bluuebunny/crossref_metadata_2025_split huggingface dataset:
Femoral vein blood flow during transurethral resection of the prostate
Authors: Nilsson A. , Jogestrand T. , Ekengren J. , Hahn R.G. 
Published: November 2003

Objective To determine whether bladder distension affects venous haemodynamics during transurethral resection of the prostate (TURP) such that irrigating fluid is more easily absorbed. Patients and methods The right common femoral vein was examined using an ultrasound Doppler blood‐flow scanner in 10 patients (mean age 73 years, range 63–80) undergoing TURP. Measurements of blood flow were performed before, during and after the bladder was filled with irrigating solution. Fluid absorption was measured by the ethanol method. Results Measurements before, half‐way through and immediately after the resection all showed that the luminal diameter and the cross‐sectional area of the femoral vein increased significantly when the bladder was filled with irrigating fluid. Furthermore, a decrease in the normal variation of blood flow with breathing often occurred when the bladder was filled, indicating that proximal venous obstruction was the cause of the increase in vessel diameter. However, there was no apparent association between these changes and the absorption of irrigating fluid. Conclusions Filling the bladder with irrigating fluid with the patient in the lithotomy position during TURP was followed by signs of iliac venous obstruction but this did not correlate with the absorption of irrigating fluid.
Rectus abdominis muscle flap (RAMF) technique
Authors: Celayir S. , Kiliç N. , Dervisoglu S. , Büyükünal C. 
Published: November 2003

Objective To investigate the efficacy of the rectus abdominis muscle flap (RAMF) technique for the closure and augmentation of small, inelastic bladder extrophies using a rabbit model with a large bladder defect.Materials and methods Fifteen New Zealand White rabbits were studied in two groups; nine rabbits in group 1 underwent resection of 65% of the bladder and then bladder augmentation using a full‐thickness RAMF, including peritoneum, and six rabbits in group 2 (control) underwent a similar bladder resection but the bladder remnant was closed primarily. Urodynamic investigations were carried out in both groups pre‐operatively and 4 weeks after surgery. Intravenous pyelography (IVP), voiding cystourethrography (VCUG), urodynamic and histopathological investigations were also carried out for up to 4 months after surgery.Results As assessed by IVP, the urinary system appeared normal, with no signs of upper urinary tract dilatation and VCUG showed a normal voiding pattern. After surgery, the bladder capacity and compliance decreased in both groups, but both variables partially recovered in group 1, although not significantly.Conclusions This animal model indicates that the RAMF technique is a suitable alternative for the management of large bladder defects and bladder exstrophies with small, inelastic, non‐compliant bladders.
Delayed vasal reanastomosis in rats: comparison of a microsurgical technique and a fibrin‐glued procedure
Authors: Vankemmel O. , Rigot J.M. , Burnouf T. , Mazeman E. 
Published: November 2003

Objectives To compare fibrin‐glued vasovasostomy to a conventional microsurgical technique in a protocol of delayed vasovasostomy.Materials and methods Forty male Sprague‐Dawley rats underwent bilateral vasectomy through a midline abdominal incision. Two weeks later all animals underwent a bilateral vasectomy reversal through a bilateral inguino‐scrotal incision, following two different protocols. Invariably, the proximal segment had a larger lumen. The control group (20 rats) had a conventional modified one‐layer sutured vasal anastomosis with 10/0 nylon. The experimental group (20 rats) underwent vasal anastomosis using fibrin glue and consisting of three transmural sutures with 10/0 nylon followed by the application of fibrin glue circumferentially to seal the anastomosis. The fibrin‐tissue adhesive was obtained from pooled donor plasma and was virally inactivated by a solvent‐detergent treatment. Seven weeks after surgery all animals were killed and the vasal specimens were evaluated for gross patency and the incidence of sperm granuloma.Results The control group had a patency rate of 85% and half had sperm granuloma. The experimental group had a patency rate of 92% and 40% had sperm granuloma; neither difference was significant. The mean operative time was significantly shorter for the fibrin glue‐assisted vasovasostomy (P<0.001).Conclusion This study showed that a delayed fibrin‐glued vasovasostomy gave a comparable anatomical success and an incidence of sperm granuloma similar to that using a conventional microsurgical technique, but with the advantages of a shorter operative time and a less technically demanding anastomosis.
A step towards day case prostatectomy
Authors: Suvakovic N. , Hindmarsh J.R. 
Published: November 2003

Objective To compare laser prostatectomy, using both side‐fire and contact lasers, with transurethral resection of the prostate (TURP) to identify the advantages and disadvantages of all three in the short‐and long‐term (1 year). Patients and methods Forty patients were randomized into one of four groups undergoing TURP, side‐fire laser prostatectomy alone, side‐fire with debridement and contact laser prostatectomy. Strict entry criteria ensured that no patients with malignancy were selected. The patients were reviewed after 3, 6 and 12 months. Results The duration of operation and length of hospital stay were significantly shorter in those undergoing laser side‐fire treatment than those undergoing TURP. However, the early (3‐month) symptom score was significantly worse in those treated by side‐fire laser than in those treated by side‐fire laser with debridement. After 1 year there was no significant difference in mean symptom score and mean urinary flow rate among the four groups. Conclusion Laser prostatectomy offers the prospect of a shorter theatre and hospital stay and, by debriding the thermocoagulated tissue, the early irritative symptoms were reduced, with a significant improvement in symptom score after 3 months in patients with small prostates.
Detection and distribution of heat shock proteins 27 and 90 in human benign and malignant prostatic tissue
Authors: Thomas S.A. , Brown I.L. , Hollins G.W. , Hocken A. , Kirk D. , King R.J.B. , Leake R.E. 
Published: November 2003

Objective To determine whether it is possible to predict the behaviour of prostate tumours by identifying cellular characteristics, specifically specific heat shock proteins (HSPs). Materials and methods An immunohistochemical study staining for HSP 27 and 90 was undertaken on 15 benign and 13 malignant samples of freshly frozen prostatic tissue obtained from patients with a similar age range in each group (benign, mean age 71.6 years, range 61–86; malignant, mean age 72.7 years, range 58–87). Gleason scores for the tumours ranged from 2 to 8. Results Consistent patterns of cytoplasmic staining were seen in all sections of tissue from benign prostatic hyperplasia (BPH). The stroma stained strongly positive for HSP 27, but negatively for HSP 90 and glandular epithelium showed positive apical staining for both HSPs. Stromal patterns in prostatic carcinoma tissue were similar to that of BPH tissue for both HSP 27 and 90. Areas of prostatic intra‐epithelial neoplasia stained as strongly as did adjacent areas of BPH. For HSP 27, there was varied staining of individual epithelial cells, suggesting cellular heterogeneity, with an apparent reduction in staining with increasing Gleason score and invasiveness. For HSP 90, this pattern was less marked, with a predominance for positive staining throughout all grades of carcinoma. Conclusions The distribution of HSPs, primarily HSP 27, may aid in identifying different cell populations within prostatic carcinomas and thus help forecast biological behaviour.
Prostatic radioimmunoscintigraphy: preliminary results using technetium‐labelled monoclonal antibody, CYT‐351
Authors: Feneley M.R. , Chengazi V.U. , Kirby R.S. , Nimmon C.C. , Granowska M. , Mather S.J. , Ellison D. , Granowski A.R. , Britton K.E. 
Published: November 2003

Objective To investigate the clinical application of a new technique for imaging prostatic malignancy using planar imaging and single‐photon emission tomography (SPET) with technetium‐99m‐labelled antibody to a prostatic cell surface membrane antigen. Patients and methods Prostatic malignancy was imaged by radioimmunoscintigraphy (RIS) using a 99mTc‐labelled monoclonal antibody, CYT‐351, raised against a newly identified membrane antigen present in normal and malignant prostatic tissues. The protocol involved taking serial images and assessing the changes in activity, as the uptake of specific antibody increased with time and non‐specific uptake decreased. Data from planar images were collected at 10 min, 6 and 24 h after injection with antibody, and by SPET at 6 and 24 h using a Siemens Orbiter Large Field of View gamma camera. Twenty‐two RIS scans were evaluated, which included six patients with clinically localized disease, six patients with previous incidental carcinoma at prostatectomy for apparently benign disease, four patients with evidence of local recurrence after radical prostatectomy and six patients with metastatic disease. Results Primary tumours and secondary lymphatic and bone metastases were demonstrated. Only one minor side‐effect was experienced. Conclusion This RIS technique was capable of imaging primary prostatic malignancy and metastatic disease in lymph nodes and bone. Its clinical application remains to be defined, but potentially it provides a new means for tumour staging based upon tissue characterization. It may be particularly useful before radical prostatectomy and it is capable of imaging local recurrence following radical treatment of localized disease. Future applications include monitoring the progression of disease and the response to treatment.
Genetic instability of 3p12‐p21‐specific microsatellite sequences in renal cell carcinoma
Authors: Willers C.P. , Siebert R. , Bardenheuer W. , Lux A. , Michaelis S. , Seeber S. , Luboldt H.‐J. , Opalka B. , Schütte J. 
Published: November 2003

Objective To determine the role of structural alterations of human chromosome region 3p12‐p21 in the possible inactivation of one or more tumour‐suppressor genes in the pathogenesis of renal cell carcinoma (RCC), lung cancer and other neoplasms.Materials and methods As microsatellite instability (MI), in particular MI with loss of heterozygosity (LOH), may indicate putative tumour‐suppressor gene loci, 20 kidney tumours, including 14 clear cell carcinomas and six non‐clear cell neoplasms, were investigated with 10 polymorphic simple sequence‐repeat markers spanning 3p12‐p21. Six of these markers map to the region of deletion flanked by markers D3S1285 and D3S1295 bracketing the t(3;8) translocation breakpoint in 3p14.2 of hereditary RCC.Results Twelve of 14 clear cell RCCs displayed MI for at least one locus, as opposed to none of the non‐clear cell tumours (P=0.001). Locus D3S1274 in 3p13 located in the region deleted in lung cancer line U2020 and loci D3S1313 and D3S1300 in 3p14.3 characterized common regions of instability and LOH. Two patients with RCC who also had lung cancer and colon cancer, respectively, showed LOH at D3S1313 or D3S1300 as the only alterations of their kidney tumours.Conclusions These results suggest that human chromosome region 3p14.3 distal to the hereditary t(3;8) translocation breakpoint and the region deleted in the U2020 lung cancer cell line might be involved in the tumorigenesis or progression of clear cell RCC.
Bladder cancer in various population groups in the greater Durban area of KwaZulu‐Natal, South Africa
Authors: Groeneveld A.E. , Marszalek W.W. , Heyns C.F. 
Published: November 2003

Objective To study the incidence of different histological types of bladder cancer in various racial groups living within the same geographical region.Patients and methods The study included 615 new patients with bladder cancer seen at three Provincial hospitals in Durban from January 1980 to January 1990. The patients were classified as Caucasian (white people of European descent), African (indigenous black people), Asian (people originating from the Indian subcontinent) or Coloured (people of mixed race). The bladder tumours were classified according to standard histopathological criteria as transitional cell carcinoma, adenocarcinoma or sarcoma. Mixed tumours consisted of both carcinomatous and sarcomatous or undifferentiated elements.Results Transitional cell carcinoma constituted 95% of the cancers in Caucasians, compared with only 30% in Africans, whereas squamous cell carcinoma occurred in 53% of the African patients, but in only 2% of the Caucasians. In Asian patients, 75% of the tumours were transitional cell and 18% were squamous cell carcinoma, whereas in Coloureds 82% were transitional cell and 9% squamous cell carcinoma. Undifferentiated carcinoma occurred in 8% of African and only 1% of Caucasian patients, whereas adenocarcinoma, mixed tumours and sarcoma occurred in 9% of African patients and only 2% of Caucasian patients. Ova of Schistosoma haematobium were seen in microscopic sections of the bladder tumour in 85% of the patients with squamous cell carcinoma, in 50% of those with undifferentiated tumours and adenocarcinoma, in 17% of those with mixed tumours or sarcoma, and in only 10% of the patients with transitional cell carcinoma. At presentation, African patients were a mean of >20 years younger than Caucasians. In African patients with squamous cell carcinoma, 90% had stage T3 or T4 disease at presentation, whereas in Caucasian patients with transitional cell carcinoma 76% had stage T1 or T2 disease at presentation. From the study group, it appears that bladder cancer is about six times more common in Caucasians than in Africans. However, the value for Caucasian patients with bladder cancer probably underestimates the true value by about five times, so that bladder cancer in the greater Durban area may be as much as 30 times more common in Caucasians than in Africans.Conclusion In African patients, endemic Schistosomiasis appears to be related to a high incidence of not only squamous cell carcinoma, but also undifferentiated tumours and adenocarcinoma of the bladder. The effective management of squamous cell carcinoma of the bladder in African patients will depend on the eradication of Schistosomiasis and the early detection of bladder cancer at a stage when it may still be cured by radical treatment.
Bacillus Calmette‐Guérin perfusion therapy for carcinoma in situ of the upper urinary tract
Authors: Yokogi H. , Wada Y. , Mizutani M. , Igawa M. , Ishibe T. 
Published: November 2003

Objective To analyse the clinical and therapeutic consequences of bacillus Calmette‐Guérin (BCG) perfusion therapy for carcinoma in situ (CIS) of the upper urinary tract. Patients and methods Eight pyelo‐ureteric systems in five patients with cytologically confirmed CIS of the upper urinary tract were treated using perfusion of BCG through a percutaneous nephrostomy tube in five and a retrograde ureteric catheter in three. Follow‐up cystoscopy, retrograde pyelography and selective urinary cytology were obtained 4 weeks after the last treatment and every 3 months thereafter. Results In three patients (five pyelo‐ureteric systems) the cytology remained negative for 10–46 months after the treatment was completed. The remaining two patients (three pyelo‐ureteric systems) had persistently positive cytology. Of two patients who received BCG therapy through a ureteric catheter, one developed a ureteric stricture and the other developed renal tuberculosis. Conclusions Although long‐term adaptation to a nephrostomy tube disturbs the quality of life of the patient, percutaneous perfusion therapy through a nephrostomy tube seems to be safer than retrograde perfusion through a ureteric catheter.
Early clinical experience with 5‐aminolevulinic acid for the photodynamic therapy of superficial bladder cancer
Authors: Kriegmair M. , Baumgartner R. , Lumper W. , Waidelich R. , Hofstetter A. 
Published: November 2003

Objective To report clinical experience with intravesical instillations of 5‐aminolevulinic acid (ALA) for the photodynamic therapy of superficial bladder cancer and to assess any side‐effects of the treatment. Patients and methods Ten patients (six men and four women, mean age 62.3 years, range 42–73) with refractory superficial bladder cancer were treated with photodynamic therapy using 5 g of ALA dissolved in 30 mL sodium bicarbonate instilled intravesically. After a mean retention of 5.1 h, the bladder interior was illuminated transurethrally at radiation integrals of 15, 30 or 60 J/cm2 . At integrals of 15 or 30 J/cm2 red light (635 nm) was used and at 60 J/cm2 , green light (514 nm, 40 J/cm2 ) was combined with a subsequent application of red light (635 nm, 20 J/cm2 ). Results After 10–12 weeks, four patients had a complete remission, two a partial remission, there was no change in three and one had progressive disease. Of those patients responding, the bladder was preserved in five after a mean follow‐up of 15 months (range 6–27). There were no photodermatoses or bladder shrinkage in any patient. Conclusions Photodynamic therapy with intravesically applied ALA is effective in destroying superficial urothelial carcinomas of the bladder. There were no serious side‐effects which could preclude further clinical testing.
Sildenafil, a novel effective oral therapy for male erectile dysfunction
Authors: Boolell M. , Gepi‐Attee S. , Gingell J.C. , Allen M.J. 
Published: November 2003

Objectives To determine the efficacy and safety of sildenafil, a novel orally active inhibitor of the type‐V cyclic guanosine monophosphate‐specific phosphodiesterase (the predominant isoenzyme in the human corpus cavernosum) on penile erectile activity in patients with male erectile dysfunction of no established organic cause.Patients and methods Twelve patients (aged 36–63 years) with male erectile dysfunction of no established organic cause were entered into a double‐blind, randomized, placebo‐controlled, crossover study which was conducted in two phases. In the first phase (four‐way crossover), treatment efficacy was evaluated by measurements of penile rigidity using penile plethysmography during visual sexual stimulation at different doses of sildenafil (10, 25 and 50 mg or placebo). In the second phase (two‐way crossover), efficacy was assessed by a diary record of penile erectile activity after single daily doses of sildenafil (25 mg) or placebo for 7 days.Results The mean (95% confidence interval, CI) duration of rigidity of >80% at the base of the penis was 1.3 min (0.4–3.1) in patients on placebo, 3.5 min (1.6–7.3; P = 0.009) on 10 mg, 8.0 min (3.7–16.7; P = 0.003) on 25 mg and 11.2 min (5.6–22.3; P < 0.001) on 50 mg of sildenafil. The mean (95% CI) duration of rigidity of >80% at the tip of the penis was 1.2 min (0.4–2.7) on placebo and 7.4 min (2.4–8.5; P=0.001) on 50 mg sildenafil. From the diary record of daily erectile activity, the mean (95% CI) total number of erections was significantly higher in patients receiving sildenafil was 6.1 (3.2–11.4), compared with 1.3 (0.5–2.7) in those on placebo; 10 of 12 patients reported improved erectile activity while receiving sildenafil, compared with two of 12 on placebo (P= 0.018). Six patients on active treatment and five on placebo reported mild and transient adverse events which included headache, dyspepsia and pelvic musculo‐skeletal pain.Conclusion These results show that sildenafil is a well tolerated and effective oral therapy for male erectile dysfunction with no established organic cause and may represent a new class of peripherally acting drug for the treatment of this condition.
Urethroplasty for posterior urethral strictures
Authors: Mundy A.R. 
Published: November 2003

Objective To assess the long‐term results and complications of urethroplasty for patients with pelvic fracture injuries of the posterior urethra and to determine which type of of procedure is most appropriate.Patients and methods Eighty‐two patients were followed prospectively after undergoing transperineal bulbo‐prostatic anastomotic urethroplasty (AU). The results and complications in these patients were compared with 59 patients who had a ‘patch’ urethroplasty (PU) for a short stricture which in other circumstances might have been amenable to AU.Results The 1‐, 5‐ and 10‐year re‐stricture rates were 7, 12 and 12%, respectively, for AU and 12, 20 and 31% for PU. Four of the 10 patients who re‐strictured during the 5‐year follow‐up after AU were >55 years of age and four of the seven patients who had an AU and who were >55 years old re‐strictured. All the patients who restrictured were impotent. The commonest complications after AU were principally a consequence of the original injury rather than the surgery, whereas the complications after PU were principally related to the surgery. Impotence sometimes occurred after both types of urethroplasty.Conclusions Anastomotic urethroplasty is the best available procedure for traumatic proximal urethral strictures but was not tolerated well in the elderly and caused impotence in a small but significant proportion. The results of PU were less satisfactory and the difference became progressively more marked with a longer follow‐up.
An assessment of the ability of a silver‐releasing device to prevent bacterial contamination of urethral catheter drainage systems
Authors: Stickler D.J. , Morris N.S. , Williams T.J. 
Published: November 2003

Objective To investigate the ability of a silver‐releasing device to protect the catheterized bladder from infection by blocking the ascending migration of bacteria from contaminated urine‐drainage bags. Materials and methods A simple physical model of the catheterized bladder and drainage system was used with the device located in the drainage‐tube just below the sampling port. Urine was supplied to the model at 1.0 mL/min and the drainage bag was contaminated with Pseudomonas aeruginosa, Escherichia coli and Proteus mirabilis. Over 10 days, urine from the bag, catheter sampling‐port and bladder were examined for contamination. Results Bacteriological analysis showed that the mean time for test organisms to reach the sampling ports of four different control bag systems ranged from 5.7 to 7.7 days. Urine from the sampling ports of the test systems incorporating the silver device remained sterile for 10 days. The device also prevented the growth of the large populations of bacteria (108 colony‐forming units per mL) that occurred in the control bags. While scanning electron microscopy showed the formation of bacterial biofilm throughout the control drainage systems, no bacterial colonization was visible on the surfaces of the test systems. Chemical analysis established that the devices consistently generated concentrations of silver in urine ranging from 1.0 to 2.0 μg/mL. Conclusion The incorporation of the silver‐releasing device into the drainage systems produced an antibacterial barrier which protected the catheterized bladder from intraluminal contamination for at least 10 days. These in vitro tests suggest a useful role for the device in controlling infection in patients undergoing short‐term indwelling bladder catheterization.