bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of histamine in human penile erection
Authors: Cará A.M. , Lopes‐Martins R.A.B. , Antunes E. , Nahoum C.R.D. , De Nucci G.
Published: November 2008

ObjectiveTo investigate the relaxant action of histamine on human corpus cavernosumin vitroand the erectile response caused by the intracavernous injection of histamine in patients with psychogenic impotence.

Patients and methodsHuman corpus cavernosum (HCC) tissue was cut into strips of approximately 2 cm and suspended in a cascade bioassay. The strips were then superfused with oxygenated and warmed Krebs solution and precontracted with nor adrenaline (3 μm). Glyceryl trinitrate, acetylcholine and histamine were injected as a single bolus in the absence or in the presence of mepyramine and cimetidine. For the in vivo studies, histamine (30–60 μg) was injected intra‐cavernously as a single bolus into the right corpus cavernosum 1 cm from the balamo‐preputial sulcus. Similar protocols were carried out for papaverine (50 mg). The erectile response was divided into four grades: no response, tumescence, partial and full erection.

ResultsIn vitrostudies demonstrated that histamine (3–100 μg) caused dose‐dependent relaxation of the HCC strips which was significantly inhibited by cimetidine (5–10 μm). The histamine H1receptor antagonist mepyramine (1 μm) potentiated histamine‐induced relaxation. The co‐infusion of both mepyramine and cimetidine did not abolish histamine‐induced relaxation. When injected intracavernously in humans, histamine (30 μg) caused full erection in 13% of the patients, whereas 87% had partial erection or tumescence. A higher dose of histamine (60 μg) caused full erection in 26% of the patients and 74% had partial erection or tumescence. Papaverine induced full erection in the majority of patients (66%). In contrast to papaverine, the duration of erection induced by histamine was markedly shorter (mean 200 and 6.5 min, respectively). The penile erections induced by papaverine were associated with complications such as pain, haematoma and priapism. Histamine did not induce any complications. Treatment of eight male patients with psychogenic impotence with the histamine H1receptor antagonist astemizol (10 mg orally once daily for 1 week) did not affect histamine‐induced erectile responses.

ConclusionThese results indicate that histamine may play a role in human penile erection. The erection‐promoting action of histamine is probably due to H2receptor activation, although another histamine receptor, possibly H3, also seems to be involved. This study suggests that histamine could be a valuable tool in the diagnosis of erectile dysfunction.
Clinical and anatomopathological study of 2000 cryptorchid testes
Authors: Gracia J. , González N. , Gómez M.E. , Plaza L. , Sáanchez J. , Alba J.
Published: November 2008

Objective To establish whether age at the time of surgery and location of the testes help to determine the anatomopathological lesions.

Patients and methods Between 1972 and 1992 surgery was performed on 2000 testes in 1342 children, 658 of whom had bilateral cryptorchidism. The clinical, surgical and anatomopathological records were reviewed.

Results Parametric and non‐parametric tests failed to reveal any relation between the tubular fertility index or tubular diameter and the time of surgery or testicu‐lar location.

Conclusion We cannot recommend a particular age at which surgery should be performed, in relation to the anatomopathological damage.
Congenital testicular maldescent: significance of the complete hernial sac
Authors: Donnell S.C. , Rickwood A.M.K. , Jee L.D. , Jackson M.
Published: November 2008

Objective To test the hypothesis that testicular maldescent is rarely congenital in the absence of a complete hernial sac.

Patients and methods The study comprised 110 boys undergoing orchidopexy. Operative findings (complete hernial sac versus no hernial sac) were compared with recorded testicular descent at birth.

Results Among 70 testes recorded as maldescended neonatally there was no example without a complete hernial sac at orchidopexy. Among 60 recorded as descended neonatally, 43 had no sac at orchidopexy.

Conclusions The findings are consistent with the hypothesis, though not with the proposition, that the presence of a complete hernial sac at orchidopexy constitutes proof of congenital testicular maldescent.
Early catheter removal: a prospective study of 100 consecutive patients undergoing transurethral resection of the prostate
Authors: Dodds L. , Lawson P.S. , Crosthwaite A.H. , Wells G.R.
Published: November 2008

Objective To determine whether early catheter removal after transurethral resection of the prostate (TURP) leads to early hospital discharge with no increase in complications.

Patients and methods From October 1992 50 consecutive patients undergoing TURP in each of two hospitals were catheterized for <24 h or > 36‐48 h after the operation. Patients were followed up to assess the frequency and extent of post‐operative complications.

Results The two groups, which were standardized as far as possible, had a similar outcome whether the catheter was removed within 24 h or >36 h after TURP.

Conclusion Brief catheter drainage after TURP is safe and allows an earlier discharge from hospital than the standard duration of catheterization.
High failure rate associated with long‐term follow‐up of neoadjuvant androgen deprivation followed by radical prostatectomy for stage C prostatic cancer
Authors: Cher M.L. , Shinohara K. , Breslin S. , Vapnek J. , Carroll P.R.
Published: November 2008

Objective To evaluate whether neoadjuvant androgen deprivation before radical prostatectomy decreases tumour stage in patients with stage C prostatic cancer and to estimate the efficacy of cancer control achieved with this form of treatment.

Patients and methods Thirty men (mean age 65 years, range 52‐74) with clinical stage C adenocarcinoma of the prostate were included in a phase II trial of neoadjuvant androgen deprivation (luteinizing hormone‐releasing hormone agonist and an anti‐androgen) before radical prostatectomy. The timing and extent of the changes in serum prostate specific antigen (PSA) levels and both prostate and cancer volume were recorded. Twenty‐six men underwent radical prostatectomy with pelvic lymphadenectomy, two had pelvic lymphadenectomy alone, one had pelvic lymphadenectomy with radiotherapy and one refused additional treatment despite significant reductions in tumour volume and PSA while undergoing androgen deprivation.

Results The toxicity of the treatment was low. Significant reductions in prostatic volume (mean 35%), tumour volume (mean 50%) and PSA concentrations (mean 96%) occurred in all patients, with the maximum reductions recorded during the first 2 months of androgen deprivation. However, despite significant physiological changes in prostate and tumour volume, tumour stage was reduced in only four patients. Of the patients who were surgically staged 41% were ultimately identified as having more advanced disease, including lymph node metastases in 21%. Overall, with a mean follow‐up of 32.7 months, 72% of patients had evidence of disease recurrence, including detectable PSA. Of 26 patients who underwent radical prostatectomy, local recurrence occurred in five (19%), distant recurrence in one (4%) and both local and distant recurrence in one (4%).

Conclusions This study suggests that tumour stage reduction is uncommon in patients with stage C prostatic cancer treated with neoadjuvant androgen deprivation followed by radical prostatectomy, Furthermore, local and distant recurrences, as well as detectable levels of PSA, are common after such treatment.
Bladder transection revisited
Authors: Crooks J.E. , Khan A.B. , Meddings R.N. , Abel B.J.
Published: November 2008

Objective To ascertain the safety and effectiveness of bladder transection for the treatment of enuresis and urinary frequency.

Patients and methods Twelve patients who had an open bladder transection performed at the Victoria Infirmary, Glasgow, were followed up for a mean of 37 months.

Results Of the 12 patients, three were ‘cured’, seven were better, two were no better and none were worse than before the operation. All six patients with pre‐operative enuresis were cured of this by the procedure.

Conclusions Bladder transection remains a useful procedure in selected patients and avoids the problems associated with enterocystoplasty.
Electrolyte homeostasis in urothelial neoplasia: the effects of amiloride
Authors: Cartman M.L. , Morris J.A. , Huddart H. , Staff W.G.
Published: November 2008

Objective To investigate the effect of amiloride pre‐incubation on the intracellular electrolyte levels in neoplastic and non‐neoplastic urothelium.

Materials and methods Samples of papillary transitional cell carcinomas (grades 1 and 2) and non‐neoplastic human urothelium were either frozen immediately or after pre‐incubation with Krebs saline alone or with Krebs saline containing amiloride. The frozen samples were planed in a cryo‐ultramicrotome and then examined by low temperature scanning electron microscopy. Intracellular electrolyte levels were measured using X‐ray microanalysis.

Results In the cells frozen immediately the ratios K+/Na+, K+/P and K+/Cl‐ were significantly increased in neoplastic compared with non‐neoplastic urothelial cells (P<0.001). This difference was also found in the cells pre‐incubated with Krebs saline alone but was not present in the cells pre‐incubated with amiloride.

Conclusions These results were consistent with the concept that activation of the amiloride‐sensitive Na+/H + membrane exchanger is a primary event in neoplasia.
Is follow‐up necessary after transurethral resection of the prostate?
Authors: Perkins J.M.T. , O'Brien T.S. , Hanbury D.C. , Cranston D.W.
Published: November 2008

Objective To assess the necessity for routine out‐patient review following transurethral resection of the prostate (TURP) for benign prostatic hypertrophy.

Patients and methods One‐hundred and two patients with histologically proven benign prostatic hypertrophy were prospectively reviewed as out‐patients. The views of their general practitioners were established by postal questionnaire.

Results At their first out‐patient review 94 of 102 (92%) patients were discharged and only 2% (2/102) patients remained under review after 1 year. Apart from routine urine analysis, only four additional investigations were initiated at the routine clinical assessment. One patient was listed to undergo prostatic surgery again following the post‐operative out‐patient review. Over the next 16 months only three patients (3%) were re‐referred with further urological problems. Confidence in a system without routine hospital outpatient review was expressed by 90% of general practitioners and 78% of patients.

Conclusion Follow‐up after TURP cannot be justified in terms of the perceived therapeutic benefit to patients. Patients should be discharged to the community and be assessed rapidly in out‐patients if and when problems arise.
Prognostic value of prostate‐specific antigen minimum after orchidectomy in patients with stage C and D prostatic carcinoma
Authors: RIEDL C.R. , HUEBNER W.A. , MOSSIG H. , OGRIS E. , PFLUEGER H.
Published: November 2008

Objective To determine the significance of the minima of prostate‐specific antigen (PSA) levels after orchidectomy in patients with advanced carcinoma of the prostate (stage C and D disease), to thereby discriminate patients who have a statistically significant difference in prognosis and thus individualize their adjuvant treatment.

Patients and methods A retrospective analysis of 50 patients (mean age 75.8 years) with extracapsular prostate cancer (58% stage C, 42% stage D disease) was performed. PSA measurement and clinical assessment were continued at 3‐monthly intervals until there was evidence of clinical progression. The minimum values of PSA were determined, the patients grouped at intervals of 1 ng/mL and the groups compared statistically on the basis of disease progression.

Results Serum PSA levels decreased in all patients to a minimum after 3–6 months. There was a statistically significant difference in the probability of, and time to, disease progression for PSA minima at 1 ng/mL and 10 ng/mL. Of the 13 patients in group 1 (with PSA minima < 1 ng/mL), 11 stayed in remission during a mean follow‐up duration of 45.9 months. Of 25 patients in group 2 (with PSA minima between 1 and 10 ng/mL) 19 developed progression after a mean remission period of 16.7 months, while all 12 patients in group 3 (with PSA minima > 10 ng/mL) progressed after a mean remission period of 12.5 months.

Conclusion Post‐orchidectomy PSA minima are an excellent prognostic factor with significant predictive value. While patients in group 1 tend to have a favourable prognosis after orchidectomy alone, group 2 and 3 patients need adjuvant treatment as early as possible. Group 3 patients, with their high probability of early progression, also form a uniform cohort for studies concerning new therapeutic modalities. If the PSA minimum was included in further examinations, the results of treatment should improve.
The blocking urinary catheter: the role of variation in urine flow
Authors: BURR R.G. , NUSEIBEH I.
Published: November 2008

Objectives To relate blockage of the urinary catheter to urine chemistry.

Patients and methods Of 44 patients (age range 19–72 years) with an indwelling urinary catheter, 21 were troubled by frequent blockage and 23 experienced no blockage. Variation in urinary pH and calcium concentration were determined during a 24 h period and related to the occurrence of blockage using discriminant analysis.

Results The maximum pH and calcium concentrations observed, or the maximum discriminant factors calculated, correctly discriminated 91% of patients (95% CI, 78–97%).

Conclusion Attention to volume and variability of fluid intake by the patient should have a major impact on the incidence of blockage of the indwelling urinary catheter.
Long‐term histological response to subcutaneously injected Polytef and Bioplastique in a rat model
Authors: DEWAN P.A. , OWEN A.J. , BYARD R.W.
Published: November 2008

Objective To compare the long‐term carcinogenic effect of Polytef and Bioplastique in the subcutaneous space of the rat.

Materials and methods One hundred Sprague Dawley rats received a subcutaneous injection of one of two particulate plastics; subsequently 48 of those injected with Polytef paste containing polytetrafluoroethylene, 48 injected with silicone containing Bioplastique, and 48 control animals were available for assessment. Animals were killed when they became unwell, developed a tumour, or were 2 years of age. The injection site and all major organs and tumours were examined histologically.

Results One or more tumours were found in 30 Polytef‐injected rats, 34 Bioplastique‐injected animals and 36 of the controls. The majority of the tumours were breast and pituitary adenomas with a similar incidence in each group. No tumours were found at the injection site of the Polytef‐injected animals. Four poorly differentiated sarcomas were found on the back of Bioplastique‐injected rats; three were intimately associated with silicone particles, whereas the fourth was separate from the injection site.

Conclusion This study would suggest that the carcinogenic risk from injectable plastics is low, but further work should be conducted with the larger particles, to ensure that their use in humans is safe.
Transrectal ultrasonography versus digitally guided prostate biopsies in patients with palpable lesions on digital rectal examination
Authors: TÜRKERI L. , TARCAN T. , BIREN T. , KÜLLÜ S. , AKDAS A.
Published: November 2008

Objective To compare the efficacy of digital and ultrasonographic guidance of biopsies when there is a palpable lesion on the prostate.

Patients and methods Forty patients with a palpable nodule confined to a single lobe of the prostate underwent digitally guided biopsies of this lesion or biopsies directed by transrectal ultrasonography (TRUS) and/or systematic biopsies.

Results According to the histopathological examination, 21 patients were found to have prostate carcinoma (PCa) using TRUS‐guided biopsies, whereas digitally guided biopsies revealed PCa in 18 patients but did not detect three cases. In the study group, the prostate of 10 patients had a normal ultrasonographic appearance and two patients had PCa revealed by systematic biopsies.

Conclusion We suggest that in the presence of a palpable lesion in the prostate, regardless of TRUS findings, systematic biopsies are mandatory. Present data indicates that digitally guided biopsies are unnecessary as they do not provide additional information over systematic or TRUS‐guided biopsies.
Micturition habits and incontinence at age 17—reinvestigation of a cohort studied at age 7
Authors: HELLSTRÖM A. , HANSON E. , HANSSON S. , HJÄLMÄS K. , JODAL U.
Published: November 2008

Objective To study the epidemiology of micturition disturbances in teenagers.

Subjects and methods A subsample of 1034 teenagers previously evaluated at age 7 years was reinvestigated 10 years later. A postal questionnaire was used and a response rate of 71% (736) obtained. Those who reported bladder symptoms were contacted by telephone for a detailed history concerning imperative urge, daytime incontinence, emptying difficulties and bedwetting.

Results There was a general decrease in the frequency and intensity of symptoms from 7 to 17 years of age. At age 17 at least one symptom was reported by 5.9% of the girls and 0.9% of the boys. Overall the symptoms were regarded as mild or moderate.

Conclusion At age 17 years, micturition disturbances were reported infrequently and few subjects wanted medical help.
Wilms' tumour and hypertension: incidence and outcome
Authors: STEINBRECHER H. A. , MALONE P.S.J.
Published: November 2008

Objective To determine the incidence and outcome of hypertension associated with Wilms' tumour and to reduce peri‐operative morbidity by appropriate treatment.

Patients and methods The medical and nursing case‐notes of 17 consecutive patients with Wilms' tumour treated over a 5.5 year period (1989–1994) were analysed retrospectively.

Results Ten of 17 patients had hypertension, with a mean blood pressure of 150/103 mmHg (130–220 mmHg systolic and 85–145 mmHg diastolic). There was no significant difference between the hyper‐and normotensive patients in their mode of presentation. Blood pressure was stabilized pre‐ operatively in all the hypertensive patients. Perioperative monitoring in these patients was performed using arterial and central venous pressure lines. No patient had any peri‐operative hyper‐or hypotensive episodes caused by handling the tumour or after nephrectomy. Thirteen patients had a favourable histological diagnosis and all the hypertensive patients were in this group. The blood pressure of all patients returned to normal within 1 month of surgery.

Conclusion Both the recognition of hypertension and appropriate peri‐operative treatment is mandatory for the safe surgical management of this condition.
Multicystic renal dysplasia diagnosed in the antenatal period: a note of caution
Authors: GOUGH D.C.S. , POSTLETHWAITE R.J. , LEWIS M.A. , BRUCE J.
Published: November 2008

Objective To document the urological problems associated with multicystic renal dysplasia (MCRD), to assess the efficacy of radiological methods for following the natural history of MCRD and to review current experience in the light of historical data regarding this condition.

Patients and methods From January 1982 to December 1992 data were obtained prospectively on 62 patients (41 boys and 21 girls, age range 1–11 years) who had a diagnosis of MCRD suspected on antenatal ultrasonography. All patients had the diagnosis confirmed with radioisotope scans and micturating cysto‐grams. Serum creatinine was measured in each patient and repeated clinically as indicated. Follow‐up was from 1 to 11 years, with a clinical review and an annual ultrasonogram. The natural history of these patients was compared with those in other published studies.

Results Of the 62 patients, 12 had associated vesico‐ureteric reflux. Four patients developed impaired renal function during the course of observation and 10 patients required urological surgery for other pathologies. In the patients managed conservatively, 38% underwent no resolution on sequential ultrasonograms during the 2‐year follow‐up, and in four children, where complete resolution of the MCRD had occurred on ultrasonography, significant cellular renal masses were excised at subsequent surgery.

Conclusion Patients with MCRD have significant associated urological malformations and the natural history in such patients is unpredictable. We do not regard MCRD as an entirely benign condition and feel that all patients require appropriate investigation of their urinary tract and long‐term follow‐up where conservative treatment is instituted. From the natural history of these patients, reviewed in conjuction with the literature, we recommend that decisions for management can only be taken with the full informed consent of the parents and that surgical excision is offered as part of that process.
The temporal relationship between the severity of hydroureter and the dynamic changes of obstructed ureters in a rat model
Authors: CHUANG Y.H. , CHUANG W.L. , HUANG S.P. , LIU K.M. , HUANG C.H.
Published: November 2008

Objective To investigate dynamic changes in the obstructed rat ureter and to evaluate the usefulness of the rat model in the study of obstructive uropathy.

Materials and methods Unilateral ligation of the ureter was performed in 26 rats. After ureteric ligation, four to seven rats were killed and examined after 1, 3, 7, 10, and 14 days. The severity of hydroureter and hydronephrosis was assessed by pyelography and the hydroureter‐hydronephrosis index. The middle portion of the ureter was prepared for light and electron microscopic observation. Five rats which received a sham operation were also examined as controls.

Results The severity of hydroureter and hydronephrosis in the ligated ureters progressively increased during the period of obstruction (P < 0.005) and reached a maximum 10–14 days after ligation. Hypertrophy of the smooth muscle layer developed on the third day after ligation and proliferation of submucosal connective tissue occurred on the 10th day after ligation. The changes in smooth muscle and connective tissue layers also progressed consistently during ureteric obstruction (P < 0.001 and < 0.005, respectively). The number and size of granular endoplasmic reticulum and Golgi apparatus in the smooth muscle cells increased after ureteric ligation and then caveolae exocytosis developed. Deposition of collagen fibres between muscle cells became apparent later.

Conclusion The rat model of hydrouropathy demonstrated a clear temporal relationship between the severity of hydroureter and the dynamic changes in the obstructed ureter and could be used as a conventional method for the study of obstructive ureter.
Derivation and application of upper limits for prostate specific antigen in men aged 50–74 years with no clinical evidence of prostatic carcinoma
Authors: DALKIN B.L. , AHMANN F.R. , KOPP J.B. , CATALONA W.J. , RATLIFF T.L. , HUDSON M.A. , RICHIE J.P. , SCARDINO P.T. , FLANIGAN R.C. , DEKERNION J.B. , WATERS W.B. , KAVOUSSI L.R. , MACFARLANE M.T.
Published: November 2008

Objective To derive age‐specific upper limits for prostate specific antigen (PSA) level in men 50–74 years of age with no clinical evidence of prostatic carcinoma, and to test the sensitivity and specificity for cancer detection of these upper limits.

Subjects and methods A total of 6166 men were recruited for a multicentre study of prostate cancer detection and underwent a serum PSA determination and digital rectal examination (DRE). Men considered to be clinically free of prostatic carcinoma were those with a normal DRE and a PSA level ≤ 4.0 ng/mL, and men with an abnormality in either parameter who underwent ultrasonography‐guided prostate biopsy that revealed no evidence of carcinoma. By these criteria, 5469 men had no evidence of prostatic carcinoma. Dividing the population into 5‐year age increments, three statistical methods were assessed to derive upper limits for serum PSA level by age; the mean +2 sd, the 99th percentile, and a 97.5% prediction interval based on linear regression.

Results Newly‐derived upper limits calculated by each method in the 50–54 and the 70–74 age group were 3.9 ng/mL and 7.6 ng/mL (mean + 2 sd), 5.2 ng/mL and 14.0 ng/mL (99th percentile), and 4.7 ng/mL and 8.2 ng/mL (97.5% prediction interval). The sensitivity of the newly‐derived upper limits was tested using receiver operating characteristic curves derived from men with no suspicious findings on DRE and a serum PSA concentration > 4.0 ng/mL. Although the specificity of the test increased with increasing PSA upper limits, no upper limits derived from these three methods yielded adequate sensitivity to detect cancer; sensitivities by age range were from 53 to 94%, using mean + 2 sd, from 25 to 50% with the 99th percentile, and from 47 to 64% with the 97.5% prediction interval.

Conclusion We do not recommend age‐referenced adjustments in upper limits for serum PSA concentration, but recommend that an upper limit of 4.0 ng/mL be used in all men 50–74 years of age.
Antimicrobial prophylaxis for transrectal prostatic biopsy: a prospective randomized trial of cefuroxime versus piperacillin/tazobactam
Authors: BREWSTER S.F. , MACGOWAN A.P. , GINGELL J.C.
Published: November 2008

Objective To compare the clinical and microbiological outcome of a single‐dose administration of cefuroxime or combined piperacillin/tazobactam (PT) after transrectal prostatic core‐biopsy (TPB) in a prospective, randomized, open‐label study.

Patients and methods Of 111 eligible men consecutively undergoing ultrasonographically guided TPB, 56 received 1.5 g cefuroxime and 55 received 4.5 g PT intravenously 20 min before the procedure. The anterior rectal wall was cleaned with an antiseptic swab and four biopsies were taken. Urine and blood cultures were evaluated before the procedure and again after 48 h, and oral temperature and symptoms recorded for 72 h after TPB.

Results A clinically successful outcome (no symptoms to indicate urinary or systemic sepsis or pyrexia ≥37.5°C after TPB) was achieved in 100 of 108 men (92.6%), of whom 51 received cefuroxime and 49 PT. Microbiological success (no bacteriuria >105 organisms/mL, or bacteraemia, after TPB) was observed in 98 of 103 men (95%), of whom 48 received PT and 50 cefuroxime. Bacteriuria was present 48 h after TPB in 5% of the men. One man randomized to receive cefuroxime became bacteraemic (with Escherichia coli) and required hospital admission. Four of the five microbiological failures were caused by organisms sensitive to the administered antimicrobial agent. No anaerobic organisms were cultured. The most common adverse event recorded was transient diarrhoea, reported by 16 men receiving PT and two receiving cefuroxime.

Conclusion With this prophylactic regimen, there was no significant difference in outcome between the groups. Most of the organisms isolated were sensitive to the administered antimicrobial agent. Thus, further reductions in sepsis after TPB may be achieved by the administration of additional oral antimicrobial prophylaxis.
The effect of extracorporeal piezoelectric lithotripsy on the contractility of the human pelvicalyceal system
Authors: HAWKYARD S. J. , PARR N.J. , SMITH G. , MOUSSA S.A. , TOLLEY D.A.
Published: November 2008

Objective To assess the effect of extracorporeal piezoelectric lithotripsy (EPL) on the contractility of the human pelvicalyceal system.

Patients and methods Contractions of the pelvicalyceal system were measured in 12 patients (mean age 55 years) before and after EPL. Pelvicalyceal pressure was measured via a Cope nephrostomy tube which had remainedin situfollowing stone debulking procedures days or weeks earlier. All patients were treated using a Wolf Piezolith 2300 lithotripter.

Results The pelvicalyceal systems of two patients were acontractile before and after treatment. Immediately after treatment, contractions were completely abolished in eight of the remaining 10 systems, and reduced in frequency in the other two. All 10 systems regained contractions 24 h after treatment.

Conclusion Piezoelectric lithotripsy temporarily abolishes upper urinary tract motility.
Eliminating the need for per‐operative frozen section analysis of pelvic lymph nodes during radical prostatectomy
Authors: BANGMA Chr. H. , HOP W.C.J. , SCHRÖDER F.H.
Published: November 2008

Objective To eliminate the need for per‐operative frozen section analysis by using pre‐operative serum prostate‐specific antigen (PSA), clinical stage and Anderson biopsy grade to predict lymph node metastasis.

Patients and methods Between 1988 and 1994, 214 patients underwent bilateral pelvic lymphadenectomy before an intended retropubic radical prostatectomy for clinically confined prostate carcinoma. Preoperative serum PSA, clinical stage and Anderson biopsy grade were analysed to investigate whether they were able to predict the results of per‐operative frozen sections of pelvic lymph nodes.

Results Serum PSA level was the best predictor of a frozen section which was positive for lymph node metastasis, followed by biopsy grade. Clinical T‐category combined with PSA level predicted lymph node status less well than did biopsy grade and had no additional value when combined with biopsy grade and PSA. Pre‐operative serum PSA combined with biopsy grade predicted a negative frozen section result of bilateral pelvic lymphadenectomy with 95% certainty in at least 17% of patients undergoing radical prostatectomy for clinically confined prostate cancer. Frozen section analysis had a false negative rate of 4.7% when compared with histological staging. Therefore, combining those patients with an estimated 95% chance of a negative frozen section with the group of false negatives. 11 in 214 patients (5.1%) would have undergone radical prostatectomy while having micrometastases.

Conclusions Selecting men for whom the per‐operative frozen section analysis could be omitted may save operating time and allow more efficient use of facilities.
Evaluation of testicular volume by three orchidometers compared with ultrasonographic measurements
Authors: SALIM A. AL , MURCHISON P.J.T. , RANA A. , ELTON R.A. , HARGREAVE T.B.
Published: November 2008

Objective To investigate the accuracy of three commonly used orchidometers (Prader, Takihara punched‐ring and Seager) compared with ultrasonography (US) for the measurement of testicular size.

Subjects and methods A prospective, randomized, blinded trial to compare three methods of measuring testicular volume was performed, involving 31 men attending the Fertility Problems Clinic for the assessment of fertility. Testicular size was measured independently by three doctors and compared with estimates obtained independently by US in the Radiology department.

Results The Prader and Takihara punched‐ring orchidometers consistently overestimated testicular size compared with that estimated by US. A substantial proportion of the measurements obtained using the Prader orchidometer were more than twice the value estimated by US.

Conclusions The Prader and Takihara orchidometers were useful in comparing different testicular sizes but the absolute values obtained would probably be overestimated in many clinical situations. The Seager orchidometer, although more difficult to use, agreed best with the US estimates.
Hypospadias repair: the two‐stage alternative
Authors: BRACKA A.
Published: November 2008

One‐stage repairs for hypospadias are attractive in concept and are currently in vogue, but many surgeons remain unhappy with their inherent limitations and drawbacks. Two‐stage repair, reconstructing the new urethra with a full‐thickness skin graft, offers a realistic alternative and the method described here can be applied to almost any degree of deformity, be it a simple primary case or salvage of a multi‐operated and skin‐deficient hypospadias ‘cripple’. From a personal series of over 600 cases the author concludes that a two‐stage operation is an acceptable price to pay for a repair that offers unique versatility, excellent reliability and a sophistication of function and aesthetics thatis hard to achieve with one‐stage methods.
Pelvic floor exercises for children: a method of treating dysfunctional voiding
Authors: WENNERGREN H. , ÖBERG B.
Published: November 2008

Objective To evaluate the clinical effect of a pelvic floor exercise programme developed for children.

Patients and methods Sixteen girls with non‐neurogenic dysfunctional voiding were treated by a physiotherapist, mostly in small groups. The exercises were designed to increase the child's awareness of their pelvic floor musculature and to teach them how to contract and relax these muscles at will. The emphasis on pelvic floor relaxation served to improve the child's voiding pattern.

Results After 1 year, nine girls were cured and seven improved. Another three girls were cured at the 3–4 year follow‐up, giving a total cure rate of 12/16.

Conclusion This non‐invasive method seems to be a useful alternative or complement to other treatments of children with dysfunctional voiding.
The diagnostic accuracy of digital rectal examination, transrectal ultrasonography, prostate‐specific antigen (PSA) and PSA density in prostate carcinoma
Authors: AKDAS A. , TARCAN T. , TÜRKERI L. , ÇEVIK I. , BIREN T. , GÜRMEN N.
Published: November 2008

Objective To evaluate the efficacy of digital rectal examination (DRE), transrectal ultrasonography (TRUS), prostate‐specific antigen (PSA) and PSA density (PSAD) in the diagnosis of prostate cancer (CaP).

Patients and methods Retrospective data were analysed from a selected population of 159 patients (mean age 66.7 years, range 50–83), 56 with histologically diagnosed CaP and 103 with benign prostatic hyperplasia (BPH).

Results Among the four methods, DRE was found to have accuracy, sensitivity and specificity rates of 79.9, 91 and 73.8% respectively. The most common clinical practice, the combination of PSA (> 4 ng/mL), DRE and TRUS, showed a higher accuracy, a similar specificity rate, but a lower sensitivity (84.2, 91.2 and 71.4%, respectively). Rates from the combination of PSAD (> 0.15 ng/mL/cm3) with DRE and TRUS were not significantly different from those obtained using the combination of PSA, DRE and TRUS.

Conclusion PSAD alone or in combination did not improve the diagnostic value of PSA. We cannot claim DRE was the best method for the diagnosis of CaP, because this study group did not represent a true screening population. However, this study revealed that DRE should not be omitted from the physical examination of patients and, despite technological developments, it remains a major tool in the diagnosis of CaP.
Palliation of obstructive nephropathy due to malignancy
Authors: HARRINGTON K.J. , PANDHA H.S. , KELLY S.A. , LAMBERT H.E. , JACKSON J.E. , WAXMAN J.
Published: November 2008

Objective To conduct a prospective study of patients with malignant obstructive uropathy treated actively by percutaneous nephrostomy and J‐J ureteric stents.

Patients and methods Forty‐two patients (27 men, 15 women, median age 62 years, range 29–83) with obstructive nephropathy secondary to malignancy underwent urinary diversion followed, where appropriate, by active treatment of the underlying cancer.

Results The median survival of all patients was 133 (range 7–712) days. Seventeen patients (40%) survived for > 6 months and five (12%) for < 1 month. Patients who had received no prior therapy and for whom further therapeutic options were available were more likely to benefit from urinary diversion. In nine patients (21%) nephrostomy insertion failed to relieve renal failure. In 20 patients (48%) obstructive nephropathy recurred. The procedure was complicated by urinary tract or nephrostomy site infection in 16 patients, by septicaemia in six patients, by percutaneous urine leak in 13 patients and by pelvi‐calyceal perforation in two patients, but not by haemorrhage or death. The median percentage of the patients' remaining life which was spent in hospital was 23.6% (range 2.2–100).

Conclusions Patients likely to benefit from nephrostomy were those for whom there were therapeutic options available for the treatment of their malignancy. Prolonged survival is possible in obstructive nephropathy secondary to malignancy, which should no longer be cited as an absolute contra‐indication to urinary diversion. Patients unlikely to benefit from urinary diversion can also be identified and they should not routinely undergo this intervention.
Interactive effect of central obesity and hypertension on cognitive function in older out‐patients with Type 2 diabetes
Authors: Kim E. , Cho M. H. , Cha K. R. , Park J. S. , Ahn C‐W. , Oh B. H. , Kim C‐H.
Published: November 2008

Aim  Central obesity, hypertension and diabetes mellitus have been related individually to cognitive dysfunction. We aimed to study the interactive effects of these co‐occurring risk factors on cognitive decline, which remain unclear in older patients with diabetes.

Methods  We assessed metabolic profiles and neuropsychological functions in 60 older out‐patients with Type 2 diabetes to examine the associations of central obesity with cognitive functions, while controlling for other confounding factors in these subjects.

Results  Waist circumference was associated with poor performance in digits forward (r2 = 0.11, P = 0.02), choice reaction time (r2 = 0.08, P = 0.04) and cognitive reaction time (r2 = 0.07, P < 0.05) even after adjustment for potential confounders including age, gender, education and HbA1c. There were also significant interactions between central obesity and hypertension with respect to performance of digits forward (P = 0.04) and delayed verbal cued recall (P = 0.03).

Conclusion  Our findings suggest that, in addition to glycaemic control, central obesity and hypertension influence cognitive functions, such as attention and psychomotor speed in older patients with Type 2 diabetes.
ON NETWORK COMPETITION AND THE SOLOW PARADOX: EVIDENCE FROM US BANKS
Authors: MALLICK SUSHANTA K. , HO SHIRLEY J.
Published: November 2008

In this paper we develop a model to examine the effect of information technology (IT) in the banking industry. IT can reduce operational cost and create network externality. Empirical studies, however, have shown inconsistency, the so‐called Solow paradox, which we explain by stressing the heterogeneity in banking services. In a differentiated model, we characterize the conditions to identify these two effects and explain how the two seemingly positive effects turn negative. Using a panel data set of 68 US banks over 1986–2005, our results show that the profitability effect of IT spending is negative, reflecting a negative network competition effect in the banking industry.
How Do Investment Banks Value Initial Public Offerings (IPOs)?
Authors: Deloof Marc , De Maeseneire Wouter , Inghelbrecht Koen
Published: November 2008

Abstract:  We investigate the valuation and the pricing of initial public offerings (IPOs) by investment banks for a unique dataset of 49 IPOs on Euronext Brussels in the 1993–2001 period. We find that for each IPO several valuation methods are used, of which Discounted Free Cash Flow (DFCF) is the most popular. The offer price is mainly based on DFCF valuation, to which a discount is applied. Our results suggest that DDM tends to underestimate value, while DFCF produces unbiased value estimates. When using multiples, investment banks rely mostly on future earnings and cash flows. Multiples based on post‐IPO forecasted earnings and cash flows result in more accurate valuations.
Evaluating the role of mentor for advanced practitioners: an example from community matrons in England
Authors: Girot Elizabeth A. , Rickaby Caroline E.
Published: November 2008

This study evaluates the role of mentor for the new community matron role in England and identifies the implications for others in advanced practice roles. With the introduction of 3000 community matrons in England by March 2008, a national pilot education programme was introduced to prepare them for their role. Given the recent requirement by the UK Nursing and Midwifery Council to introduce support at the advanced level of nursing practice, a purposely developed mentorship module was introduced for those supporting the new community matrons.

A mixed‐method approach to data collection was used. This involved documentary analysis of a range of sources and, during July 2006, a self‐administered postal questionnaire was sent to all community matrons undertaking the pilot education programme (n = 70) with a response rate of 67% (n = 47). Individual telephone interviews were conducted with 17 students, and 6 mentors on the purposely developed mentor module. A focus group interview was undertaken with the education programme development team (n = 5). Quantitative data were analysed using spss and qualitative data analysed using content and thematic analyses.

Despite some initial problems, 96% (n = 45) students had access to a mentor during the programme. Overall, the findings reinforce the value placed on individual support for the role and identify the problems associated when support was absent or unsuccessful. For those who had support, there were different expectations of the mentoring role, variation in the quality of their relationship and the perceived value of education to support the mentors in their role.

The study concludes that supporting pioneers to develop new roles when neither party is clear about its strategic direction, nor fully aware of its impact on service, requires risk taking by both parties, and a genuineness, openness and commitment by both in forging the new pathway.
Benefits of information technology training to National Health Service staff in Wales
Authors: Warm Daniel L. , Thomas Susan E. , Heard Victor R. , Jones Vicky J. , Hawkins‐Brown Tania M.
Published: November 2008

The use of computers in the National Health Service (UK) as a workplace is fundamental to its future. However, there is evidence of a paucity of information technology skills within the workforce and therefore, information technology skill training is essential. The National Health Service in Wales has been using the European Computer Driving Licence qualification to educate its staff in order to cover this skill gap. This paper reports on an evaluation of the perceived benefits to staff, both clinical and non‐clinical, working for the National Health Service in Wales of information technology training through the European Computer Driving Licence qualification. Results show that there is an increase in confidence in terms of tasks undertaken but also towards other general life skills. Additionally, for those respondents with clinical contact, there is a perceived increase both in the time available with and the quality of care, given to patients. As the continued move towards a computer orientated healthcare system occurs, the information technology skills obtained through but not limited to training schemes such as European Computer Driving Licence will become of paramount importance, particularly as the single most important failure for technology‐related projects in healthcare is a lack of readiness.
Impeded drainage stimulates extracellular phenol oxidase activity in riparian peat cores
Authors: Toberman H. , Freeman C. , Artz R. R. E. , Evans C. D. , Fenner N.
Published: November 2008

Peat drainage, a common land‐use practice in Europe, has been associated with habitat degradation and increased particulate and dissolved carbon release. In the UK, peatland drain blockage has been encouraged in recent years as a management practice to preserve peatland habitats and to reduce fluvial carbon loss and municipal water discoloration. Drain blockage has, however, been found to increase drain‐water dissolved organic carbon (DOC) concentrations and coloration in the short term. In order to investigate the contribution of changes in extracellular phenol oxidase activity to the increase in water coloration following peatland drain blockage, cores collected from a riparian peatland in North Wales were incubated under impeded drainage conditions. Impeded drainage resulted in the stimulation of peat extracellular phenol oxidase activity and heightened soluble phenolic concentrations, suggesting that changes in extracellular phenol oxidase activity may be a key driver of increases in DOC and water coloration following peatland drain blockage. An increase in peat pH with impeded drainage was also observed that may have contributed to the heightened soluble phenolic concentrations – directly (through effects on solubility) and/or indirectly as a driver of the elevated extracellular phenol oxidase activity.
A portable device to measure soil erosion/deposition in quarter‐drains
Authors: Kornecki T. S. , Fouss J. L. , Prior S. A.
Published: November 2008

Assessment of soil loss/deposition from quarter‐drains (drainage ditches perpendicular to furrows) at specific locations or determining sediment transport within ditch systems following a rainfall event is difficult and time consuming. Automatic samplers are stationary and usually located at the end of plots to assess total sediment loss from a whole area. However, to quantify changes to cross‐sectional areas at specific points within a ditch system, a portable measuring tool is required. To precisely assess soil erosion along the length of a quarter‐drain, a portable device was designed and tested under typical field conditions. One person can effectively operate the device and because of its low cost, it is ideal for cases where budget constraints exist. The tool can measure depths up to 500 mm and easily be modified for usage with large ditches. The device was successfully employed in the spring and summer of 2003 and 2004 where it was utilized after rainfall events to assess soil erosion/deposition from quarter‐drains on sugarcane fields in southern Louisiana.
Effects of different land use types on infiltration capacity in a catchment in the highlands of Ethiopia
Authors: Yimer F. , Messing I. , Ledin S. , Abdelkadir A.
Published: November 2008

Infiltration capacity is an important variable for understanding and predicting a range of soil processes. This study investigated for different slope positions the effects of forest conversion to cultivation and grazing on soil infiltration capacity. Infiltration capacity was measured in the field in each land use type using a double‐ring infiltrometer. A total of 108 soil samples (3 slope positions × 3 land use types × 4 soil profiles × 3 soil depths) were collected to determine the variables that affect infiltration capacityviz.particle size distribution, organic carbon content, dry bulk density and soil moisture content. The results showed that in the cultivated and grazed land compared with forest, infiltration capacity and soil moisture content were 70 and 45% smaller respectively, and dry bulk density was 13–20% larger. Changes in soil structure caused by surface soil compaction because of tillage and animal trampling coupled with a smaller soil organic carbon content, are likely to be the principal factors causing the decline in infiltration capacity and soil moisture content after conversion of forest to cultivation and grazing.
Soils are back on the global agenda
Authors: Hartemink A. E.
Published: November 2008

In the 1990s and early 2000s, there was widespread pessimism on the status of soil science in most parts of the world. This was mainly due to dwindling research budgets, reduced number of students and the overall perception that soil science and pedology were dead and buried. Renewed interest in agriculture for food, feed and fuel has brought soils back onto the global research agenda. Soil erosion, nutrient depletion and pollution are key issues brought up in many recent reports by UN and other international organizations. The need for up‐to‐date and fine resolution soil information and the revival of soil research is highlighted and prioritized in several studies. There is increased interest in soils in the popular press and media, and soils have entered the policy arena. For the global soil science community, there are challenges ahead and there is a direct need to educate a new generation of soil scientists.