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  • 1
    UID:
    (DE-627)1580875238
    Format: 6
    ISSN: 1464-410X
    Content: Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Different spacing agents have been tested to reduce incidential radiation exposure of the rectum during radiotherapy to the prostate. These agents all had certain drawbacks; either the created space was too small or the agents used did not stay in place during radiotherapy treatment. The study describes the transperineal injection technique of a spacing agent in detail. Furthermore it shows the safety and efficacy of the spacing hydrogel used and shows that it overcomes some of the drawbacks of the previously examined spacing agents. OBJECTIVE • To describe the technique used to apply a hydrogel spacer between the prostate and rectum so as to decrease the radiation dose to the rectum in patients with prostate cancer who are undergoing radiotherapy. METHODS • A prospective study evaluating the safety and efficacy of prostate-rectum spacer injection was conducted in 29 male patients with prostate cancer scheduled for radiotherapy. • Spacing hydrogel was injected into the perirectal space using a transperineal approach under real-time transrectal ultrasonography guidance. • With the needle tip positioned beyond the rectourethralis muscle, saline injection opened the space between Denonvilliers' fascia and the anterior rectal wall, allowing needle advancement to the mid-prostate without rectal wall injury. Injection of hydrogel precursors further opened this space, which was then maintained as a result of hydrogel polymerization. • Procedure duration and adverse events were monitored. Computed tomography and/or magnetic resonance imaging simulation scans were performed before and after injection. The hydrogel-created space was measured and the reduction in percent volume of the rectum receiving at least 70 Gy (rectal V70) was determined. RESULTS • Hydrogel injection resulted in mean (sd) additional prostate-rectum space relative to baseline of 9.87 (5.92) mm. • The mean (sd) procedure time, as measured by needle insertion and removal, was 6.3 (3.2) min. • The relative reduction in rectal V70 was 60.6%. • There were no unanticipated adverse events associated with the hydrogel procedure or the hydrogel. CONCLUSIONS • Hydrogel spacer injection using hydrodissection is a fast and effective procedure to separate the rectal wall from the prostate in order to avoid rectal toxicity. • Hydrogel spacer injection resulted in the addition of ∼1 cm of space • Computed incidental radiation exposure, the rectal V70, was substantially reduced.
    Note: Gesehen am 11.09.2018
    In: BJU international, Oxford : Wiley-Blackwell, 1999, 110(2012), 11b, Seite E647-E652, 1464-410X
    In: volume:110
    In: year:2012
    In: number:11b
    In: pages:E647-E652
    In: extent:6
    Language: English
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  • 2
    UID:
    (DE-627)1572344733
    Format: 7
    ISSN: 1464-410X
    Content: Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Muscle invasive bladder cancer has a mortality rate at 5 years of 50%, despite radical therapy, as a result of tumour progression and dissemination. This suggests that half of patients have disseminated disease at the time of diagnosis, which is not detected by the staging techniques currently used. The prognostic factors (histological grade and tumour stage) and current staging techniques do not discriminate between those patients who will be cured with surgical treatment and those who will die from metastatic spread. New diagnostic and prognostic tools that complement the existing methods and provide a proper assessment of carcinoma invading bladder muscle are therefore essential. Molecular staging techniques using specific biomarkers have been applied in various solid tumours to determine the presence of missed tumour cells in lymph nodes (LNs) during routine pathological examination. These techniques could identify patients with LN micrometastases who may potentially benefit from early treatment with chemotherapy. This study compares the performance of conventional histological analysis and molecular biomarkers in detecting bladder cancer LN micrometastases and predicting patient's clinical outcome. The study found that, even though a clear trend to a worse outcome was shown in those patients who became node-positive after molecular analysis, no statistical differences were found in cancer-specific and recurrence-free survival analysis between those patients who were negative by histology but positive by molecular analysis and those who were negative by both techniques. We concluded that molecular analysis of LN spreading in bladder cancer has a better detection rate than conventional histological examination. OBJECTIVE • To improve the sensitivity of histological examination in detecting occult lymph node (LN) dissemination of bladder cancer using gene expression analysis. PATIENTS AND METHODS • We carried out a retrospective study that included 504 formalin-fixed paraffin-embedded LNs from 90 patients with muscle invasive bladder cancer and 35 controls. • Gene expression values of two molecular biomarkers (FXYD3 and KRT20) were analysed using reverse transcription real-time quantitative PCR (RT-qPCR). • Molecular results were compared with histological status and patients' clinical outcomes. RESULTS • Of the 90 patients analysed, 16 were positive and 74 were negative by histological analysis. Of these 74, 19 were classified as positive using RT-qPCR. • Significant differences in cancer-specific (P= 0.011) and recurrence-free (P= 0.009) survival were found between the three patient groups (patients positive by both techniques, patients negative by both techniques, and patients negative by histological but positive by molecular analysis). • A significant difference was not found between histologically negative but molecularly positive patients and patients who were negative by both techniques, but a clear trend to a worse outcome was found in those patients who became node-positive after molecular analysis. CONCLUSIONS • The analysis of FXYD3 and KRT20 could improve current pathological examination for the detection of micrometastases in LNs. • Further and more extensive studies will determine the real prognostic value of such LN micrometastases.
    Note: Gesehen am 15.11.2018
    In: BJU international, Oxford : Wiley-Blackwell, 1999, 110(2012), 9, Seite 1310-1316, 1464-410X
    In: volume:110
    In: year:2012
    In: number:9
    In: pages:1310-1316
    In: extent:7
    Language: English
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  • 3
    UID:
    (DE-627)1497881420
    Format: 12
    ISSN: 1464-410X
    Note: Gesehen am: 17.03.2015
    In: BJU international, Oxford : Wiley-Blackwell, 1999, 112(2013), 1, Seite 109-120, 1464-410X
    In: volume:112
    In: year:2013
    In: number:1
    In: pages:109-120
    In: extent:12
    Language: English
    URL: Volltext  (kostenfrei)
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  • 4
    UID:
    (DE-627)25410083X
    ISSN: 1464-4096
    Note: Beteil. Körp. anfangs: British Association of Urological Surgeons ; Société Internationales d'Urologie ; European Society of Pediatric Urology , Ungezählte Beil.: Supplement , 102.2008,12 u. 106.2010,12 nicht ersch.; Suppl. nur teils als Internetausg. ersch.
    Additional Information: Beil. Essential evidence for urologists
    Additional Edition: 1464-410X
    Additional Edition: CD-ROM-Ausg. BJU international on CD-ROM Oxford : Blackwell Science, 1999
    Additional Edition: Online-Ausg. BJU international Oxford : Wiley-Blackwell, 1999 1464-410X
    Former: Vorg. British journal of urology
    Language: English
    Keywords: Andrologie ; Zeitschrift ; Urologische Chirurgie ; Urogenitalkrankheit ; Urologie ; Zeitschrift
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  • 5
    UID:
    (DE-602)gbv_25410083X
    ISSN: 1464-4096
    Note: Beteil. Körp. anfangs: British Association of Urological Surgeons ; Société Internationales d'Urologie ; European Society of Pediatric Urology , Ungezählte Beil.: Supplement , 102.2008,12 u. 106.2010,12 nicht ersch.; Suppl. nur teils als Internetausg. ersch.
    Additional Information: Beil. Essential evidence for urologists
    Additional Edition: ISSN 1464-410X
    Additional Edition: CD-ROM-Ausg. BJU international on CD-ROM Oxford : Blackwell Science, 1999
    Additional Edition: Online-Ausg. BJU international Oxford : Wiley-Blackwell, 1999 ISSN 1464-410X
    Former: Vorg. British journal of urology
    Language: English
    Keywords: Andrologie ; Zeitschrift ; Urologische Chirurgie ; Urogenitalkrankheit ; Urologie ; Zeitschrift
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  • 6
    E-Resource
    E-Resource
    Oxford : Blackwell Science ; 1999 -
    UID:
    (DE-627)311120326
    Additional Edition: Druckausg. BJU international Oxford : Wiley-Blackwell, 1999 1464-4096
    Additional Edition: Online-Ausg. BJU international Oxford : Wiley-Blackwell, 1999 1464-410X
    Former: Vorg. British journal of urology on CD-ROM
    Language: English
    Keywords: Urogenitalkrankheit ; Zeitschrift ; CD-ROM ; Urologie ; Zeitschrift ; CD-ROM ; Zeitschrift
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  • 7
    E-Resource
    E-Resource
    Oxford : Blackwell Science ; 1999 -
    UID:
    (DE-602)gbv_311120326
    Additional Edition: Druckausg. BJU international Oxford : Wiley-Blackwell, 1999 ISSN 1464-4096
    Additional Edition: Online-Ausg. BJU international Oxford : Wiley-Blackwell, 1999 ISSN 1464-410X
    Former: Vorg. British journal of urology on CD-ROM
    Language: English
    Keywords: Urogenitalkrankheit ; Zeitschrift ; CD-ROM ; Urologie ; Zeitschrift ; CD-ROM ; Zeitschrift
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  • 8
    Online Resource
    Online Resource
    Oxford : Wiley-Blackwell | Oxford : Blackwell Science | Oxford [u.a.] : Blackwell ; 83.1999 -
    UID:
    (DE-627)320599426
    Format: Online-Ressource
    ISSN: 1464-410X
    Note: Gesehen am 27.06.14
    Additional Edition: 1464-4096
    Additional Edition: Erscheint auch als Druck-Ausgabe BJU international Oxford : Wiley-Blackwell, 1999 1464-4096
    Additional Edition: Erscheint auch als CD-ROM-Ausgabe BJU international on CD-ROM Oxford : Blackwell Science, 1999
    Former: Vorg British journal of urology
    Language: English
    Keywords: Andrologie ; Zeitschrift ; Online-Ressource ; Urologische Chirurgie ; Zeitschrift ; Online-Ressource ; Urogenitalkrankheit ; Zeitschrift ; Online-Ressource ; Urologie ; Zeitschrift ; Online-Ressource ; Zeitschrift
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  • 9
    UID:
    (DE-627)1794997199
    Format: 5
    ISSN: 1464-410X
    Content: OBJECTIVE To develop and evaluate a new clinical method for measuring bladder wall tension (BWT) on detrusor contraction during physiological voiding and under pathological conditions, as in experimental trials during subvesical obstruction the ability to generate pressure increases, whereas the contractile force per cross-sectional area of detrusor muscle decreases. PATIENTS AND METHODS In all, 24 patients were divided into three equal groups: group 1 (mean age 58, sd 8.6 years) comprised men with bladder outlet obstruction in accordance with the Abrams-Griffiths nomogram; group 2 (four men and four women, 56, sd 7.2 years) had detrusor instability; and group 3 (54, sd 9.6 years) had normal bladder emptying. BWT, as the detrusor force per cross-sectional area of bladder tissue (in N/cm2), was calculated after a urodynamic evaluation and ultrasonographic estimate of bladder wall thickness. RESULTS In all patients it was possible to measure BWT; the mean (sd) maximum BWT in group 1 was 9.8 (3.9) N/cm2, in group 2 during bladder instability was 11.7 (2.6) N/cm2 and in group 3 was 2.8 (0.5) N/cm2. CONCLUSIONS Estimating BWT in humans is possible by combining a urodynamic evaluation with an ultrasonographic estimate of bladder wall thickness. Further clinical research should elucidate the clinical relevance of BWT under comparable conditions.
    Note: Gesehen am 08.03.2022
    In: BJU international, Oxford : Wiley-Blackwell, 1999, 92(2003), 6, Seite 584-588, 1464-410X
    In: volume:92
    In: year:2003
    In: number:6
    In: pages:584-588
    In: extent:5
    Language: English
    URL: Volltext  (lizenzpflichtig)
    URL: Volltext  (lizenzpflichtig)
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  • 10
    UID:
    (DE-627)51895918X
    Format: Online-Ressource
    ISSN: 1365-2176
    Note: Gesehen am 20.06.14 , Erster Zusatz ab 79.1997
    Additional Edition: 0007-1331
    Additional Edition: Erscheint auch als CD-ROM-Ausgabe British journal of urology on CD-ROM Oxford : Blackwell, 1991
    Additional Edition: Erscheint auch als Druck-Ausgabe British journal of urology Oxford : Blackwell, 1929 0007-1331
    Later: Forts BJU international
    Language: English
    Keywords: Zeitschrift
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