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New York-Recently published data could better help diagnose and select treatments for infertile couples, targeting treatments likely to work and perhaps sparing some patients invasive, high-cost treatments less likely to prove effective.

Patients with metastatic renal cell cancer historically have had a poorprognosis, and attempts with hormonal therapy and chemotherapy have haddisappointing results. In this exclusive Urology Times interview, W. MarstonLinehan, MD, discusses new treatment strategies for renal cell carcinoma,including multimodality therapy with surgery and systemic therapy, and adoptiveimmunotherapy. Dr. Linehan is chief of urologic surgery at the NationalCancer Institute, Bethesda, MD. UT Editorial Consultant Andrew C. Novick,MD, chairman of the Cleveland Clinic Urological Institute, conducted theinterview.

It's time to add electronic medical records, or EMR, to the list of buzzwordscommon in medical practices today. This new technology, although in itsinfancy, has the opportunity to facilitate many of the goals common to allpractices-efficiency, correct coding, Medicare and HIPAA compliance, andimproved outcomes. We are in a new age of medicine, and EMR technology willtransform the way you practice.

New Orleans-The radioactive seeds implanted during prostate brachytherapyapparently find their way into the lungs of more than one-third of patients,according to researchers from the Robert Wood Johnson Medical School, Universityof Medicine and Dentistry of New Jersey, New Brunswick.

Washington-Andrew C. von Eschenbach, MD has been named the firsturologist to head the National Cancer Institute. Dr. von Eschenbach, 60, comes to NCI from the University of Texas M.D.Anderson Cancer Center, where he was director of the Genitourinary Centerand director of the Prostate Cancer Research Program. A prolific investigator,Dr. von Eschenbach has published hundreds of papers on prostate cancer,cancer biology, and urologic surgery.

Washington-Despite the combined efforts of the American LithotripsySociety and the Urology Society of America to delay implementation of theStark II regulations until a lawsuit is brought before the courts, the groups'injunction has been denied by the Federal District Court. The setback essentiallyclears the way for the Stark II regulations to encompass lithotripsy whenthe rules go into effect this month.

Concerns related to stem cell research and human cloning appear to havebeen resolvedWashington-Even though Congress is heavily embroiled in issues resultingfrom the Sept. 11 catastrophe, health care strategists are trying to figureout how to move several Medicare issues of importance to urologists andother physicians. At the same time, important decisions are being made onsuch key policy concerns as stem cell research, human cloning, and eventhe shortage of nurses.

Unique tax laws make fringe benefits affordable to employees and principalsalikeWhen it comes to today's employment picture, we live in a strange world.A high school student is paid $10 per hour to sit inside while a successfulexecutive pumps his or her own gas out in the rain. The manager of the fast-foodplace down the street sides with a surly employee because it is far easierto attract customers than to find and train new employees. And the conveniencestore on the corner is offering unheard-of wages plus fringe benefits andcannot find applicants.

Shiga, Japan-The improvement of interstitial cystitis symptoms with a still-investigational oral agent correlates well with a reduction in bladder platelet-derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) expression, suggesting the agent's potential for treating symptoms in patients with nonulcerative IC.

New Products and Services...as reported December 1, 2001

Recent technological advances in small semi-rigid and flexible ureteroscopes, combined with the development of ancillary instruments, have made retrograde ureteroscopy a viable treatment option for calculi in the ureter. This review will present the technique for ureteroscopic treatment of ureteral calculi above and below the iliac vessels.

Toronto-Not unlike many of the patients seen in urology practices, a significant percentage of young infertile men take alternative therapies, some of which may adversely affect their fertility. But many of these men may be hesitant to share this information with you.

New York-A newer monoclonal antibody is showing a canny ability to target prostate cancer cells in both bony and soft tissue, and its therapeutic potential is now undergoing testing. Neil Bander, MD, and colleagues from New York Presbyterian-Weill Cornell Medical Center developed the antibody, dubbed J591 (licensed by BZL Biologics, Inc., Framingham, MA, and sub-licensed by Millennium Pharmaceuticals, Cambridge, MA).

Demands by the public and changing practice patterns in urology are significantly impacting the recertification process for urologists. In this exclusive Urology Times interview, Martin I. Resnick, MD, discusses the changes that will affect all urologists with time-limited certificates. Dr. Resnick is professor and chairman of the department of urology at Case Western Reserve University School of Medicine/University Hospitals, Cleveland, and president-elect of the American Board of Urology. He was interviewed by Richard D. Williams, MD, professor and chairman of the department of urology at the University of Iowa, Iowa City

For many Americans from every walk of life, California typifies the American dream-a high standard of living, prestigious colleges and universities, and some of the country's best-known attractions. But for many physicians, including urologists, the Golden State represents the worst aspects of practicing medicine in the twenty-first century.

Package also provides tax incentives for doctors to expand and investin their practicesPresident Bush signed a long sought-after economic stimulus package onMarch 9. The "Job Creation and Worker Assistance Act of 2002"(H.R. 3090) is a combination of business economic stimulus provisions, reliefprovisions for lower-Manhattan businesses affected by the Sept. 11 terroristattacks, a 13-week extension of unemployment benefits, extensions for expiredor soon-to-expire tax breaks, and technical corrections.

This is an exciting time to be involved with interstitial cystitis, fromthe clinical aspect of caring for patients, to the search for markers andbetter methods of diagnosis, to the basic research so critical in ultimatelyfinding etiologies and a cure. The articles in this month's Urology Times help to underscore these issues(see page 8). Tomohiro Ueda, MD, PhD, and colleagues have identified a cytokineinhibitor that seems to improve interstitial cystitis symptoms and increasebladder capacity, according to a preliminary trial in patients with non-ulcerativedisease. The potassium chloride test study of Tony Yen-Huang Chen, MD, wouldappear to limit the usefulness of this potentially painful examination asa diagnostic adjunct. The profile that Frederic Liandier, MD, did of 287IC patients serves to confirm that while we have many therapies for thisdisorder, nothing works for everyone and the treatment of IC is as muchart as it is science-perhaps more so.

Seattle-Physician Micro Systems, Inc. has released Web View, a featureallowing information contained in the company's Practice Partner PatientRecords and Appointment Scheduler to be viewed via the Internet.

Iselin, NJ-The UROSKOP Access fluoroscopic and digital radiographic systemfrom Siemens Medical Systems, Inc., is a dedicated urodiagnostic table thatoffers unrestricted and symmetrical patient access from every side.

Carle Place, NY-Nuclear Associates' Glassers Radiation Protection Eyewearprovides unimpaired peripheral vision. Available with prescription or non-prescriptionlenses, the products' extra-large lens area reduces scatter radiation strikingthe eye-socket bone structure, the company says. Lenses provide .50-mm lead-equivalentprotection. For added comfort, the eyewear has plastic-reinforced ear rests.

San Fernando, CA-Precision Dynamics Corp. introduces the UR-Assure Legand Drainage Bags, both of which are intended for use for up to 15 days.The short-time use helps to prevent the possibility of urinary tract infections,according to the company. In addition, both bags feature anti-reflux mechanisms,further ensuring patient cleanliness and comfort. Each bag features graduationmarks so collection amounts are easy to determine, the company says.

Uppsala, Sweden-Q-Med has received FDA approval to market Deflux, a treatmentfor vesicoureteral reflux grades II-IV in children.

Downers Grove, IL-Vysis, Inc. has received FDA approval to market itsUroVysion assay for monitoring bladder cancer recurrence.

Assign specific tasks, outline agenda, and highlight objectives to avoid confusionThe recent tragedies at the World Trade Center and the Pentagonhave made air travel more difficult-and have increased the need for teleconferences.Teleconferences for businesses, clinical trials, and medical organizationshave become increasingly popular in recent years and are now becoming avital communication tool.

About 42% of physicians currently work in practices that have a web site.Patients who connect with their physicians through the Internet commenton the ability to feel more connected to the practice and more in controlof their care.

Boston-Perhaps offering a measure of reassurance to prostatitis patientsand their urologists, data from a prospective study suggest that the symptomsof chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) typicallyimprove or remain stable over time. During a 1-year follow-up of a cohort receiving "usual care"for their symptoms, half the patients had symptom improvement, and morethan one-third reported their symptoms unchanged. Symptoms deterioratedin about 14% of patients.

Uppsala, Sweden-If use of sentinel node detection in bladder cancer provesas successful as recent studies suggest, it will not be long before moleculartests on the sentinel tissues replace full histologic reports in stagingthis disease. That's the prediction of Dan Theodorescu, MD, PhD, who hasbeen at work on a genetic-based cancer-detection test, but who thinks workthis year by a group in Sweden may portend a significant diagnostic toolfor bladder cancer: sentinel node analysis.

Worsening economic downturn has shifted focus to helping unemployed pay for health insuranceWashington-In early September, it appeared that advocates of a new patients'bill of rights would see success, and lobbyists for business and insuranceorganizations who opposed the initiative were willing to settle for thebest deal they could get.

The presentations of Jay Pearson, PhD, and Brett Carver, MD, cited in this issue of Urology Times, provide further experimental and epidemiologic evidence that nonsteroidal anti-inflammatory drugs (NSAIDs) may have some role in the fight against prostate cancer. While these are certainly not the first reports that NSAIDs might beuseful for the prevention or treatment of this malignancy, they continueto identify the remarkable value of these agents for human health and raiseimportant questions as to why so many different types of disease statesare affected by them. Arthritis, benign cardiac conditions, and colon andprostate cancer are diseases of extraordinarily different tissues, etiologies,pathologies, and outcomes. Yet each of these conditions are likely benefitedby NSAID therapy.

New York-The young, otherwise healthy men urologists see for an infertility evaluation may be hiding a condition more commonly observed in older men and women. Researchers from the Cornell Institute of Reproductive Medicine in New York report that three-fourths of men with nonobstructive azoospermia, a severe form of male infertility, are at risk for significant bone loss.