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  • 1
    Electronic Resource
    Electronic Resource
    Growth fractions of human renal cell carcinoma defined by monoclonal antibody Ki-67. Predictive values for prognosis (2001)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 8 (2001), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We used immunohistochemical techniques to elucidate the role of growth fractions of renal cell carcinoma in the clinicopathology of the condition and patient survival.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:Fifty-two fresh-frozen nephrectomy specimens were immunostained with Ki-67 monoclonal antibody. Ki-67 indexes were determined to examine the relationship between tumor size, grade, stage and survival curve. This study included 43 men and nine women with the mean age 58.4 ± 11.7 years, who had been followed up for 39 ± 25 months.〈section xml:id="abs1-4"〉〈title type="main"〉Results:The Ki-67 index ranged from 0.6 to 14.1%, averaging 4.6 ± 5.8%. It was 2.8 ± 2.4% in tumors 〈5 cm, 4.7 ± 3.6% in tumors ≥5 cm and 7.1 ± 9.0% in tumors ≥10 cm. The Ki-67 index of grades 1, 2 and 3 tumors was 2.3 ± 1.1%, 3.3 ± 2.7% and 12.0 ± 10.4%, respectively. Grade 3 tumors had a significantly higher Ki-67 index than grade 1 or grade 2 tumors. There was no correlation between the Ki-67 index and tumor stage. Patients with a Ki-67 index 〈 5.6% had a better prognosis than those with an index 〉 5.6% (P = 0.029). However, multivariate analysis demonstrated that tumor size (P = 0.034) and grade (P = 0.038) were higher in hazard ratio than the Ki-67 index.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:Most renal cell carcinomas had low growth fractions. Although a high Ki-67 index should indicate a poor prognosis, Ki-67 did not correlate to metastasis. We believe it is necessary to investigate the factors, other than growth potential, that affect metastasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.2001.00379.x
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  • 2
    Electronic Resource
    Electronic Resource
    Early experience of laparoscopic radical nephrectomy for T3b renal cell carcinoma (2004)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 11 (2004), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract We report our experience with laparoscopic radical nephrectomy for a 79-year-old man who had renal cell carcinoma (RCC) with a renal vein thrombus. For the transaction of the renal vein with the thrombus, we used an endoscopic gastrointestinal anastomosis stapler. The operating time was 4 h and blood loss was 400 mL. The patient could walk and drink on the first postoperative day. He recovered normal activity 30 days postoperatively. There were no intraoperative and postoperative complications. The present report demonstrates the feasibility of laparoscopic radical nephrectomy in patients with T3b RCC who suffer from tumor thrombus in the renal vein.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1442-2042.2004.00891.x
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  • 3
    Electronic Resource
    Electronic Resource
    A comparative study of endoscopic trigonoplasty for vesicoureteral reflux in children and in adults (1999)
    Melbourne, Australia : Blackwell Science Asia Pty. Ltd.
    International journal of urology 6 (1999), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Endoscopic trigonoplasty is an experimental therapy for vesicoureteral reflux. We investigated differences in surgical results between children and adults. Methods : Endoscopic trigonoplasty was performed on 51 patients and 15 pediatric and 21 adult patients were included in this study. The children accounted for 27 cases of refluxing ureter (grade II, 8; III, 14; IV, 4; V, 1) and the adults for 28 cases (I, 4; II, 18; III, 4; IV, 2). There was a greater proportion of bilateral disease and a higher average degree of reflux in the children’s group. Results : We found no significant differences in operative time, complications, analgesics usage, the duration of the indwelling catheter and hospital stay. Our follow up at 3 months showed that the reflux had ceased in 19 of 27 cases (70%) in the children’s group and in 27 of 28 cases (96%) in the adults’ group. The next follow up at 12 months showed that there was no reflux in 16 of 27 cases (59%) in 15 children and in 17 of 23 adult cases (74%). Trigonal splitting caused recurrence of reflux greater than grade II, in two children (13%) affecting four ureters and in three adults (14%) affecting four ureters. Conclusions : Endoscopic trigonoplasty has proved to be equally less invasive in children and in adults, but vesicoureteral reflux was less often resolved in children. This suggests that the greater original distance between the ureteral orifices and the greater thickness of the detrusor muscle favor the adult patient. For children, a new surgical concept is needed to increase cessation rate of vesicoureteral reflux.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.1999.611105.x
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  • 4
    Electronic Resource
    Electronic Resource
    Determination of the relative probability for prostate cancer to avoid unnecessary biopsy (2005)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 12 (2005), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  Background:  To investigate whether using a new concept of relative probability for prostate cancer (RPpca) can increase sensitivity and specificity in detecting prostate cancer.Methods:  For 217 patients with total prostate-specific antigen (PSA) level of 4–20 ng/mL, prostate volume and free to total PSA (F/T) ratio were measured. From the fitted curves between positive predictive values for prostate cancer and age, prostate volume, total PSA or the F/T ratio, each function predicting prostate cancer was determined. RPpca defined by the combined functions of age, prostate volume, total PSA and F/T ratio was calculated for each individual patient. The probability of prostate cancer was also calculated, using logistic regression analysis (LRPpca). Receiver-operating characteristic analysis was performed to elucidate the areas under the curve (AUC), sensitivities and specificities and cutoff values of the conventional and new parameters. Finally, we investigated the applicability of the above parameters in the other patient group using a different PSA assay kit (AxSYM).Results:  Although RPpca had the largest AUC in the total PSA range of 4–20 ng/mL, it did not reach statistical significance between RPpca and F/T ratio or LRPpca. The cutoff values of F/T ratio, LRPpca and RPpca were determined as 0.15, 0.12 and 0.20, respectively. Using these cutoff values in AxSYM data, RPpca had the highest sensitivity (91%) and specificity (57%).Conclusions:  RPpca can provide more precise information to avoid unnecessary biopsy than LRPpca or F/T ratio. RPpca could be valuable to decide whether to perform prostate biopsy when using various PSA kits.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1442-2042.2005.01056.x
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  • 5
    Electronic Resource
    Electronic Resource
    Measurement of prostate specific antigen complexed to α1-antichymotrypsin to avoid unnecessary biopsy in patients with serum prostate specific antigen levels 4–20 ng/mL (2005)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 12 (2005), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract Aim: To investigate whether measuring prostate specific antigen complexed to α1-Antichymotrypsin (PSA-ACT) can increase sensitivity and specificity in detecting prostate cancer. Methods: In this prospective study, we measured serum total PSA, PSA-ACT, free PSA, prostate volume and transition zone volume on 210 patients with total PSA level of 4–20 ng/mL. From fitted curves between positive predictive values for prostate cancer and age, prostate volume, transition zone volume, total PSA, PSA-ACT or F/T ratio, each function predicting prostate cancer was determined. Relative probabilities for prostate cancer (RPpca) which were defined by combined functions of age, F/T ratio, prostate volume or transition zone volume, and total PSA or PSA-ACT were calculated. Furthermore, using logistic regression, analysis was performed to determine the probability of prostate cancer. Receiver-operating characteristic analysis was performed to clarify the areas under the curve (AUC) for conventional single parameters, RPpca and logistic regression probability. Results: F/T ratio showed the largest AUC among conventional parameters. The AUC of RPpca was larger than those of F/T ratio and logistic regression probability. RPpca using the functions of age, transition zone volume, PSA-ACT and F/T ratio showed the largest AUC and highest specificity at sensitivity 95% level, however, specificities at sensitivity 90% and 85% were identical to those of RPpca using the functions of age, prostate volume, total PSA and F/T ratio. Conclusions: RPpca using the functions of age, transition zone volume, PSA-ACT and F/T ratio was the best way to detect prostate cancer, however, the usefulness of PSA-ACT appears limited, considering the cost.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1442-2042.2005.01167.x
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  • 6
    Electronic Resource
    Electronic Resource
    Morbidity of laparoscopic radical prostatectomy: Summary of early multi-institutional experience in Japan (2003)
    Melbourne, Australia : Blackwell Science Pty
    International journal of urology 10 (2003), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim:  Laparoscopic radical prostatectomy is being evaluated throughout the world. The aim of the present study is to report early multi-institutional experience of the procedure in Japan.Methods:  A total of 148 men who were diagnosed with clinically localized prostate cancer underwent laparoscopic radical prostatectomy at seven different institutions in Japan. Early complications (within 30 days postoperatively) and postoperative convalescence were reviewed retrospectively. The median age of patients was 68.0 years (range, 51–80).Results:  The median operative time was 403 minutes (range, 167–925; average, 427). Blood loss ranged from 50 to 5000 mL (median, 540; average, 856). A total of 66 complications were reported in 55 patients (37.2%). Intraoperative complications were noted in 25 of 148 patients (16.9%): 10 rectal injuries (6.8%); five bladder injuries (3.4%); five cases of subcutaneous emphysema (3.4%); two intestinal injuries (1.4%); one major vessel injury (0.7%); one ureteral injury (0.7%); and one obturator nerve injury (0.7%). Overall, 16 of 148 patients (10.8%) required open conversion or postoperative open surgical repair. The most common postoperative complications were anastomotic leakage (6.8%), wound-related complications (4.7%) and perineal pain (4.7%). The bladder catheter was removed on day 7 or earlier in 73 cases (49.3%). The median time to ambulation was 1 day (mean 1.4, range 1–5). Oral intake was started on postoperative day 1 in 67 patients (45.2%) and on postoperative day 2 in 65 (43.9%).Conclusion:  Although laparoscopic radical prostatectomy is technically demanding, reduced blood loss and shorter convalescence periods can be expected from the procedure. Surgeons should be aware of the disturbingly high morbidity rate related to early experience. By mastering laparoscopic skills and sharing knowledge, surgeons could reduce the impact of the learning curve required to complete this procedure competently.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1442-2042.2003.00658.x
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  • 7
    Electronic Resource
    Electronic Resource
    Anterior Urethral Diverticulum Produced by Cowper's Gland Duct Cyst (1996)
    Oxford, UK : Blackwell Publishing Ltd
    International journal of urology 3 (1996), S. 0 
    Details
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A case of congenital urethral diverticulum is presented. The patient was a 16-year-old boy with the chief complaint of dribbling urine since he was 14 years old. A retrograde urethrogram revealed a diverticulum of the bulbar urethra, which had been produced by a cystic dilation of the Cowper's gland duct. The walls of the diverticulum were resected endoscopically.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1442-2042.1996.tb00568.x
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  • 8
    Electronic Resource
    Electronic Resource
    Cyclosporin a effective therapy for fifty-two cadaver kidney recipients (1985)
    Springer
    Surgery today 15 (1985), S. 160-165 
    Details
    ISSN: 1436-2813
    Keywords: cyclosporin A ; cadaveric renal transplantation ; HLA-DR matching
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fifty-two consecutive patients receiving cadaveric renal transplants were prescribed cyclosporin A and steroid therapy. Three of the recipients underwent re-transplantation and two of the patients were grafted with kidneys shipped from the United States. One year actuarial patient and graft survival rate with no exclusions were 94.2 percent and 81.6 percent, respectively, this rate being significantly better than results in case of the conventional combination of azathioprine, steroid and antilymphocyte globulin. The role of HLA-DR matching on cyclosporin A treatment was studied. One year actuarial graft survival rates of two HLA-DR matched and one HLA-DR matched were 91.7 percent and 78.9 percent, respectively. To assess the effects of cyclosporin A in the management of patients with acute tubular necrosis, the patients were divided into two groups, in terms of whether or not hemodialysis treatment was required for acute tubular necrosis. Although in the present protocol, cyclosporin A administration was begun before the operation, no significant differences in the graft survivals were evident between the two groups. Nephrotoxicity, hepatotoxicity and other side-effects of cyclosporin A could usually be dealt with by dosage adjustments, making feasible the chronic ingestion of this agent. The exceptional effectiveness and safety of cyclosporin A were evident throughout these early trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02469747
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  • 9
    Electronic Resource
    Electronic Resource
    Three-drug combination chemotherapy for advanced urothelial tract carcinoma (1987)
    Springer
    Cancer chemotherapy and pharmacology 20 (1987), S. S20 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A prospective chemotherapeutic trial using combinations of three drugs consisting of three different protocols was performed in 24 patients with advanced transitional-cell carcinoma of the urothelial tract between April 1981 and August 1986. All patients had histologically proven transitional-cell carcinoma and bidimensionally measurable lesions. The protocol I (PPA) was a 5-day course of treatment with 20 mg/m2 cis-platinum and 5 mg/m2 peplomycin (a derivative of bleomycin) on days 1–5, and 25 mg/m2 adriamycin on day 1. Protocol II (CFMit) was a 10-day course with 3 mg/m2 mitomycin-C and 300 mg/m2 cyclophosphamide on day 1, and 180 mg/m2 5-fluorouracil on days 1–10. Protocol III (PAM) was a 1-day course comprising 60 mg/m2 cis-platinum, 30 mg/m2 adriamycin, and 40 mg/m2 methotrexate. In protocols I and III, the drugs were administered every 4–5 weeks, while in protocol II, the drugs were administered continuously without any interval. Of the 9 patients who received 1 to 5 PPA courses, only 3 patients showed a minor response. In the 10 patients who received 4 to 44 CFMit courses, 3 (33%) achieved partial remission for 1.5–22 months, and 3 had a minor response. Of the 5 patients receiving 3 to 7 PAM courses, 1 patient achieved partial remission for 5 months, and 1 had a minor response. Myelosuppression, nausea, vomiting, and anorexia were frequently observed in each protocol. Loss of hair was often observed in protocols I and III. Stomatitis and diarrhea were observed in protocol II. Three patients in protocol I, 4 patients in protocol II, and 1 patient in protocol III were unable to tolerate more courses of the regimen due to the severe side effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00262479
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  • 10
    Electronic Resource
    Electronic Resource
    Prognostic value of pressure-flow study in surgical treatment of benign prostatic obstruction (1999)
    Springer
    World journal of urology 17 (1999), S. 274-278 
    Details
    ISSN: 1433-8726
    Keywords: Key words Urodynamics ; Benign prostatic obstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The prognostic value of pressure-flow study (P-FS) in the surgical treatment of bladder outlet obstruction (BOO) was retrospectively studied in patients with benign prostatic hyperplasia. In 74 patients who underwent surgical treatment for BOO, P-FS and free uroflowmetry were performed pre- and postoperatively. On P-FS, obstruction and detrusor contractility were analyzed according to the Schäfer nomogram. The patients were classified into the following 3 groups according to their preoperative P-FS: group A consisted of 39 patients with normal detrusors and obstruction (obstruction grade 3–6); group B consisted of 13 patients with weak detrusors and obstruction; and group C included 22 patients with weak or very weak detrusors combined with minimal obstruction, if any (obstruction grade 0–2). Postoperatively, the detrusor pressure at maximal flow rate and obstruction grades on P-FS improved significantly in groups A and B but not in group C. The rate of improvement was most prominent in group A, followed by groups B and C. On free uroflowmetry, however, a significant improvement occurred in all three groups with respect to maximal flow rate, average flow rate, and postvoid residue. Moreover, the rate did not differ among the three groups except for the maximal flow rate as determined between groups A and C. Although good detrusor contractility and evident obstruction on analysis of P-FS will guarantee the best surgical outcome, subjects with weak detrusors and minimal obstruction will also have a good outcome by the relief of BOO. In the weak detrusor, P-FS may be limited in diagnosing obstruction and have a low prognostic value, and such patients should not necessarily be excluded from surgical indications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003450050145
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