153 patients, 116 had negative urine cytology before and after (96%) a visibly normal cystoscopy and 37 had positive urine cytology before and after cystoscopy that showed recurrent tumour.CONCLUSIONSUrine cytology immediately after flexible cystoscopy correlates well with results of urine cytology before cystoscopy.