bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cellular resistance to mitomycin C is associated with overexpression of MDR‐1 in a urothelial cancer cell line (MGH‐U1)
Authors: Hayes M.C. , Birch B.R. , Cooper A.J. , Primrose J.N. 
Published: March 2003

Objective To compare multidrug resistance (MDR)‐1 and MDR‐3 gene expression in a new urothelial cancer cell line (MGHU‐1, with resistance to mitomycin C) against controls and the established (epirubicin‐resistant) MDR clone, and to correlate MDR with cytotoxicity data. Materials and methods Resistance to mitomycin C was induced by the long‐term exposure of wild‐type MGHU‐1 cells to increasing concentrations (20–400 nmol/L) of mitomycin C. The cytotoxicity of mitomycin C or epirubicin was then compared in MGHU‐1, MGHU‐MMC (mitomycin C‐resistant) and MGHU‐1R (established MDR) cells, using the tetrazolium biomass assay. The expression of MDR‐1 and ‐3 was investigated by the reverse transcriptase‐polymerase chain reaction, using cDNA‐specific primers after titration, and compared with DNA and negative controls. Results MDR‐1 and ‐3 were significantly and equally overexpressed in MGHU‐1R, and associated with a dramatic increase in the 50% inhibitory drug concentration (P < 0.001) for mitomycin C and epirubicin against controls. In MGHU‐MMC, the overexpression of MDR‐1 was three times greater than that of MDR‐3. The cytotoxicity profile for both agents was very similar to that of MGHU‐1R. Trace amounts of MDR‐1, but not MDR‐3, were identified in the MGHU‐1 wild‐type. Conclusions Urothelial cancer cell resistance to mitomycin C is associated with cross‐resistance to epirubicin and overexpression of MDR‐1, suggesting that mitomycin C falls within the MDR category. Clinical application of this methodology may allow patients to be identified who are unlikely to benefit from intravesical chemotherapy.
Detection of chromosomal alterations in bladder cancer by comparative genomic hybridization
Authors: Yu D.‐S. , Hsieh D.‐S. , Chang S.‐Y. 
Published: March 2003

Objectives To characterize which genomic alterations occur in bladder cancers of different grades and stages, and to evaluate the prognostic implication of chromosomal imbalances. Materials and methods Twelve transitional cell carcinoma cell lines were used to study chromosomal aberrations, using comparative genomic hybridization to examine metaphase cells. Results There was a mean of 6.0 aberrations per tumour with 4.9 gains and 1.08 deletions per tumour cell line. The mean number of aberrations was the same in grade 2 and 3 tumours. High‐stage ( T2) carcinomas had markedly more genomic gains than had low‐stage (T1) tumours, with 7.2 gains and 1.3 deletions per  T2 tumour, and 2.7 gains and 0.8 deletions per T1 tumour, although the difference was not statistically significant. The most frequent changes were gains of chromosome 1 (seven), 9 and 16 (six), and losses of chromosomes 14 (three), 21 and Y (two). The changes 1p+, 3p+, 9q+, 14p–, 16q+ and Yp– were significantly more frequent in low‐grade tumours, with 1p+, 3p+ and Yq– the most frequent in stage T1 tumours, and 16p+, 9q+ and 13q– the most frequent in stage  T2 tumours. Conclusion These findings indicate several genomic regions in chromosomes 1, 9, 14 and 16 that may carry genes for the development and progression of bladder cancers.
The choice of timing for diuresis renography:the F+0 method
Authors: Adeyoju A.A.B. , Burke D. , Atkinson C. , Mckie C. , Pollard A.J. , O'Reilly P.H. 
Published: March 2003

Objective To investigate a method of diuresis renography where the radiopharmaceutical and frusemide (diuretic) are given simultaneously, in contrast to conventional renography which involves an intravenous injection with frusemide 20 min after administering the radiopharmaceutical (F+20) or 15 min before (F−15), with particular interest in the effect of this change on assessing split renal function and interpreting upper tract drainage dynamics. Patients and methods In a prospective study, 29 patients (18 women and 11 men, mean age 47 years, range 21–86) were assessed. Each patient had two renograms taken over a 48‐h period, either by the F+20 or F−15, and the F+0 method. Data for split renal function and drainage curves were obtained in the usual way. Two independent assessments of the drainage curves were obtained and the results compared. Results The split function assessments were identical (<5% variation) in all but two patients; 26 of 29 (90%) gave identical conclusions about the drainage curves. The three patients with discrepancies between the studies had either hugely dilated upper tracts or otherwise had multiple complicating factors, e.g. impaired renal function, neuropathic bladder. Conclusions F+0 renography has been used in paediatric urological practice before, but there are no comparative studies and no data on its use in adults. This prospective study confirmed that in investigating dilated upper tracts, the F+0 technique gives similar results to the conventional techniques. The F+0 method has the potential to reduce the time required to undertake standard F+20 renography but it may not be useful in evaluating the grossly dilated upper tract, where the F−15 technique has the best record in terms of reducing equivocal results.
Reliability and validity of the International Prostate Symptom Score in a Malaysian population
Authors: Quek K.F. , Low W.Y. , Razack A.H. , Loh C.S. 
Published: March 2003

Objective To validate the English version of the International Prostate Symptom Score (IPSS) in patients with and without urinary symptoms in a Malaysian population. Patients and methods Validity and reliability were assessed in patients with lower urinary tract symptoms (LUTS) and in patients with no LUTS. Reliability was evaluated using the test‐retest method and 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 (TURP). Results Internal consistency was excellent; there was a high degree of internal consistency for each of the seven domains and for the total score (Cronbach's α0.60 and  0.79, respectively) in the populations studied. The test‐retest correlation coefficient for the seven domain scores was highly significant. The intra‐class correlation coefficient was high ( 0.59). There was a high level of sensitivity and specificity for the effects of treatment, with a very significant change between the seven scores domains in the treated group but not in the control group. Conclusions The IPSS is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
Intrarenal bacillus Calmette‐Guérin therapy for carcinoma in situ of the upper urinary tract: long‐term follow‐up and natural course in cases of failure
Authors: Okubo K. , Ichioka K. , Terada N. , Matsuta Y. , Yoshimura K. , Arai Y. 
Published: March 2003

Objective To assess the long‐term efficacy of intrarenal bacillus Calmette‐Guérin (BCG) therapy for the treatment of cytologically diagnosed upper tract carcinoma in situ (CIS) and report the time course in cases of failure. Patients and methods Fourteen renal units in 11 patients cytologically diagnosed as having upper urinary tract (UUT) CIS were treated with intrarenal BCG instillation. The BCG solution was administered by retrograde ureteric catheterization weekly for 6 weeks. Results Seven units were radiologically and cytologically free of disease at a median follow‐up of 60 months. Two units which showed an initial response had recurrence with ipsilateral UUT CIS. The remaining five units did not respond to BCG. Of seven units with an initial negative response or recurrent UUT CIS, nephroureterectomy was undertaken in one because of coincidental renal cell carcinoma. In four of the remaining six units, invasive pelvic tumour developed at a mean follow‐up of 20.5 months after the final instillation. Computed tomography showed wall thickening of the renal pelvis in two and mass‐forming tumour in the renal parenchyma mimicking renal cell carcinoma in two. In three of these four cases, retrograde pyelography did not show typical findings of renal pelvic tumour, e.g. filling defect, infundibular obstruction or stenosis. Conclusions Intrarenal BCG is effective in the treatment of UUT CIS in a long‐term follow‐up. In cases with a poor response or ipsilateral recurrence of CIS, there is a high risk of developing invasive tumour. Close follow‐up using computed tomography is recommended because of the atypical radiographic findings of such tumours.
99mTechnetium‐C595 radioimmunoscintigraphy: a potential staging tool for bladder cancer
Authors: Simms M.S. , Perkins A.C. , Price M.R. , Scholfield D.P. , Bishop M.C. 
Published: March 2003

Objectives To assess whether immunoscintigraphy using a conjugate of the anti–MUC1 monoclonal antibody C595 and 99mTc could be used to target transitional cell bladder cancer after intravenous administration to patients. Patients and methods Twenty‐one patients with invasive or metastatic transitional cell carcinoma were recruited. Patients received 1 mg of C595 labelled with 800 MBq 99mTc followed by imaging at 0.5, 6 and 24 h using a combination of planar and single‐photon emission computed tomography. Of these patients, 14 subsequently underwent cystectomy, four underwent radiotherapy and the remaining three had histologically confirmed metastatic disease. The results of immunoscintigraphy were compared with surgical findings and conventional radiology. Results There were no adverse reactions in any patient. Of the 20 patients who were found to have tumour at the time of the study, positive localization of antibody in tumour was apparent in 16. Of the remaining four patients, false‐positive localization of antibody in presumed nodal tissue was detected in two. The remaining scan results were equivocal. In three patients, histologically confirmed pelvic nodal metastases that had not been detected on preoperative computed tomography were identified. Conclusion These early results show the potential of 99mTc‐C595 immunoscintigraphy for staging bladder cancer. A larger study is needed to fully evaluate the technique.
Re‐auditing a regional lithotripsy service
Authors: Parkin J. , Keeley F.X. , Timoney A.G. 
Published: March 2003

Objective To assess, in a repeat audit of a regional lithotripsy service, whether changes implemented after a regional audit in 1994 (which showed disappointing results from shock wave lithotripsy, attributable to both poor patient selection and an inadequate fixed‐site lithotripter) have had any effect. Patients and methods A data‐collection sheet was devised to gather information on the site, size and number of stones treated, together with information on the lithotripsy treatment and outcome. Patients selected for the audit were the first 50 new patients treated with lithotripsy at each centre in 1999. As only one hospital has a fixed‐site lithotripsy machine, the results of mobile lithotripsy were grouped by machine for analysis. Results There was an overall improvement in patient selection from the previous audits. Few stones of > 16 mm or < 4 mm were treated. Two units treated more ureteric stones, thought to reflect first the influence of a fixed‐site lithotripter, and second a willingness to insert a ureteric stent and await the next mobile lithotripter visit. The stone free rates were all disappointingly low (16.7–26.7%) but the results improved when fragments of < 4 mm were included as ‘successful’ giving an ‘overall success rate’ of 45.9–66.7%. The unit with a fixed‐site lithotripter appeared to perform better (two‐thirds successful) than the mobile machines (Modulith SLX, 51%; Modulith SLK, 46%). One centre visited by both mobile machines had a success rate of 65% but a high rate of auxiliary procedures (35% vs 16–19% vs the fixed‐site). Conclusion Although these results show some improvement in patient selection for our regional lithotripsy service, stone‐free and success rates are poorer than those reported elsewhere. This may reflect the modern lithotripsy machines that allow day‐case treatment with minimal analgesia, and confirms reports by other authors who encourage a re‐examination of success rates of shock wave lithotripsy.
Renal and ureteric trauma: diagnosis and management in Poland
Authors: Dobrowolski Z. , Kusionowicz J. , Drewniak T. , Habrat W. , Lipczyn˜ski W. , Jakubik P. , Wêglarz W. 
Published: March 2003

Objective To analyse retrospectively kidney and ureteric injuries (the former often associated with multiple‐organ trauma and thus optimize diagnostic and treatment methods. Patients and methods The records and details of kidney and ureteric injures treated between 1995 and 1999 in 61 urological departments in Poland were analysed. Results In all, 887 kidney injuries were analysed; blunt trauma comprised 97%, with most injuries classified as renal contusion and minor parenchymal damage (687 cases). Intravenous urography was used in 80% of the patients and computed tomography in only 20%. In all, 234 patients (26%) underwent surgery; nephrectomy was the most common surgical treatment, in 170 patients (73% of those undergoing surgery). Complications occurred in 9% of patients after conservative treatment and in 5% after surgery. Of the 452 ureteric injuries, 340 (75%) were iatrogenic, 81 (18%) blunt injuries and 31 (7%) open injuries. Of the iatrogenic injuries 73% occurred during gynaecological procedures, 14% in general surgery and 14% in urological procedures. The most frequent diagnostic method was intravenous urography (244 cases), with retrograde pyelography (98) and ureteric catheterization in 125. The diagnosis was established immediately during surgery in 104 patients. The most frequent surgical treatment was uretero‐neocystostomy (213, 47%), the others being a Boari flap (113, 25%), end‐to‐end anastomosis (92, 20%), reconstruction with an ileal loop (30, 7%) and autotransplantation (four, 1%). Conclusion In Poland, patients with blunt kidney injuries often undergo surgery, with nephrectomy the most frequent procedure. Computed tomography with the intravenous administration of contrast medium should be considered the diagnostic method of choice for kidney injures. Catheterization of the ureters before surgery and an indigocarmine intravenous infusion (to stain the urine) when a ureteric injury is suspected may reduce the rate of iatrogenic injury and improve the rate of intraoperative diagnosis. We suggest catheterizing the ureters in any doubtful case to avoid injury, because prevention is better than treatment.
A randomized comparative dose‐ranging study of interferon‐α and mitomycin‐C as an internal control in primary or recurrent superficial transitional cell carcinoma of the bladder
Authors: Malmström P.‐U. 
Published: March 2003

Objective To compare, in a phase II study, the activity and toxicity of three dose levels of interferon‐α, and of mitomycin‐C given intravesically (as an internal control to validate the results), the primary objective being to investigate the percentage of complete responses (complete disappearance of a marker lesion) induced by the three interferon‐α dose levels on a marker lesion; a secondary objective was to compare the interferon‐α doses for toxicity. Patients and methods In all, 115 patients were enrolled, with the inclusion criteria being multiple grade 1 or 2, stage Ta or T1, primary or recurrent transitional cell carcinoma of the bladder. Interferon‐α (30, 50 and 80 MU) and mitomycin‐C (40 mg) intravesical treatments were given as follows. Patients randomized to one of three interferon‐α dose levels were treated weekly for 12 weeks. However, in week 9 (first cystoscopy after baseline) interferon‐α treatment was stopped if there was a complete response or disease progression. Patients randomized to mitomycin‐C were treated weekly for 8 weeks only and in week 9 underwent follow‐up cystoscopy. Results Interferon‐α at doses of 30, 50 and 80 MU gave response rates at 13 weeks of 19%, 33% and 41%, respectively. Although the response rates were higher for 50 and 80 MU than for 30 MU, the differences were not statistically significant. All three interferon‐α groups had significantly lower response rates than the internal control, mitomycin‐C (72%). The safety analysis showed that most of the adverse events were of mild to moderate severity. Adverse events were experienced by 37%, 37% and 48% of patients receiving 30, 50 and 80 MU interferon‐α, respectively, and by 55% of patients receiving mitomycin‐C. The corresponding rates for severe adverse events related to treatment were 9% for interferon‐α and 10% for mitomycin‐C. Conclusion Ablative therapy with interferon‐α was less effective than mitomycin‐C in patients with superficial bladder cancer. Both drugs were well tolerated, although interferon‐α appeared to have a slightly better overall safety profile.
Catheter‐less Cohen transtrigonal ureteric reimplantation
Authors: Anderson P.D. , Dewan P.A. 
Published: March 2003

Objective To review the profile and outcome of patients in whom it was elected not to insert a bladder catheter as part of the management of Cohen transtrigonal ureteric reimplantation surgery. Patients and methods Between April 2000 and April 2001, 37 patients underwent ureteric reimplantation by the senior author, using the Cohen transtrigonal technique. The use of the catheter‐less protocol began after the blockage of a suprapubic catheter soon after surgery; the catheter was removed with no adverse event. Subsequently, 27 of those undergoing ureteric reimplantation were selected not to have a bladder catheter. Later in the study a greater proportion of patients had no catheter inserted, as confidence with the catheter‐less technique increased. Caudal anaesthetic, oral analgesia and a single dose of intravesical bupivacaine were used for pain relief. The children were monitored closely after surgery and a urethral catheter inserted in the one patient who had not voided after 6 h. Results The patients generally tolerated the lack of a bladder catheter well. Of the 27 patients who did not have a catheter inserted at surgery, one required catheterization (a girl with bilateral duplex systems and large ureteroceles). Two children stayed in hospital for 2 days after surgery, one was discharged on the day of surgery, and the remainder went home on oral analgesia on the first day after surgery. Since starting the catheter‐less approach, 10 patients have had a suprapubic catheter because they had more complex surgery, were older or because the approach had not developed sufficiently at the time of surgery. Conclusions Intravesical ureteric reimplantation is not only safe when omitting a bladder catheter but, if used selectively, there appears to be a significant decrease in the hospital stay and discomfort after surgery.
Is mechanical bowel preparation necessary in patients undergoing cystectomy and urinary diversion?
Authors: Shafii M. , Murphy D.M. , Donovan M.G. , Hickey D.P. 
Published: March 2003

Objective To compare the surgical outcome in patients with or with no bowel preparation before cystectomy and ileal conduit urinary diversion, specifically assessing local and systemic complications. Patients and methods All patients undergoing cystectomy and ileal conduit urinary diversion between January 1991 and December 1999 were assessed retrospectively. Twenty‐two receive no bowel preparation (group 1) and were compared with 64 who had (group 2). Patients had similar demographic characteristics, stage and grade of tumour. Patients in group 2 received a standard 4‐day bowel preparation and group 1 received no lavage or enemas. All patients underwent a standard iliac and obturator lymph node dissection, and cystoprostatectomy or anterior exenteration and ileal conduit urinary diversion. All patients received intraoperative metronidazole and gentamicin intravenously, and two further doses after surgery. Results Deaths after surgery were comparable in the two groups (two in group 1 and four in group 2) and the incidence of wound infection was similar (three and seven, respectively). There were no significant differences between the respective groups for fistula and anastomotic dehiscence (two and six) or sepsis (three and six). Group 2 had a higher incidence of wound dehiscence (one) than in group 1 (none). The incidence of prolonged postoperative ileus was lower in group 1 (one vs 12), as was the length of hospital stay (31.6 days vs 22.8 days). Conclusions Bowel preparation had no advantage for the surgical outcome but it increased the length of hospital stay.
Blunt renal trauma in children with previously undiagnosed pre‐existing renal lesions and guidelines for effective initial management of kidney injury
Authors: Önen A. , Kaya M. , Ciǧdem M.K. , Otçu S. , Öztürk H. , Dokucu A.İ. 
Published: March 2003

Objectives To record pre‐existing renal lesions (PERL) found incidentally during evaluation for blunt renal trauma in children, determine their importance, suggest guidelines for the effective initial management of children with significant renal trauma and to evaluate the role of temporary percutaneous nephrostomy tube drainage (TPND) in these patients. Patients and methods We reviewed 338 children who were hospitalized with blunt abdominal trauma between 1992 and 2000. Thirty‐one patients had significant renal injury, 17 before 1997 (reviewed retrospectively) and the others reviewed and followed prospectively. Results Eleven of the 31 children had a PERL, which had been undiagnosed before the injury. The mean (range) follow‐up was 52 (15–104) months. There were 22 boys and nine girls (mean age 9.1 years, range 2–13). The mean age was lower in patients with a PERL than in children with isolated renal injury. The most common cause of blunt renal injuries was a fall (45%) followed by motor vehicle accidents. Renal stones were present in five children, pelvi‐ureteric junction obstruction in four, megaureter in one and a renal cyst in one. The mean injury severity scores were 12 in the children with a PERL and 14 in patients without. TPND was used in seven (22%) children; four were associated with a PERL. The mean grade of injury score for the kidney was higher in patients with a PERL and in children who underwent TPND than in patients who previously had a normal kidney and in children who did not undergo TPND. Early surgical intervention was required in three children; all were associated with a PERL. Of the 13 children who underwent surgery 11 had previous disease. Conclusions The frequency of PERL is high (36%) in children with blunt renal trauma. PERL can predispose minor trauma to cause kidney injury even with no evidence of hydronephrosis. When a minor trauma results in renal injury, it is important to seek a PERL. In selected patients, TPND may decrease the length of hospital stay and improve the outcome of the injured kidney, thereby decreasing the need for further surgery in those with isolated renal injury; however, it appears not to decrease the need for later operations in children with a PERL.