bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathological staging and biochemical recurrence after neoadjuvant androgen deprivation therapy in combination with radical prostatectomy in clinically localized prostate cancer: results of a phase II study
Authors: Cookson M.S. , Sogani P.C. , Russo P. , Sheinfeld J. , Herr H. , Dalbagni G. , Reuter V.E. , Begg C.B. , Fair W.R. 
Published: November 2003

Objectives To assess the pathological staging and biochemical progression‐free survival (assessed using serum prostate‐specific antigen level) of patients with clinically localized prostate cancer using neoadjuvant androgen deprivation therapy (ADT) in combination with radical retropubic prostatectomy (RRP). Patients and methods A prospective study was carried out on 69 patients with localized prostate cancer who were enrolled in a trial of 3 months of ADT followed by RRP (group 1). These patients were compared with 72 patients matched for age and clinical stage who declined ADT therapy and had RRP concurrently (group 2). Assignment to the individual treatment groups was thus determined by the patient's preference and not the physician's selection. Pathological staging and biochemical progression‐free recurrence were compared between the groups. Results The rate of organ‐confined (pT2) tumours was 74% in group 1 and 49% in group 2 (P<0.01), and the rate of margin‐negative tumours was 87% in group 1 and 64% in group 2 (P<0.01). Within a median follow‐up of 35 months, there was no significant difference in biochemical failure between the groups (P=0.37). Patients with pT2 disease, regardless of treatment, had similar biochemical failure rates. In the patients with margin‐positive disease, there was a significantly higher biochemical failure rate in group 1 (P=0.02). Conclusions The rates of organ‐ and specimen‐confined disease were higher among the patients treated with ADT. The preliminary follow‐up suggested that patients with pT2 disease after ADT have a biochemical progression‐free recurrence rate similar to pT2 patients treated with RRP alone. Additionally, high biochemical failure rates in patients with margin‐positive disease after ADT may identify a subset of more biologically aggressive tumours in need of early adjuvant treatment.
Assessment of testicular cytology by fine‐needle aspiration and the imprint technique: are they reliable diagnostic modalities?
Authors: Odabas Ö. , Ugras S. , Aydin S. , Yilmaz Y. , Kemal Atilla M. 
Published: November 2003

Objective To investigate whether testicular cytology may be considered diagnostic in the evaluation of infertile men. Patients and methods Specimens of testicular tissue obtained either surgically (imprint smear) or through fine‐needle aspiration (FNA) were used as a source of cytological smears; 58 testes from 24 men with azoospermia or severe oligospermia and from five men with advanced prostate cancer were evaluated cytologically and compared with the histological diagnosis. Results FNA caused no apparent trauma. The results from FNA smears generally agreed with the histological findings but four patients with no spermatozoa in the FNA smears were diagnosed histologically as hypospermatogenic and two others judged histologically as having Sertoli‐cell‐only (SCO) syndrome and spermatogenic arrest had detectable spermatozoa in their FNA smears. There was complete agreement between the results of imprint smears and histological findings in those patients with SCO syndrome and spermatogenic arrest. There were no evident differences in sperm counts between hypospermatogenesis and normal spermatogenesis on the imprint slides, but FNA smears detected this difference. Conclusion FNA of the testis is a relatively non‐invasive and reproducible technique for evaluating qualitative and quantitative cytology. However, it is insufficient for diagnosing some testicular pathologies. Imprint smears supplement the histological diagnosis, especially if the histological slides are stained unsatisfactorily.
Spontaneously released substance P and bradykinin from isolated guinea‐pig bladder
Authors: SABAN R. , FRANZ J. , BJORLING D.E. 
Published: November 2003

Objectives To investigate whether the isolated urinary bladder spontaneously releases substance P (SP) or bradykinin (BK), which can act as potent mediators of pain and inflammation of the urinary bladder, and whether peptidase inhibitors enhance peptide release.Materials and methods Urinary bladder segments (2×10×0.8–1 mm) were isolated from guinea pigs and studied in vitro; tissue contraction was assessed using force‐displacement transducers and the release of peptides by specific enzyme immunoassays.Results In the absence of any exogenous agonists, the inhibition of neutral endopeptidase and angiotensin‐converting enzyme by phosphoramidon and captopril, respectively, increased the frequency and magnitude of spontaneous motility of isolated bladder strips. Phosphoramidon increased the net release of SP‐like immunoreactivity (SP‐LI) and captopril increased the net release of SP‐LI and BK‐LI, concomitant with contraction. Peptide‐LI was recovered primarily from bladder mucosa and to a lesser degree from detrusor smooth muscle. Similarly, peptidase inhibitors primarily affected the bladder mucosa; phosphoramidon induced a fourfold increase in SP‐LI and captopril induced a significant increase of SP‐LI and BK‐LI from the mucosa. Tissues contracted in response to peptidase inhibitors in the presence of atropine and indomethacin, but contraction was reduced significantly by in vitro capsaicin desensitization or removal of bladder mucosa. BK stimulated SP‐LI release from mucosa but not detrusor. SP stimulated increased BK‐LI release from mucosa and detrusor.Conclusions These findings indicate the basal release of peptide‐like immunoreactivity by isolated bladder and further support the concept that peptidases located in the bladder mucosa are important in terminating the effects of endogenous peptides.
Exogenous calcitonin gene‐related peptide can induce the testis to cross the scrotal septum
Authors: CLARNETTE T.D. , HUTSON J.M. 
Published: November 2003

Objectives To determine: (i) whether the pattern of gubernacular migration can be changed by local injections of calcitonin gene‐related peptide (CGRP) in rats with a normal testicular position, (ii) the effects of both endogenous and exogenous CGRP on contralateral gubernacular migration and (iii) whether the scrotal septum acts as a barrier to prevent gubernacular migration.Materials and methodsFour groups of neonatal rats were used, all of which underwent right orchidectomy with: group 1 (29 rats) division of the genitofemoral nerve (GFN) on both sides; group 2 (31 rats) division of the left GFN; group 3 (31 rats) division of the left GFN and injections of oil into the right hemiscrotum; and group 4 (34 rats) division of the left GFN and injections of CGRP into the right hemiscrotum. After 26–38 days, the rats were killed and the testicular positions determined.ResultsIn rats receiving no injections (groups 1 and 2), the testes were oriented further to the right side where the right GFN was not divided (group 2). With the addition of oil into the right hemiscrotum where the right GFN was not divided (group 3), the testes were oriented further to the left compared with those in group 2. Injections of CGRP into the right hemiscrotum in the presence of an intact right GFN (group 4) resulted in more testes where the axis was orientated to the right side of the scrotum compared with the other groups with an intact right GFN (groups 1 and 3) but this was not reflected in the mean distance from the midline, which was similar among these groups. A significant number of testes in groups 1,2 and 4 crossed the midline.ConclusionsThe presence of an intact GFN on the right side where the left nerve was divided provides a directional signal influencing migration of the contralateral gubernaculum to the right side of the scrotum. Oil injected into the scrotum interferes with the normal concentration gradient of CGRP released from the right GFN, resulting in gubernacular migration further toward the left side. CGRP injections were poorly localized to the right hemiscrotum, resulting in gubernacular migration toward in some and away from the site of injection in others. The midline scrotal septum is not a barrier to gubernacular migration and most likely forms as a secondary event following descent of the testis.
Free and total prostate‐specific antigen in a screened population
Authors: BANGMA C.H. , KRANSE R. , BLIJENBERG B.G. , SCHRÖDER F.H. 
Published: November 2003

Objectives To determine whether the ratio of free to total (F/T) prostate‐specific antigen (PSA) can differentiate between men with prostate carcinoma or benign conditions in a screened population.Subjects and methods Total and free serum PSA (measured using Delfia PSA assays, Abbott IMx and Hybritech Tandem E methods) were determined retrospectively in 1726 men aged 55–77 years, in whom 67 prostate carcinomas were detected by screening with a digital rectal examination, transrectal ultrasonography, and total serum PSA level. Predictors for a positive biopsy result were estimated as a function of total PSA, free PSA and the combination of both.Results There was an excellent correlation between the Delfia ProStatus, the Abbott IMx and the Hybritech Tandem E assays. Compared with the total serum PSA level, the F/T ratio improved the specificity significantly only in those men with a total PSA of ≥7 ng/mL. Using the information given by the total and free PSA values, a maximum sensitivity of 75% at a specificity of 74% was obtained for the whole PSA range from 4 to 10 ng/mL; the maximum sensitivity was 79% with a specificity of 71%.Conclusion The optimal mathematical combination of free and total serum PSA improves the specificity of total serum PSA level in detecting prostate carcinoma more than the does the F/T PSA ratio.
The ice‐water test in the diagnosis and treatment of the neurogenic bladder
Authors: RONZONI G. , MENCHINELLI P. , MANCA A. , DE GIOVANNI L. 
Published: November 2003

Objective To determine the usefulness of the ice‐water test (IWT) in the diagnosis and treatment of neurological bladder disease.Patients and methods The IWT was carried out in 148 patients with neuropathic bladder dysfunction resulting from a traumatic lesion, to assist in their diagnosis and treatment, and in 130 patients with neuropathic bladder dysfunction and multiple pathogenic disorders; the results of the IWT were used to classify those patients with hyperactive bladders.Results The IWT was positive in 95% of patients affected by complete and in 86% of patients with incomplete medullary lesions. The IWT in patients with lower motor neuron medullary lesions was always negative. The test was used diagnostically in all patients with lower and in 43% of those with upper motor neuron lesions. In the latter, it was used in 48% of patients as a rehabilitation method during the medullary‐shock phase to accelerate the appearance of the micturition reflex. In 9% of patients it was used to induce micturition during cystography.Conclusion Because it is simple to perform, the IWT is a useful complement to urodynamic examinations in patients with neurological bladder disease and in patients with micturitional disorders that are otherwise difficult to interpret.
Tubulogenesis by microvascular endothelial cells is mediated by vascular endothelial growth factor (VEGF) in renal cell carcinoma
Authors: NAKAGAWA M. , EMOTO A. , HANADA T. , NASU N. , NOMURA Y. 
Published: November 2003

Objective To investigate the role of vascular endothelial growth factor (VEGF) in tumour angiogenesis in renal cell carcinoma (RCC).Materials and methods The expression of VEGF was examined in tissue samples from 25 patients with RCC using the reverse‐transcriptase polymerase chain reaction (RT‐PCR). Cellular localization of VEGF was studied in normal kidney and RCC tissues. Tube formation by human omental microvascular endothelial (HOME) cells co‐cultured with A498 RCC cells was quantified in a three‐dimensional collagen gel using computer‐image analysis.Results RT‐PCR detected VEGF m‐RNA in tissue from 20 of 25 patients with RCC. An immunohistochemical study revealed that VEGF was primarily localized in the cytosol of normal renal tubule cells and RCC cells. Tube formation by HOME cells was increased in the presence of A498 cells overexpressing VEGF mRNA, induced by exogenous VEGF in a dose‐dependent manner and completely inhibited by an anti‐VEGF antibody.Conclusion VEGF, which is produced and released from RCC cells, may elicit tumour angiogenesis by inducing microvessel tubulogenesis in patients with RCC. The co‐culture system may be useful for screening inhibitors of tumour angiogenesis in RCC.
The anatomy and reconstruction of the adult female genitalia in classical exstrophy
Authors: WOODHOUSE C.R.J. , HINSCH R. 
Published: November 2003

Objective To review the anatomy and reconstruction of the external genitalia in adult females born with exstrophy.Patients and methodsBetween 1981 and 1995, 47 females (born between 1953 and 1980) were seen in the adolescent clinic at St Peter’s Hospital. The notes of 42 were reviewed to obtain data on genital reconstruction and sexual function. When patients were no longer under personal review, a telephone contact was made to obtain further information.ResultsThe pelvic structures were displaced forwards so that the introitus was a structure of the lower abdominal wall. The clitoris was bifid and the labia were not united anteriorly; the introitus was very narrow. The pubic hair lay on either side of the introitus. Twenty‐eight patients had a modified episiotomy and two a vaginoplasty to allow penetrative intercourse. Fifteen patients had a vulvoplasty and a monsplasty. The surgical results were good in all but one case. One patient had partial necrosis of the skin flaps for the monsplasty. All patients who had an episiotomy were able to have intercourse while only four unreconstructed cases could do so.ConclusionsThe genital anatomy in females with exstrophy is abnormal. Reconstructive surgery can improve the appearances and allows penetrative sexual intercourse.
A high‐risk group for prostatism: a population‐based epidemiological study in Korea
Authors: LEE E. , PARK M‐S. , SHIN C. , LEE H. , YOO K. , KIM Y. , SHIN Y. , PAIK H‐Y. , LEE C. 
Published: November 2003

Objective To evaluate the effect of sociodemographic, dietary and physical factors on prostatism in Korean men aged 50 and over.Subjects and methods A community‐based cross‐sectional epidemiological study was performed in Yonchon County, Korea. The Korean version of the International Prostate Symptom Score (IPSS) was used to assess the severity of prostatism. Data on occupation, marital status, education, smoking habits, alcohol intake, daily consumption of nutrients, body mass index, abdominal circumference, waist‐to‐hip ratio, blood pressure, serum glucose, cholesterol, triglyceride and high‐density lipoprotein (HDL) levels were analysed. The age‐adjusted relative risk of these factors was calculated for moderate to severe prostatism (IPSS ≥8). A multivariate analysis of all significant factors was performed to examine the joint effect of risk factors.Results Of 514 subjects, 119 (23.2%) had moderate to severe prostatism, the risk for which was related to age and alcohol consumption; waist‐to‐hip ratio (which represents the degree of abdominal obesity) and the serum level of HDL showed a biphasic association with prostatism in the multivariate analysis.Conclusion In addition to previously reported risk factors, these data suggest that there might be an association between the development of prostatism and abnormal lipid metabolism.
Lymph‐node revealing solution: a new method for detecting minute lymph nodes in cystectomy specimens
Authors: KOREN R. , PAZ A. , LASK D. , KYZER S. , KLEIN B. , SCHWARTZ A. , GAL R. 
Published: November 2003

Objective To describe the use of a new lymph‐node revealing solution (LNRS) for detecting lymph node involvement in total cystectomy specimens from patients with locally confined invasive transitional cell carcinoma (TCC) of the bladder, and to compare the results obtained with those using the conventional method (palpation and sectioning perivesical fat) that may fail to detect very small lymph nodes.Materials and methods Of 12 cystectomy specimens obtained from patients with TCC, six in which 0–3 metastatic nodes were identified by the conventional method were further investigated using LNRS. The revealing solution comprised 95% ethanol, diethyl ether, glacial acetic acid and buffered formalin (65:20:5:10 v/v) prepared under a fume‐hood. After evaluation using the conventional method, the specimens were immersed for 6–12 h in the solution, washed under running tap water and the adipose tissue sectioned at intervals of 2–3 mm. Lymph nodes were identified as white, chalky nodules against the background of yellow fat. The number of the lymph nodes identified by conventional and the LNRS methods was recorded and classified according the TNM system.Result Twenty‐two lymph nodes were detected by the conventional method, of which four were positive for tumour metastasis. Using the LNRS, an additional 21 nodes were identified among which 12 were positive. The mean size of the lymph nodes detected by the conventional and LNRS methods was 7.96 mm and 3.81 mm, respectively. The stage of three patients was increased (Nx to N2, N0 to N2 and N1 to N2) and therefore two of these patients received adjuvant chemotherapy.Conclusions LNRS significantly enhanced the yield of normal and metastatic nodes of cystectomy specimens and may identify smaller nodes. The LNRS method allows a more accurate staging with better assessment of the prognosis and need for adjuvant therapy.
Prostatic asymmetry as a risk factor for prostatic carcinoma: serial prostate‐specific antigen monitoring and cancer detection
Authors: HANSEN JR J.G. , DALKIN B.L. , HARRIS C.H. , JOHNSON C.S. , AHMANN F.R. 
Published: November 2003

Objective To compare the rates of cancer detection in men with a normal, asymmetric, or suspicious prostate on digital rectal examination (DRE) initially and after 3 years of serial monitoring of prostate specific antigen (PSA) level.Patients and methodsProstatic ‘asymmetry’ was defined as asymmetric growth of the lateral lobes of the prostate without induration or nodules, as assessed by a DRE. The study included 963 men with no clinical evidence of prostate cancer and whose serum PSA levels were monitored at 4 month intervals. Prostatic biopsy was recommended if the PSA level became persistently abnormal (>4ng/mL) or increased by >20% after having been initially abnormal. Cancer detection rates were compared among groups categorized by the initial DRE findings and serum PSA level.ResultsOn comparing groups with suspicious and normal DREs, and abnormal with normal PSA levels both, as expected, were associated with a statistically significant increase in cancer detection. However, an asymmetric prostate did not carry an increased risk of detecting prostate cancer when compared with a normal prostate, regardless of PSA level.ConclusionsAn asymmetric prostate does not appear to be an independent risk factor for detecting prostate cancer. Therefore, an asymmetric prostate with no abnormality in PSA level should not mandate prostatic biopsy, or even an increase in monitoring frequency above the presently recommended annual interval.
Endovascular treatment of renal artery aneurysms with conventional non‐detachable microcoils and Guglielmi detachable coils
Authors: KLEIN G.E. , SZOLAR D.H. , BREINL E. , RAITH J. , SCHREYER H.H. 
Published: November 2003

Objective To evaluate the efficacy and safety of endovascular occlusion of true renal artery aneurysms (RAAs) with conventional non‐detachable microcoils (NDCs) and Guglielmi detachable coils (GDCs).Patients and methods Over a 5‐year period, 12 RAAs were treated by endovascular selective embolization. Four RAAs were occluded using NDCs and eight were treated with GDCs. All coils were delivered through a microcatheter. Eight RAAs were located in the bifurcation of the main renal artery, two in the main renal artery and two were intrarenal. Before treatment, four patients presented with hypertension, one associated with renal infarction and a second had flank pain due to microembolization. Two other patients had renal infarction, associated with haematuria in one; one other patient also had haematuria and five patients were asymptomatic. All patients were followed using clinical and angiographic examinations after 6 months, 1 and 2 years.Results All RAAs were occluded successfully. In two patients treated with NDCs there were minor complications, i.e. one subsegmental peripheral infarction and one misembolization, both without clinical symptoms. In the group treated with GDCs there were no complications. Five of seven patients were clinically improved, while two patients remained clinically unchanged.Conclusion Superselective endovascular treatment of RAAs with microcoils is a safe, efficient, and less invasive alternative to surgical treatment. The high flexibility and softness of the GDC and the controlled detachment enables a safer and more complete occlusion of RAA than current alternatives.
Radiofrequency heat‐treatment to the prostate for bladder outlet obstruction associated with benign prostatic hyperplasia: a 4‐year outcome study
Authors: DAWKINS G.P.C. , HARRISON N.W. , ANSELL W. 
Published: November 2003

Objectives To evaluate the long‐term effect on symptom relief and voiding performance of prostatic radiofrequency thermal treatment for bladder outlet obstruction (BOO) associated with benign prostatic enlargement (BPE).Patients and methods During 1991–1994, 151 patients (mean age 76 years, range 49–91) with symptomatic BOO associated with BPE (i.e. reduced urinary flow rate and persistent residual urine) but with no clinical evidence of carcinoma of the prostate, were treated using the Thermex II (Direx, Israel) intraurethral radiofrequency (RF) prostatic thermal treatment system. This treatment raises the intraurethral temperature to 48°C for 3 h in a single session under local anaesthesia. The patients were followed using symptom scores and uroflowmetry for 24–48 months after treatment.Results At 1 year, 70% had a good outcome, but by 3 years this had fallen to 40% and at 4 years to 22%. An increase in mean urinary flow rate, from 9 to 12 mL/s, was sustained throughout the follow‐up. There was a reduction in mean residual urine from 83 to 51 mL at 6 months, but this increased to 70 mL by 3 years (not significant). The voiding pressure, which declined at 6–12 months, increased again to near pre‐treatment values at 1–2 years.Conclusions In patients with symptomatic BPE, prostatic thermal treatment with RF relieves symptoms in 60% for at least 2–3 years. In selected cases it is a useful form of management, as it can be performed as a day‐case with minimal risk. Changes in standard objective variables were small but statistically significant for at least one year. The study highlights the importance of waiting for late results from clinical trials.