bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlations among prostatic‐specific antigen, Gleason score, staging and grading in patients after radical prostatectomy
Authors: Szymanowski J. , Dudek P. , Ratajski J. , Wysocki M. 
Published: March 2003

Objectives To evaluate the correlation between Gleason grade, T stage, tumour grade and preoperative prostate‐specific antigen (PSA) level (< or > 20 ng/mL) in patients after radical prostatectomy (RP). Patients and methods The serum total PSA level was measured 3 months before surgery in 87 patients who then underwent RP between 1994 and 2000; the tumour specimens were staged and graded. Results There were 57 (66%) patients with a PSA level of < 20 ng/mL; in this group only four (7%) patients had a Gleason grade of > 7 and eight (14%) had G3 tumours. Thirty (34%) patients had a PSA level of > 20 ng/mL; in this group only two (7%) patients had a Gleason grade of > 7 and 26 (87%) had G1 and G2 tumours. Conclusions These results confirm our previous observations that the PSA level cannot be use as the only factor to indicate RP in patients with prostate cancer, but further evaluation on more patients is needed.
Microangiographic imaging of the prostate
Authors: Slojewski M. , Czerwinski F. , Sikorski A. 
Published: March 2003

Objective To present the results of microangiography in visualizing prostatic microvascularization. Materials and methods A contrast medium was injected into the vessels of prostate specimens obtained during surgery, to fill small vessels; nine specimens were obtained after cystoprostatectomy and two after radical prostatectomy. Branches of prostatic or seminal vesicle arteries were used for the injection, the specimens then fixed in formalin, sectioned and X‐rayed. Results In five samples the quality of the images was sufficient to visualize small arteries; the remaining vessels were partially filled. The vascular map was compared with previous results from historadiographic studies. Conclusions Microangiographic imaging of prostate specimens provides a unique view of the angioarchitecture of the prostate and correlates closely with historadiographic studies. The correlation with other imaging methods, e.g. Doppler ultrasonography, needs further evaluation.
Treatment of posterior and anterior urethral trauma
Authors: Dobrowolski Z.F. , Weglarz W. , Jakubik P. , Lipczynski W. , Dobrowolska B. 
Published: March 2003

Objective To assess the occurrence and treatment of posterior urethral (most often caused by traffic accidents and comprising half of all cases of urinary tract traumas and anterior urethral injury (usually iatrogenic during catheterization or cystoscopy, or caused by blunt trauma, e.g. straddle injury or penetrating trauma). Patients and methods The records and details of patients with posterior and anterior urethral trauma were analysed from 61 urological departments in Poland between 1995 and 1999. Results During the 5‐year period there were 268 cases of posterior and 255 of anterior urethral injury; for the former, most occurred during traffic accidents, and of the latter 206 were iatrogenic (during catheterization or cystoscopy), of which 48 were accompanied by perineal injury. The posterior injuries were isolated or involved many organs, mainly pelvic bones. Both types of injuries were diagnosed using ascending urethrography, voiding cysto‐urethrography and urethroscopy/endoscopy. Treatment for posterior injuries included cystostomy alone or cystostomy with abdominal drainage or perineal drainage; some patients also had their urethra reconstructed. The treatment for anterior injuries was conservative in 193 patients and surgical in 62. Conclusion The early detection and appropriate surgical treatment of posterior and anterior urethral injury is crucial for the recovery of urethral function, and avoids many complications.
The anocutaneous reflex and urinary continence in children with myelomeningocele
Authors: Sanders C. , Driver C.P. , Rickwood A.M.K. 
Published: March 2003

Objective To examine the hypothesis that because most patients with myelomeningocele and a positive anocutaneous reflex have a competent sphincteric mechanism they are more likely to be continent on intermittent catheterization than those with a negative reflex, and to become so with less need for adjunctive surgical treatment. Patients and methods The study included 111 patients with myelomeningocele treated for urinary incontinence; their present means of treatment and the outcome achieved were assessed and related to the presence or absence of an anocutaneous reflex. Results Among 29 patients with a positive anocutaneous reflex, 26 (90%) are currently dry on a regimen of intermittent catheterization, as opposed 41 (50%) of the 82 with a negative reflex (P < 0.001). Two (7%) of those with a positive and 23 (28%) of those with a negative reflex have undergone adjunctive surgery (P=0.024). Conclusion These findings are consistent with both aspects of the hypothesis detailed in the Objective.
Severe partial ureteric obstruction in newborn rats can produce renal dysplasia
Authors: Wen J.G. , Frøkiær J. , Zhao J.B. , Ringgaard S. , Jørgensen T.M. , Djurhuus J.C. 
Published: March 2003

Objective To investigate whether partial unilateral ureteric obstruction (PUUO produces renal dysplasia in newborn rats. Materials and methods Left mild (in 31) or severe (in 34) PUUO was induced in 2‐day‐old rats by embedding a quarter or two‐thirds of the ureter into the psoas muscles, respectively. Sham‐operated control rats (36) were assessed in parallel. Kidney morphology, renal parenchymal weight and histology were examined 24 weeks and 30 months afterward. Results There was significant pelvic dilatation in all obstructed kidneys; four kidneys were dysplastic in those severely obstructed, with a significant decrease in renal volume. There were three dysplastic kidneys after 6 months and one at 30 months. The in vitro dysplastic kidney weight was 36% of the control kidneys. Microscopy showed primitive glomerular and tubular structures, with renal parenchymal developmental disorganization and marked fibrosis. The glomeruli, tubules and collecting ducts were deficient in number and had often undergone cystic changes. Columnar tubular epithelium and peritubular mesenchymal collars were present. There was no renal dysplasia in the mildly obstructed and sham‐operated rats. The parenchymal weight of the kidneys contralateral to the dysplastic kidneys was significantly higher than in the controls (P < 0.001). Conclusions Severe PUUO can produce renal dysplasia in newborn rats. However, only 12% with severe obstruction had renal dysplasia, indicating that the cause of renal dysplasia might also be related to other factors.
Reliability and validity of the Malay version of the Health‐Related Quality of Life instrument in a Malaysian population
Authors: Quek K.F. , Chua C.B. , Low W.Y. , Razack A.H. , Loh C.S. 
Published: March 2003

Objective  To validate the Malay version of the Health‐Related Quality of Life (Mal‐HRQOL‐20) questionnaire in patients with and without urinary symptoms in a Malaysian population. Patients and methods  The validity and reliability of the Mal‐HRQOL‐20 were assessed in patients with and without lower urinary tract symptoms (LUTS). The reliability was evaluated using the test‐retest method and the internal consistency using Cronbach's α. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate. Results

The internal consistency was excellent; there was a high degree of internal consistency for each of the 20 items and for the overall score (Cronbach's α0.57 and 0.79, respectively) in the population study. The test‐retest correlation coefficient for the 20 item scores was highly significant. The intra‐class correlation coefficient was high ( 0.55). The sensitivity and specificity were high for the effects of treatment. There was a very significant agreement between scores before and after treatment across all domains in the treatment cohort, but not in the control group. Conclusion  The Mal‐HRQOL‐20 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
DNA hypermethylation at the D17S5 locus is not a frequent event in human urothelial cancer
Authors: Bernués M. , Casadevall C. , Caballín M.R. , Egozcue J. , Miró R. 
Published: March 2003

Objective To analyse the DNA methylation status and the loss of heterozygosity (LOH) at the D17S5 locus (17p13.3) in urothelial cancer. Materials and methods DNA methylation was assayed and LOH analysed by Southern blotting in a series of 33 transitional cell carcinomas of the bladder and renal pelvis. Results DNA hypermethylation and LOH at the D17S5 locus were detected in six (18%) and 17 (52%) of the tumours, respectively. The six cases with DNA hypermethylation were of the papillary type, and four also had LOH at this locus. Conclusion In contrast to other epithelial tumours, DNA hypermethylation at the D17S5 locus is not a frequent event in human urothelial cancer.
Clinical oncologists favour radical radiotherapy for localized prostate cancer: a questionnaire survey
Authors: Hanna C.L. , Mason M.D. , Donovan J.L. , Barber J.P. 
Published: March 2003

Objective  To explore the treatment preferences of clinical oncologists for managing early prostate cancer and to compare the results with the preferences of urologists. Methods  A postal questionnaire survey was conducted of consultant clinical oncologists in the UK. Results  Consultant clinical oncologists favour radical radiotherapy in most men aged < 70 years, whereas a previous study showed that consultant urologists had a greater preference for radical surgery. Conclusion  There is little consensus about which treatment should be used for managing early prostate cancer. There is an urgent need for results from randomized clinical trials to determine the optimum treatment.
Nocturia in relation to sleep, somatic diseases and medical treatment in the elderly
Authors: Asplund R. 
Published: March 2003

Objective  To assess the influence of somatic diseases, symptoms and medication on nocturnal micturition in an elderly population. Subjects and methods  All 10 216 members of the pensioners’ association in two Swedish counties were asked to participate in a questionnaire survey. The questions concerned their general state of health, occurrence of somatic diseases and symptoms, number of voiding episodes per night, and the use of drugs. Results

There were 6143 evaluable questionnaires, of which 39.5% were from men. The mean (
sd ) age of the men and women participating were 73.0 (6.0) and 72.6 (6.7) years, respectively. In a multivariate logistic model, significant independent correlates of having ≥ 3 nocturnal voids (vs ≤ 2 voids) were: being 70–79 years vs < 70 years (odds ratio, OR, 1.7, 95% confidence interval, CI, 1.3–2.2), being ≥ 80 years old vs < 70 years (OR, 1.9, CI, 1.3–2.5) and poor sleep vs good sleep (OR, 2.6, CI, 2.1–3.2), sequelae after stroke (OR, 2.0, CI, 1.1–3.6), irregular heart beats (OR, 1.6, CI, 1.2–2.1) and diabetes (OR, 1.5, CI, 1.1–2.3). Sex, spasmodic chest pain and snoring were all deleted by the logistic model. Conclusion  Increasing age, poor sleep, irregular heart beats, diabetes and stroke are associated with an increase in nocturnal micturition in the elderly.
Correlation between major histocompatibility complex class I molecules and CD8+ T lymphocytes in prostate, and quantification of CD8 and interferon‐γ mRNA in prostate tissue specimens
Authors: Naoe M. , Marumoto Y. , Ishizaki R. , Ogawa Y. , Nakagami Y. , Yoshida H. 
Published: March 2003

Objective  To investigate the immunology of host‐tumour interaction, critical for the development of immunotherapy against cancers, by assessing the major histocompatibility complex (MHC) class I expression in both benign and malignant prostate disease, and the relationship between their expression and degree of tumour‐infiltrating lymphocytes.Materials and methods  Direct serial analysis of gene expression in tumours is an extremely sensitive and powerful tool for monitoring immunological changes in the immunotherapy of solid tumours. Most previous monitoring protocols rely mainly on the analysis of patient's peripheral blood but in the present study the direct molecular analysis of small tissue samples was used, and its accuracy compared with that of conventional immunohistochemical analysis. Twenty‐four formalin‐fixed, paraffin‐embedded prostate samples (11 benign and 13 carcinoma) were used for the im‐munohistochemical analysis of CD8+ T lymphocytes and MHC class I expression. CD8+ T lymphocytes were counted using an ocular grid and MHC class I measured using digital image‐analysis software. Twenty‐seven frozen prostate tissue samples (12 benign and 15 carcinoma) were used for direct gene measurements of CD8 and interferon‐γ using a quantitative real‐time polymerase chain reaction.Results  There were significantly fewer CD8+ T lymphocytes in prostate carcinoma nests than in benign prostate. There was a significant correlation between the number of CD8+ T lymphocytes and MHC class I expression in the prostate. There was a strong correlation between the immunohistochemical estimates of CD8+ T lymphocytes and CD8 gene by polymerase chain reaction, but no significant difference between benign prostate and prostate carcinoma tissue in gene measurements.Conclusion  Down‐regulation of MHC class I expression by prostate cancer cells is associated with fewer CD8+ T lymphocytes and hence might be important in cancer growth. In addition, the measurement of gene expression in small tissue samples might be useful for monitoring the efficacy of treatment throughout cancer therapy.
Penile scintigraphy with 99mTc‐human immunoglobulin G: a novel method for distinguishing the unstable and stable phases of Peyronie's disease
Authors: Erdogru T. , Boz A. , Köksal T. , Usta M.F. , Yildiz A. , Güngör F. , Baykara M. 
Published: March 2003

Objective  To investigate the value of penile scintigraphy using 99mTc‐human immunoglobulin G (IgG) to differentiate the unstable (acute) and stable (chronic) phases of Peyronie's disease (PD).Patients and methods  Thirty‐two consecutive patients (25 with PD and seven without) were evaluated using a detailed sexual history, serum chemistry panel, colour Doppler ultrasonography during simultaneous intracavernosal injection of 50 mg papaverine and stimulation, and 99mTc‐IgG scanning. When indicated, nocturnal penile tumescence monitoring, dynamic infusion cavernosometry, cavernosonography and cavernosal artery systolic occlusion pressure were measured. After administering 370 MBq of 99mTc‐IgG, images were taken at 30 min, 1, 2, 3 and 4 h. The scans were considered positive if there was any focal accumulation of radiopharmaceutical consistent with PD plaque formation.Results  Eleven of the 25 patients with PD (mean age 56 years, sd 8) were in the unstable phase, the remaining 14 being in the stable phase. There was a localized increase in 99mTc‐IgG activity in 10 patients who had unstable PD. There was complete resolution of increased activity in two patients at 12 and 13 months of follow‐up. Of the 14 patients in the stable phase, 12 (at > 1 year) showed neither increased nor decreased 99mTc‐IgG activity. In the remaining two patients there was increased activity on the plaque side. There was no local increase in activity in the control group.Conclusion  Inflammatory reactions can develop at various intervals during the unstable phase of PD. Medical methods should be used during the unstable phase and surgery delayed until the stable phase of the disease begins. An objective method of differentiating between the phases is therefore important. Penile 99mTc‐IgG imaging is a new diagnostic approach for confirming the unstable phase of PD.
Progesterone: a novel adjunct to intravesical chemotherapy
Authors: Lewin J. , Cooper A. , Birch B. 
Published: March 2003

Objective  To investigate the effect of progesterone on multidrug‐resistant urothelial cell lines, as the failure of intravesical chemotherapeutic drugs is often caused by multidrug resistance (MDR), mediated by the drug efflux pump P‐glycoprotein (PGP), the function of which can be down‐regulated by various compounds including steroid hormones.Materials and methods  Two urothelial cell lines (RT112S and MGH‐U1S) and their MDR sublines (RT112R, to cisplatin; and MGH‐U1R, a cell line expressing PGP) were used to assess the cytotoxic effects of progesterone, epirubicin and their combination. Cytotoxicity was assessed using a tetrazolium‐based assay and in situ confocal microscopy.Results  Cell lines sensitive to epirubicin (MGH‐U1S, RT112S and RT112R) required a much lower dose of epirubicin to kill half the cells than did the MDR cell line. Progesterone was intrinsically cytotoxic to all cell lines with little difference among them. Combined therapy had no cumulative effect on epirubicin‐sensitive cell lines, but reversed MDR in the MGHU1R cell line, both assessed by confocal microscopy and by the tetrazolium assay.Conclusions  Progesterone can reverse MDR in urothelial cells in vitro. This, combined with its effects on cell differentiation and apoptosis, together with its safety and tolerability compared to other MDR agents, suggests it may be a valuable adjunct to intravesical chemotherapy.
Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy
Authors: De La Taille A. , Flam T.A. , Thiounn N. , Pontvert D. , Saighi D. , Zerbib M. , Debré B. 
Published: March 2003

Objective  To assess the efficacy of salvage/adjuvant radiation therapy (RT) for patients with prostate‐specific antigen (PSA) recurrence after radical prostatectomy (RP).Patients and methods  Between 1997 and 2001, 52 patients were treated in our institution with RT for PSA recurrence after RP. The mean (range) delay between RP and RT was 30.5 (0.16–105.6) months. Eighteen patients received no hormonal therapy before RT. The failure of RT was defined as three consecutive increases in PSA levels with intervals of ≥ 6 weeks.Results  Within a mean (range) follow‐up of 27.7 (6–69) months, 18 patients presented with biochemical progression. The 3‐year biochemical progression‐free survival was 51%. Using univariate analysis, an age < 65 years (P = 0.0262), a Gleason score on the RP specimen of ≥ 8 (P = 0.0024), stage pT3 (P = 0.02), a detectable nadir PSA after RT (P < 0.001) and the absence of hormonal therapy (P = 0.0359) were associated with a lower biochemical progression‐free survival. However, only the Gleason score (P = 0.0395) and nadir serum PSA after RT (P = 0.028) remained independent predictive factors on multivariate analysis.Conclusion  Half of the present patients treated with RT for an isolated high serum PSA level after RP were free of biochemical relapse at 3 years of follow‐up. RT may be proposed to selected patients with mild morbidity. However, definitive evidence of the beneficial effect of adjuvant RT for patients with PSA recurrence after RP awaits the conclusion of randomized clinical trials.
Differences between nocturics and non‐nocturics in voiding patterns: an analysis of frequency‐volume charts from community‐dwelling elderly
Authors: Rembratt A. , Norgaard J.P. , Andersson K.‐E. 
Published: March 2003

OBJECTIVETo evaluate differences between elderly people with and without nocturia (waking up in the night to void) in terms of voiding habits, urine production and voided volumes.SUBJECTS AND METHODSNocturics (≥ two voids/night) and non‐nocturics (< one void/night) were recruited from a questionnaire survey. Subjects were asked to complete a 3‐day frequency‐volume chart, including time and volume of each void, and their bedtime and waking time. Diaries from 108 non‐nocturics and 116 nocturics were analysed. The number of voids, urine production, largest and average voided volumes were analysed using repeated‐measures analysis of variance models, controlling for variables such as age, gender, body weight and gender‐diagnosis interaction.RESULTSNocturnal urine volume was higher in nocturics than in non‐nocturics. The difference between the groups was larger among the men (estimated difference 384 mL) than among the women (227 mL), but highly statistically significant (P < 0.001) in both genders. Among the men the diurnal urine and 24‐h urine volumes were significantly higher in nocturics (difference, diurnal 131 mL, 24‐h 462 mL, both P < 0.001). In the women the diurnal urine volume was lower in nocturics than in non‐nocturics (difference 147 mL P = 0.0022) with no difference detected in 24‐h urine volume. The largest voided volume was significantly less in nocturics than in non‐nocturics; the difference was larger in women (128 mL, P < 0.001) than in men (42 mL, P = 0.0027). The average voided volume was 85 mL less (P < 0.001) in nocturics. The overlap between the groups in nocturnal urine and voided volumes was substantial and several significant covariates identified. The ratio between nocturnal urine volume and largest voided volume was the most statistically significant predictor of the number of nocturnal voids.CONCLUSIONElderly nocturics had a higher nocturnal urine production and lower volume per void than non‐nocturics. Differences between nocturics and non‐nocturics in urine production and largest voided volume did not follow the same pattern in men and women. Nocturia was a result of a mismatch between nocturnal urine volume and largest voided volume, rather than abnormal values in either. The treatment of nocturia should be directed at one or both of these factors, depending on the findings from the 3‐day frequency‐volume chart of the individual.
Health‐related quality of life in men with metastatic prostate cancer: the misleading effect of lead‐time bias
Authors: Litwin M.S. , Saigal C.S. , Lubeck D.P. , Li Y.‐P. , Henning J.M. , Carroll P.R. 
Published: March 2003

OBJECTIVETo ascertain whether the difference in health‐related quality of life, which appears to be worse in men with metastatic prostate cancer when the metastases are noted at initial diagnosis than during follow‐up after treatment for clinically localized disease, can be attributed to previous local control or to some form of measurement bias.PATIENTS AND METHODSWe analysed by univariate and multivariate methods 375 men with metastatic prostate cancer who were enroled in CaPSURE™, a national observational cohort of patients with prostate cancer treated in community and academic settings throughout the USA. In particular, we assessed whether group differences in health‐related quality of life were explained by the timing of metastatic diagnosis in the course of their disease. Health‐related quality of life was measured with the RAND 36‐Item Health Survey (SF‐36).RESULTSAfter controlling for relevant covariates (age, comorbidity and ethnicity), multivariate models suggested that men whose metastases were noted at the time of initial diagnosis scored 5–15 points worse in all eight domains of the SF‐36.CONCLUSIONMen who are diagnosed with metastatic prostate cancer during the follow‐up after treatment for clinically localized disease report a better quality of life than those who are metastatic at the time of diagnosis, not because the primary treatment confers any benefit but because they are followed more closely over time and diagnosed with metastases earlier in the course of their disease. This apparent difference in quality of life is an effect of lead‐time bias in the diagnosis of metastasis.