Per Åge Høisæter

Ureteroscopy in Pregnancy

PURPOSE We report our experience with ureteroscopy in pregnancy. MATERIALS AND METHODS From 1984 to 1994, 24 pregnant women with lasting symptoms of ureteral obstruction underwent diagnostic and therapeutic ureteroscopy. Most of the women were in the second or third trimester of gestation. RESULTS A rigid ureteroscope was introduced easily to the upper third of the ureter or into the renal pelvis in all patients. Ureteral calculi were extracted in 13 cases. There were no serious complications. CONCLUSIONS Ureteroscopy is a safe procedure that may be used to diagnose and extract obstructing ureteral calculi during pregnancy when conservative measures fails.

Clinical Background of Patients Treated with Clean Intermittent Catheterization in Norway

This study reports on the use of clean intermittent catheterization (CIC) in Norway in 1988/89. A total of 407 adult out-patients was studied. CIC was used in all age-groups and equally in both sex. The patients were divided into five diagnostic groups. There were twice as many patients suffering from neurogenic diseases as non-neurogenic ones. A neurourological index was constructed based on neurological examination and urodynamic data giving a good differentiation and expression of the bladder affection. It appeared that CIC could be performed even by highly disabled persons. A statistically significant correlation was found between the neuro-urological results in patients with decompensated bladder and their over all disability.

Estradiol receptor in uterine tissue from neonatal mice. Influence by cyclic AMP.

Abstract The estradiol receptor in uterine tissue of neonatal mice has been studied. It is present neonatally and fulfills normal criteria as regards sedimentation behaviour, specificity etc. The influence of dibutyryl-cyclic AMP (db-cAMP) on receptor characteristics has been studied using sucrose gradient centrifugation and dry mount autoradiography. A consistent change in the cytosol receptor sedimentation behaviour is found when db-cAMP is included in the incubation medium of whole uteri preparations. A depression in the 8s receptor region is found simultaneously with an increase in the 4s region. There is no uptake of tritiated estradiol as seen in autoradiograms from organ cultures of neonatal uterine cervix preparations, when these have been cultured for 48 h. When db-cAMP is included in the incubation medium, a pronounced uptake is seen in the sections. Different possible points of action of cyclic AMP related to the findings described, are discussed.

Renal malignancies: outcome of patients in stage 4 with or without embolization procedure.

During four and one-half years a total of 44 patients with renal cell carcinoma in Stage 4 were admitted to our hospital. Of these, 18 patients were treated with an embolization procedure, 8 patients had nephrectomy without embolization, and another 18 patients received no active treatment. Except for the treatment there were no differences between these groups. The survival time was equal whether or not the patients underwent an angioinfarction procedure. We conclude that the embolization procedure has no beneficial effect in itself in these patients.

The potentially curable prostate cancer patient and the pathways leading to diagnosis and treatment

Objective: Potentially curable prostate cancer is a diagnostic challenge for the general practitioner (GP). In a defined catchment area we wanted to discover why patients consulted their GPs and the reasons for their referral to the urologist. Material and Methods: Patients remitted to our “early prostate cancer clinic” with suspected potentially curable prostate cancer between January 1997 and December 2000 were included in the study. Patient information was registered according to a prospectively designed protocol. Results: Of the 872 patients examined, prostate cancer was diagnosed in 41.3% (360/872). Median age was 63.1 years and median total prostate‐specific antigen (PSA) level was 8.6 μg/l. The main reason for referral to a urologist was elevated PSA alone. However, the majority of the patients had no urological symptoms when they consulted their GP. As no local or national screening recommendations existed, we believe that opportunistic PSA screening has been common. Conclusions: The most important reason for referring patients to our specialist clinic was elevated PSA, often detected by means of opportunistic PSA screening. This study shows the effect of PSA testing in real‐life practice.

Expression of p 16 protein in prostatic adenocarcinomas, intraepithelial neoplasia, and benign/hyperplastic glands.

The tumor suppressor gene CDKN2/MTSI(p16(INK4)) may be inactivated by point mutations, deletions, or methylation in many tumor types. In prostate cancer, a very low frequency of point mutations has been reported, but deletions of 9p21 and inactivation by methylation are observed more frequently. The purpose of this study was to assess the expression pattern of the CDKN2 protein product p 16 in a series of 104 prostatic adenocarcinomas treated by radical prostatectomy, using immunohistochemical detection on archival, paraffin-embedded material. Nuclear staining was completely absent in 13 (13%) of 104 cases, whereas cytoplasmic staining was found in 99 (95%) of 104 carcinomas. Significant differences were found when comparing the staining intensity of carcinomas and coexisting prostatic intraepithelial neoplasia (PIN) with benign/hyperplastic glands. In 86 (95%) of 91 cases the overall staining intensity of carcinomas was stronger than the reactivity in benign/hyperplastic glands, which were most often weakly stained. In 71 (95%) of 75 cases the staining intensity of PIN was stronger than in benign/hyperplastic glands, a contrast also observed within single glands. However, p16 immunostaining in carcinomas was not prognostically important and it was not associated with standard clinicopathologic parameters. Our results support that CDKN2/plb is inactivated in only a small proportion of localized prostate cancers. The increased p16 staining of carcinomas/PIN in comparison with benign/hyperplastic glands suggests that p 16 protein may be involved in early stages of prostate tumorigenesis by mechanisms other than CDKN2/p16 gene inactivation, and the possibility of using p(16) immunostaining as a marker for PIN is discussed.

Binding of androgens and progestins in the human testis

Receptor-like androgen binding has been studied in normal human testis tissue and human testicular tumours. In cytosol an exchange assay with [3H]-methyltrienolone ([3H]-R 1881) has been used. Determination of nuclear binding sites was performed by a [3H]-testosterone exchange method. In normal testis cytosol a concentration of 119 ± 60 fmol/mg protein low-capacity high-affinity, heat labile androgen-binding activity was found. In only two out of five tumour specimens (seminomas) a relatively low (23–33 fmol/mg protein) exchange activity could be detected. Sucrose gradient centrifugation revealed two apparently separate peaks rather close to each other in the 4 S region. Incubation with 100-fold excess of radioinert progesterone resulted in a complete inhibition of [3H]-R 1881 binding at the position of one of the peaks. Androgen exchange activity was detected in the nuclear fractions of both normal and neoplastic tumour tissue. The highest nuclear exchange values were found in the tumour samples which had no detectable cytosol receptor activity.

Unilateral Renal Cortical Necrosis with Contralateral Hydronephrosis: Report of a Case

A case of unilateral renal cortical necrosis with contralateral hydronephrosis due to infiltrating carcinoma of the bladder is reported. It is suggested that the failure of glomerular microthrombi to locate in the hydroneph-rotic kidney may have been due to an altered intrarenal vascular pattern.

Clinical research done by the Scandinavian Prostate Cancer Group during the first 20 years

In 1981 the Scandinavian Association of Urology initiated the Scandinavian Prostate Cancer Group (SPCG) as one of eight collaborative groups representing different fields of urology. The task of the SPCG was to promote research, education and information concerning prostate cancer. In particular it became a forum for conducting clinical multicenter studies within the Nordic countries. This paper summarizes some aspects of the history of the SPCG and reviews the clinical trials initiated by the group on the occasion of its 20th anniversary.

Malignant testis tumors. Survival in 53 patients with minimum 5 years observation time.

Survival rate of 53 patients with malignant testis tumors treated during the years 1956-1971 is reported. The observation time is from 5 to 20 years. Thirty-three patients are still alive. Eighteen out of 20 patients with pure seminoma stage A-B are alive, and 1 out of 3 in stage C. Of the 30 patients with non-seminomatous tumors all 8 patients in stage A are alive, while only 1 out of 9 in stage B, and 1 out of 9 patients in stage C have survived. Four patients (including 3 children) which could not be classified according to stage are all alive. All the patients who did not survive died within 5 years after the diagnosis. A new treatment protocol for testicular malignancies is described.