Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Loss of heterozygosity (LOH) and alterations in microsatellite DNA markers have been reported in bladder-cancer tumors. We have studied, in a blinded fashion, using PCR-based microsatellite analysis, genetic alterations of cells exfoliated in urine of 59 Caucasian patients and control patients; 31 with initially confirmed bladder transitional-cell carcinoma (TCC), 17 with signs and symptoms suggestive of bladder cancer, 6 control patients who underwent renal transplantation, and 5 control patients with urolithiasis. Microsatellite analysis of cells exfoliated in the urine allowed the diagnosis of 83% (10/12) of patients with bladder TCC recurrence confirmed by cystoscopy, while 100% of patients followed up for transitional-cell carcinoma of the bladder for up to 12 months without evidence of tumor recurrence upon routine cystoscopy showed no microsatellite alterations. None of the patients without neoplasia (negative controls) had any microsatellite alterations, whereas all patients who underwent renal transplantation had additional new alleles corresponding to contamination with donor's renal and urothelial cells (positive controls). No control patients had any evidence of transitional-cell carcinoma by cystoscopy. Our results provide objective evidence that non-invasive molecular detection of bladder TCC by microsatellite analysis is reproducible with a sensitivity of 83% and a specificity of 100% in Caucasian patients. This non-invasive procedure represents a potential clinical tool for the detection and the screening of bladder TCC.
Int J Cancer 1998 Dec 18
PMID:Assessment of microsatellite instability in urine in the detection of transitional-cell carcinoma of the bladder. 984 73

A literature review was conducted on the application of economic analysis to clinical medicine, particularly urology. The surgical management of urolithiasis and the treatment of ureteropelvic junction obstruction were used as specific disease examples to evaluate how cost-effectiveness analysis has been used to address the clinical concerns of practicing urologists. As the costs and outcomes of the treatment of kidney stone disease and ureteropelvic junction obstruction can be specifically defined, the application of cost-effectiveness analysis in these two areas meets most standards of economic analysis. Economic models that incorporate poor assumptions, incomplete data, or both are unlikely to have significant clinical utility. The most useful models are those that are structurally simple and evaluate healthcare program alternatives from the patient's, provider's, or society's perspective.
J Endourol 1998 Dec
PMID:Cost-effectiveness analysis: application to endourology. 989 49

Although extracorporeal shockwave lithotripsy (SWL) is a successful treatment for ureteral calculi, introduction of miniureteroscopes has advanced endoscopic management. We combined the use of a semirigid ureteroscope with a pneumatic lithotripter (Swiss Lithoclast) for the treatment of ureteral calculi. From January 1992 to August 1994, 143 patients (87 male, 56 female; mean age 48.7 years; age range 22-74 years) with urolithiasis underwent endoscopic lithotripsy with the Swiss Lithoclast under general anesthesia. The 0.8 = mm probe was inserted through the deflected working channel (3.4F) of the Micro-6L ureteroscope (tip diameter 6.9F). The calculi were in the distal (N = 96; 67.1%), mid (N = 34; 23.8%), and proximal part (N = 13; 9.1%) of the ureter. The mean stone size was 6.8 mm (range 5-26 mm). Of the 137 patients whose stones we could access adequately, 70 (51.1%) were stone free immediately after the procedure, and another 31 (22.6%) had residual fragments <3 mm that passed spontaneously. The remaining 36 patients underwent another 50 procedures; 30 SWL sessions in 26 patients (19%), 17 further endoscopic lithotripsies in 14 (10.2%), and open surgery in 3. Application of the Swiss Lithoclast through semirigid miniureteroscopes is highly effective for endoscopic lithotripsy, regardless of stone composition. Deflection of the probe up to 30 degrees did not impair the disintegration rate. Because of the high migration rate of mid and proximal ureteral stones, the Swiss Lithoclast is not recommended in these cases as a primary procedure. Low capital cost and simple and safe handling are the device's major advantages over laser lithotripsy.
J Endourol 1998 Dec
PMID:Pneumatic lithotripsy applied through deflected working channel of miniureteroscope: results in 143 patients. 989 54

The aim of this study was to determine the effectiveness of 'fast-tracking' in an academic emergency department (ED) during a period of limited resources and space constraints. This was a prospective, double-blind, comparative clinical trial. Fast-tracking was applied every other day between 08.00 and 17.30 hours. Patients meeting fast-tracking criteria, which were determined as allergy, dyspepsia, hypertension, urinary tract infection, urolithiasis, gastroenteritis, upper airway infection, minor lacerations, and soft tissue injuries with no sign or symptom of life-threatening illness or acute abdomen, were treated by a designated fast-tracking team. In the alternate days fast-tracking was not done, and the patients having the same criteria were recorded and followed as the control group. ED length of stays were determined for each patient, and at time of discharge a questionnaire was applied to determine patient satisfaction. Follow-up was performed by telephone survey at the 5th day of discharge. The median length of stay was 36 minutes for the fast-tracked group compared with 63 minutes for the control group. The application of fast-tracking decreased ED length of stay and improved patient satisfaction in patients presenting with allergy, dyspepsia, upper airway infection, minor laceration, and soft tissue injury, but not in patients with gastroenteritis, urinary tract infection, hypertension, and urolithiasis. The rate of follow-up was 81% (n = 217), and there were no complications or hospitalizations to another hospital. It is concluded that fast-tracking is an applicable and useful system in an academic ED with limited resources, and decreases ED length of stay and improves patient satisfaction in a selected group of patients. Determination of fast tracking criteria must be individualized for each hospital according to resources. Additionally, fast-tracking seems to be safe when performed under strict criteria for patient selection.
Eur J Emerg Med 1998 Dec
PMID:Prospective, double-blind, comparative fast-tracking trial in an academic emergency department during a period of limited resources. 991 44

Statistical observations of the inpatient operations at our department during the 27-year period from 1970 to 1996 revealed the following: A total of 9,287 operations were performed, comprising 7,488 males and 1,799 females. Operations for urolithiasis numbered 3,646 (39.3%) which was the most frequent, followed by operations for urological malignancies, 2,038 (21.9%) and for prostatic hyperplasia, 1,596 (17.2%). In the last decade, the number of operations for malignancies, prostatic hyperplasia, and especially for urolithiasis has increased. However the number of operations on pediatric cases has shown a marked decrease. Thanks to the development of new diagnostic and therapeutic medical modalities, including ultrasound, computed tomographic scans, endoscope and extracorporeal shockwave lithotripsy, the frequency of early cancer has thus increased, and the surgical procedure of choice has dramatically shifted to minimally invasive surgery.
Hinyokika Kiyo 1998 Dec
PMID:[Clinical statistics on inpatient operations during a 27-year period at the Department of Urology, Mitsui Memorial Hospital]. 1002 42

The anti-inflammatory drugs, aspirin and piroxicam, are known to possess chemopreventive potential against rat superficial urinary bladder carcinogenesis induced by N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN). Recently, we found similar inhibitory effects with a selective cyclooxygenase (COX)-2 inhibitor, nimesulide. In order to clarify the inhibitory mechanisms, we have further studied the expression of COX-2 protein in urinary bladder tumors induced by BBN in Fischer 344 male rats. For comparison, papillomatosis caused by uracil-induced urolithiasis, and normal epithelial cells, were also investigated. Western blot analysis revealed COX-2 protein to be barely expressed in the normal epithelial cells, whereas it was increased 13-22-fold in varying sizes of urinary bladder tumors and 7-fold in papillomatosis. Immunohistochemically, COX-2 protein was diffusely expressed in transitional cell carcinomas and nodulo-papillary hyperplasia but weakly expressed only in basal cells in simple hyperplasia and normal-looking surrounding epithelia. In papillomatosis, it was moderately expressed only in endothelial cells in stroma. These results indicate that COX-2 plays important roles in the development of preneoplastic and neoplastic lesions in the rat urinary bladder, and therefore could be a good target for chemoprevention of superficial lesions.
Carcinogenesis 1999 Dec
PMID:Increased expression of cyclooxygenase-2 protein in rat urinary bladder tumors induced by N-butyl-N-(4-hydroxybutyl) nitrosamine. 1059 Feb 24

Primary hyperoxaluria type 1 (PH1) is a rare autosomal recessive disorder characterised by an increased urinary excretion of calcium oxalate, leading to recurrent urolithiasis, nephrocalcinosis and accumulation of insoluble oxalate throughout the body (oxalosis) when the glomerular filtration rate falls to below 40-20 mL/min per 1.73 m(2). The disease is due to a functional defect of the liver-specific peroxisomal enzyme alanine: glyoxylate aminotransferase (AGT), the gene of which is located on chromosome 2q37.3. The diagnosis is based on increased urinary oxalate and glycollate, increased plasma oxalate and AGT measurement in a liver biopsy. AGT mistargeting may be investigated by immuno-electron microscopy and DNA analysis. End-stage renal failure is reached by the age of 15 years in 50% of PH1 patients and the overall death rate approximates 30%. The conservative treatment includes high fluid intake, pyridoxine and crystallisation inhibitors. Since the kidney is the main target of the disease, isolated kidney transplantation (Tx) has been proposed in association with vigorous peri-operative haemodialysis in an attempt to clear plasma oxalate at the time of Tx. However, because of a 100% recurrence rate, the average 3-year graft survival is 15%-25% in Europe, with a 5-10-year patient survival rate ranging from 10% to 50%. Since the liver is the only organ responsible for the detoxification of glyoxylate by AGT, deficient host liver removal is the first rationale for enzyme replacement therapy. Subsequent orthotopic liver Tx aims to supply the missing enzyme in its normal cellular and subcellular location and thus can be regarded as a form of gene therapy. Because of the usual spectrum of the disease, isolated liver Tx is limited to selected patients prior to having reached an advanced stage of chronic renal failure. Combined liver-kidney Tx has therefore become a conventional treatment for most PH1 patients: according to the European experience, patient survival approximates 80% at 5 years and 70% at 10 years. In addition, the renal function of survivors remains stable over time, between 40 and 60 mL/min per 1.73 m(2) after 5 to 10 years. In addition, liver Tx may allow the reversal of systemic storage disease (i.e. bone, heart, vessels, nerves) and provide valuable quality of life. Whatever the transplant strategy, the outcome is improved when patients are transplanted early in order to limit systemic oxalosis. According to the European experience, it appears that combined liver-kidney Tx is performed in PH1 patients with encouraging results, renal Tx alone has little role in the treatment of this disease, and liver Tx reverses the underlying metabolic defect and its clinical consequences.
Eur J Pediatr 1999 Dec
PMID:Combined liver-kidney transplantation in primary hyperoxaluria type 1. 1060 4

The aqueous extract of the bark of Raphanus sativus was tested for its antiurolithiatic and diuretic activity. The urolithiasis was experimentally induced by implantation of zinc disc in the urinary bladder of rats. Significant decrease in the weight of stones was observed after treatment in animals which received aqueous extract in comparison with control groups. This extract showed an increase in the 24 h urine volume as compared to the control.
J Ethnopharmacol 1999 Dec 15
PMID:Antiurolithiatic activity of Raphanus sativus aqueous extract on rats. 1062 98

A set of simple guidelines for metabolic evaluation and medical/dietary management of patients with urolithiasis is presented. The evaluation scheme is based on the documented risk factors in the Nordic area and the results of controlled clinical trials, and takes its basis in the severity of the stone disease in the individual stone patient. The initial evaluation in all patients aims at diagnosing conditions with a definitive metabolic, infectious or anatomical/functional cause of stone formation (MIAF urolithiasis). Patients with MIAF urolithiasis are treated according to the nature of the underlying disease. Having excluded/diagnosed MIAF urolithiasis, patients with idiopathic calcium nephrolithiasis remain, and in this group, which comprises approximately 85% of the total stone population in the Scandinavian region, only those with a complicated stone disease are subjected to additional evaluation, which aims at identifying underlying pathophysiological derangements for which medical therapy has been proven to be effective in controlled clinical trials.
Scand J Urol Nephrol 1999 Dec
PMID:Metabolic evaluation and medical management of upper urinary tract stone disease. Guidelines from the Scandinavian Cooperative Group for Urinary Stones. 1063 76

The biofilm mode of growth has been implicated in the majority of human bacterial infections. In the urinary tract, notable biofilm-associated infections include prostatitis, chronic cystitis, struvite urolithiasis, and catheter-associated infections. Biofilms protect the causative organisms from host defences and antimicrobial therapy. Biofilm formation has traditionally been considered to result from adhesion and capsule formation by adherent microorganisms. Recent work has shown that a large number of genes are activated during this process, some of which have been associated with twitching motility, quorum sensing, and slow growth. In this paper, we review some of the recent work on biofilm biology and highlight its role in urinary tract infections, particularly those associated with urinary catheters.
World J Urol 1999 Dec
PMID:The development of bacterial biofilms on indwelling urethral catheters. 1065 64


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