bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spirit and Incarnation: Toward a Pneumatic Chalcedonianism
Authors: McFarland Ian A. 
Published: March 2014

AbstractThe Holy Spirit has often been used to define an alternative to Chalcedonian Christology that, by replacing the Word with the Spirit as the locus of Christ's divinity, is better able to honor Christ's humanity. Such alternatives not only display a serious misunderstanding of Chalcedon, but also exacerbate the problem they seek to address by accentuating Christ's difference from other human beings. While an orthodox Christology will see the Spirit as present in every one of Jesus' actions, this should be understood as a vindication rather than a rebuttal of Chalcedon.
Holy Spirit and Mediation: Towards a Transformational Pneumatology
Authors: Davies Oliver 
Published: March 2014

AbstractIn modern theology the living connectedness between exalted Son and Spirit of Pentecost in history has been broken, leading to their linearity and to a structure whereby the Spirit seems to ‘take the place’ of the Son. Modern forms of ‘substitutionism’ distort the theological perspective. The ‘non‐reductive physicalism’ of contemporary science can return us to an understanding of Trinity in history, based not on the modern binary of transcendence and immanence but the integrated, transformational hermeneutic of scriptural tradition. This is the critical reorientation of theology to the living Christ, in the Holy Spirit, which corrects the substitutionary structure to a mediatory one.
Ureteroscopy under Local Anaesthesia with and without Intravenous Analgesia
Authors: VÖGELI T.‐A. , MELLIN H.‐E. , HOPF B. , ACKERMANN R. 
Published: March 2014

Summary— In a prospective study of 302 ureteroscopic procedures, 161 were commenced and 133 completed without the use of general or regional anaesthesia. In 15 patients ureteroscopy (URS) was performed with lignocaine jelly in the urethra only, and in 118 with additional intravenous analgesia. Alfentanil, a synthetic morphine derivative, was used for intravenous analgesia.Ureteroscopy was performed prior to extracorporeal shock wave lithotripsy in 46 patients, for stone basketing in 40, for stone fragmentation in 29, for diagnostic purposes in 14 and for cold knife ureterotomy in 4. Ureteric lesions were observed in 9 patients (6.8%) treated under intravenous sedoanalgesia. This percentage is within the range reported in other series of patients treated under general anaesthesia. The findings suggest that URS, when performed without general or regional anaesthesia, does not increase the risk of complications or compromise the results of treatment.
Endourological Treatment of Ureteric Injuries
Authors: CORMIO L. , BATTAGLIA M. , TRAFICANTE A. , SELVAGGI F. P. 
Published: March 2014

Summary— Over the last 8 years, 30 patients with ureteric injuries underwent endoscopic treatment. There were 14 failures, 5 because of blockage or diversion of the catheter in the fistulous gap and 9 because it was impossible to penetrate the stenotic tract. All failures occurred when treatment was attempted more than 3 weeks after the trauma. Sixteen lesions were successfully treated by placing a 6 to 10 F double pigtail catheter in the damaged ureter and leaving it for at least 3 months. Patients were followed up for 24 months. No recurrences were seen and good long‐term results were achieved in all cases.In our experience, endourological treatment can be recommended for recent strictures < 2 cm in length, or for small fistulas in which continuity of the ureteric wall is still partially preserved. Despite the risk of failure, especially following late treatment of an injury, it should be considered a safe and effective procedure that is accepted well by the patients and that avoids the need for open surgery and its possible complications.
How Reliable is a Single Measurement of Urinary Flow in the Diagnosis of Obstruction in Benign Prostatic Hyperplasia?
Authors: MATZKIN H. , VAN DER ZWAAG R. , CHEN Y. , PATTERSON LYNNE A. , BRAF Z. , SOLOWAY M. S. 
Published: March 2014

Summary— Twenty‐six elderly patients with obstructive symptomatology and an initial low peak urinary flow rate (< 15 ml/s) were observed for 6 to 12 months. Repeated assessments were made of flow rates and residual volumes. Within patient variation of the maximal urinary flow was significant; the standard deviation (SD) varied from 0.8 to 5.5 ml/s. The SD varied with the mean peak flow rates and this suggests that the precision of a single determination of a patient's peak flow is inversely related to the peak flow itself. In all, 333 determinations of peak flow were obtained. Only 80% were below 2 SD of the mean Siroky nomogram. Multiple determinations were used to estimate the sensitivity rate for each patient, i.e. the proportion of peak flows that were less than 2 SD below the mean of Siroky's nomogram. The average sensitivity for all of the flow values was 0.813 when applied to voided volumes and increased only slightly to 0.838 when applied to total bladder volume.Given a prevalence of 0.70 of obstruction ascribed to benign prostatic hyperplasia (BPH) among elderly men, the positive predictive value of an abnormally low peak flow was 0.97. A single low peak flow based on assessment of voided volume may serve as an almost sure indication of obstruction. If a patient has a single normal peak flow rate, he still has a 0.31 probability of having evidence of obstruction in his following uroflow determinations. Using total bladder volume does not make a difference in most patients and is not worth the effort and discomfort. The only patients who require accurate residual measurements are those with a normal uroflow but clear‐cut obstructive symptomatology or with borderline peak flow.The results of this study are relevant to everyday clinical practice and to the evaluation of studies on alternatives to surgery in BPH.
Childhood Urethral Injuries: Perspectives on Outcome and Treatment
Authors: BASKIN L. S. , McANINCH J. W. 
Published: March 2014

Summary— To elucidate the history of childhood urethral injuries, we undertook a retrospective review of 19 male patients comprising 2 groups: those requiring surgical intervention in adulthood and those with complete disruption of the posterior urethra requiring acute intervention (cystostomy drainage).Group 1 patients (n = 12) ranged in age from 17 to 63 years, had sustained urethral injury between the ages of 3 to 15 years and underwent initial surgery from 9 to 18 years after injury. In all 12 patients the strictures developed in the bulbar urethra. All now report continence and normal voiding and none is impotent.Group 2 patients (n = 7) ranged in age from 4 to 16 years and underwent delayed primary reconstruction of the urethral rupture defect. Six patients are now continent with a good stream but the seventh has required repeat optical urethrotomy. One patient with erectile capability at the time of injury was rendered impotent and remains so.
Objective evaluation of the outcome of endopyelotomy using Whitaker's test and diuretic renography
Authors: AHLAWAT R. , BASARGE N. 
Published: March 2014

Objectives To assess the role of Whitaker's test (WT) and 99mTc‐diethylene triamine penta‐acetic acid diuretic renography (DRG) in determining objectively the outcome of endopyelotomy, and to rationalize the frequency and timing of such evaluation after endopyelotomy.Patients and methods Thirty‐one patients (age > 15 years) were prospectively evaluated after percutaneous endopyelotomy. WT was performed at 4–6 weeks via the nephrostomy maintained for external drainage, 24 h after removing the splint. DRG was performed at 3, 6 and 12 months, and then annually.Results WT performed 24 h after removing the splint diagnosed pelvic pressures in the unobstructed range (< 15 cmH2O) in 21 of the 24 treated units (87% success); 21 of 24 patients were also evaluated with DRG at 3 months. An intra‐pelvic pressure of > 15 cmH2O was correlated with a pattern of obstruction on DRG in all three units. Despite an unobstructed WT in 18 patients, categorization of DRG drainage showed disparity in six cases. All six renal units had a large pelvic area (> 15.0 cm2 in two and > 20.0 cm2 in four) and/or a poor renal function (separate glomerular filtration rate [GFR] of ≤ 25 ml/min in four of the six units). The drainage pattern on DRG was unevaluable in two renal units as the function was poor (separate GFR < 15 ml/min). During the first year, the drainage pattern on DRG improved in four cases. When followed beyond one year, the drainage pattern deteriorated at 2 years in only one of 14 evaluated renal units with an initial unobstructed WT.Conclusion Using objective methods of evaluation, endopyelotomy was successful in relieving obstruction in 87% of cases. If inaccuracies in the interpretation of DRG, i.e. a large pelvic capacity and poor renal function, are accounted for, the results of WT as early as 24 h after removal of the splint correlated with DRG. Drainage patterns on DRG did not deteriorate during the first year. An early post‐operative evaluation with WT or DRG, as appropriate, is thus sufficient evidence of the success of the procedure. Evaluations repeated during the first year after endopyelotomy may be unnecessary.
Effect of dietary intake on urinary oxalate excretion in calcium renal stone formers
Authors: MASAI M. , ITO H. , KOTAKE T. 
Published: March 2014

Objective To investigate the influence of dietary intake on urinary oxalate excretion in calcium renal‐stone formers.Patients and methods Dietary intake was monitored by using the dietary‐record method in 60 idiopathic stone formers. The patients collected their urine for 24 h at home and their urinary oxalate excretion rate was determined. The relationship between the daily intake of various nutrients and urinary oxalate excretion was examined by both monovariate and multivariate analyses.Results By monovariate analysis, the intake of carbohydrate, total protein and fat were significantly correlated with urinary oxalate excretion, but the intake of calcium and body surface area were not. In addition, the intake of total protein was highly correlated with that of fat. By multivariate analysis, the intake of carbohydrate and fat were significantly related to urinary oxalate excretion, and the intake of calcium was inversely correlated with urinary oxalate excretion, but the intake of total protein showed no significant correlation.Conclusion The intake of carbohydrate and fat was positively and the intake of calcium was inversely correlated with urinary oxalate excretion in stone formers and, taken together, these findings suggested that fat plays an important role in urinary oxalate excretion and that protein has a minimal effect.
A controlled study of intravesical epirubicin with or without alpha2b‐interferon as prophylaxis for recurrent superficial transitional cell carcinoma of the bladder
Authors: RAITANEN M‐P. , LUKKARINEN O. ,   on behalf of Finnish Multicentre Study Group
Published: March 2014

Objectives To evaluate the efficacy of intravesical epirubicin with or without alpha2b‐interferon (alpha2b‐IFN) as a prophylactic treatment for recurrent superficial transitional cell carcinoma (TCC) of the urinary bladder.Patients and methods A total of 81 patients with superficial (stage Ta and T1), well or moderately differentiated (grades 1 and 2) TCC were treated between June 1988 and December 1993. The patients were randomized into three groups: Group 1 was treated by transurethral resection (TUR) alone; Group 2 received 50 mg epirubicin and Group 3 received 50 mg epirubicin combined with 10 MU alpha2b‐IFN, intravesically in 50 mL sterile buffer solution. The instillations were started 1 week after TUR and were performed weekly during the first month and then once a month for one year. The patients were followed for a total of 2 years. Recurrence rate and tumour rate were calculated to assess the behaviour of the disease.Results The patients were followed for a mean of 20 months. Patients receiving intravesical chemoimmunotherapy (Group 3) had the most favourable outcome; they had comparatively lower recurrence and tumour rates, fewer patients with recurrences and, most importantly, the longest disease‐free interval. Side‐effects were mostly mild and transient, and no differences were found among the groups.Conclusions In reducing the number of patients having recurrences and extending the recurrence‐free interval, intravesical chemoimmunotherapy with epirubicin and alpha2b‐IFN had a promising effect on the natural course of superficial bladder cancer, particularly in patients with a history of prior recurrences.
Comparison of relaxation responses of detrusor strips from neuropathic and control patients
Authors: WILLIAMS P. , DATTA S. , GERMAN K. , STEPHENSON T.P. , BEDWANI J.R. 
Published: March 2014

Objectives To confirm the existence of relaxation responses to electrical‐field stimulation in strips of human detrusor, and to compare these responses in strips from control subjects with those in strips from a group of neuropathic patients exhibiting hyper‐reflexia.Patients and methods Detrusor specimens were obtained at operation from a group of control patients, and from a group of patients with neuropathy (mainly spina bifida) and a history of hyper‐reflexia. Muscle strips were prepared from these, mounted in organ baths, and contracted by exposure to a modified Krebs' solution containing 26 mm KCl and atropine. Relaxation responses were induced by an electrical‐field stimulation (50 V, 90 μs pulses at 2–16 Hz for 10 s).Results Of 29 strips, 20 (69%) from control patients showed relaxations, compared with 17 of 28 strips (61 %) from neuropathic patients (P > 0.1). The maximum relaxation response in the control strips was 49 ± 5.6% (mean ± sem) of the maximum relaxation induced by isobutyl methylxanthine, compared with 43 ± 4.8% in the strips from neuropathic patients (P > 0.1). The maximum response occurred at similar frequencies (4 or 8 Hz) in the two groups. The relaxations were reduced by the inhibitor of nitric oxide synthase, N‐nitro L‐arginine methyl ester (0.1 mm, P < 0.05), but were not affected by guanethidine (50 μm) or tetrodotoxin (0.5 μm).Conclusion These results confirm the existence of field stimulation‐induced relaxation in human detrusor, but suggest that hyper‐reflexia in the neuropathic bladder cannot be accounted for by any deficiency in this response.
Urethral sphincter volumes in women with obstructed voiding and abnormal sphincter electromyographic activity
Authors: NOBLE J.G. , DIXON P.J. , RICKARDS D. , FOWLER C.J. 
Published: March 2014

Objective To investigate the role of transrectal ultrasonography (TRUS) of the female urethral sphincter and to compare sphincter volumes in controls and women with obstructed voiding associated with abnormal myotonic‐like electromyographic (EMG) activity in the urethral sphincter.Patients and methods Fourteen women patients (mean age 29 ± 3.2 years) with symptoms of urinary outlet obstruction underwent videocystometrography (VCMG), urethral sphincter EMG and TRUS. Their sphincter volumes were compared with those obtained from 20 age‐matched control patients with other urodynamic diagnoses or normal urodynamics.Results In every patient the urethral sphincter was identified as an ovoid, hypoechoic structure distal to the bladder outlet. The mean volume of the sphincter in those patients with abnormal EMG activity (3.05 ± 0.23 cm3) was significantly greater than that in the control group (1.30 ± 0.09 cm3; P < 0.001).Conclusion TRUS provided a useful method of imaging the urethral sphincter in women. The results suggest that there was an increase in the volume of the urethral sphincter in females with obstructed voiding, providing collateral evidence that the abnormal EMG activity is a significant factor in the pathophysiology of the disorder.
Tethered spinal cord: the effect of neurosurgery on the lower urinary tract and male sexual function
Authors: BOEMERS T.M.L. , VAN GOOL J.D. , DE JONG T.P.V.M. 
Published: March 2014

Objective To determine the effect of neurosurgical untethering on the lower urinary tract and male sexual function, in patients with tethered spinal cord.Patients and methods Thirty‐six children with tethered spinal cord due to neurospinal dysraphism were assessed clinically and urodynamically before and after surgical untethering. Sexual function was evaluated in 14 boys before and after neurosurgery. In young boys, the assessment was by parental observation and was considered normal if erections had been observed regularly, or if the child had mentioned having an erection at any time. Older patients were asked if they had achieved voluntary erections and whether or not they were able to ejaculate.Results The mean follow‐up was 91 months and the mean follow‐up after neurosurgery was 34 months. A lasting improvement of urinary tract function occurred in only one patient, while another became worse. Seven children had temporary changes of bladder/sphincter function; two developed detrusor overactivity with sphincter dyssynergia and five had signs of bladder denervation. Long‐term follow‐up showed no permanent changes of lower urinary tract function in 94% of 34 patients. Sexual function was considered normal in 13 boys. One boy apparently gradually lost erectile ability before untethering and regained it after surgery, while another boy had erectile dysfunction post‐operatively for almost 6 months.Conclusion Changes in bladder‐sphincter function after untethering are usually transient and often the result of partial denervation. Although a small group of children seem to benefit from untethering, others can become worse and the individual outcome cannot be predicted. Erectile dysfunction can occur and parents and patients have to be informed of this possible complication. As pre‐operative progression of neurological symptoms and post‐operative denervation were observed only in patients with myelomeningocele and lipomyelomeningocele, this group may be distinct from patients with occult forms of spinal dysraphism. The natural history in the latter group of patients is unclear and a beneficial effect of prophylactic untethering remains to be proven by controlled prospective studies.
Treating erectile dysfunction with a vacuum tumescence device: a retrospective analysis of acceptance and satisfaction
Authors: BALTACI S. , AYDOS K. , KOSAR A. , ANAFARTA K. 
Published: March 2014

Objectives To evaluate the quality of erections, ability to perform sexual intercourse, incidence of complications and satisfaction of patients using an external vacuum erection device in the treatment of erectile failure.Patients and methods Of the 61 impotent men who participated in this clinical trial, 49 used the device and were surveyed. The mean follow‐up period was 12.8 months. A subjective rating scale from 1 to 10 was used to assess the patients' satisfaction with the device, where 1 indicated ‘dissatisfied’ and 10 indicated ‘very satisfied’.Results The ease of using the device, satisfaction with the quality of erections and ability to perform intercourse were given scores >5 by 88, 84 and 82% of the patients, respectively. Sixteen (33%) of the men withdrew from the trial, primarily because they were unable to achieve and maintain a full erection, or suffered conflicts in their relationship, or for reasons not related to the device. Overall, the effectiveness rate was 67%. Of 32 patients with arteriogenic impotence, 28 (88%) had satisfactory results and had an improvement in their capacity for spontaneous erections with the device. The most frequent adverse effects were blocked ejaculation, bruising or the development of ecchymosis, discomfort during pumping and discomfort from using the constriction bands.Conclusion These results suggest that the vacuum device is an effective and safe treatment for impotence of various aetiologies, especially for those patients with arteriogenic impotence.
Simplified sperm retrieval and intracytoplasmic sperm injection in patients with azoospermia
Authors: TSIRIGOTIS M. , PELEKANOS M. , YAZDANI N. , BOULOS A. , FOSTER C. , CRAFT I.L. 
Published: March 2014

Objective To evaluate the rate of recovery of spermatozoa from the epididymis using a percutaneous aspiration technique and to assess the fertilization rate following intracytoplasmic sperm injection (ICSI).Patients and methods Forty‐two patients with azoospermia underwent a total of 46 treatment cycles of in vitro fertilization (IVF) and ICSI. The sperm used for ICSI was retrieved percutaneously by fine‐needle aspiration and syringe suction (percutaneous epididymal sperm aspiration, PESA) from the epididymis in 28 patients (mean age 34.9 years), over 32 cycles. Six patients underwent microsurgical sperm aspiration (MESA) and in the remaining eight patients, neither percutaneous aspiration nor MESA yielded suitable sperm and spermatozoa extracted from testicular biopsy were used.Results A total of 362 oocytes were collected and of those, 286 (79%) were subjected to ICSI. Of the injected oocytes, 49 (17.2%) were damaged, 138 (48.3%) achieved normal fertilization and, of those, 112 (81.2%) cleaved. A total of 67 embryos were transferred and 18 more were suitable for cryopreservation. Of the 25 cycles with embryo transfer, eight resulted in a pregnancy and of these, one miscarried. The pregnancy rate was 25% per cycle and 32% per embryo transfer. The implantation rate was 12%.Conclusions This extensive series of PESA/ICSI cycles indicates that PESA can be used successfully to retrieve spermatozoa in patients with azoospermia. The technique is simple, cost‐effective and is associated with fewer complications compared to an open microsurgical procedure.
Measuring the fetal kidney with ultrasonography
Authors: SCOTT J.E.S. , WRIGHT B. , WILSON G. , PEARSON I.A. , MATTHEWS J.N. S. , ROSE P.G. 
Published: March 2014

Objectives To establish a normal range of measurements for the external and internal dimensions of the fetal kidney and, if possible, to correlate these measurements with gestational age.Subjects and methods The external and internal dimensions of the fetal kidney were measured in 810 women selected on the grounds of obstetric, fetal or technical risk factors from a consecutive series of 1136 women attending the ante‐natal ultrasonography clinic of a district general hospital. Post‐natal data were obtained from medical records on 1122 newborns. The maximum of pairs of renal measurements was used for analysis. Measurements were cross‐sectional in 347 cases and longitudinal in 463. The total number of measurement episodes was 2294.Results External renal dimension and gestational age were closely related, enabling accurate growth centile charts to be constructed. The correlation between renal pelvic dimension and gestational age was weak. The maximum dimension of the renal pelvis at any gestational age in 92.7% of fetuses was < 5 mm. Using longitudinal measurements, 6.5% of cases with a renal pelvic dimension of < 5 mm at the first scan measured ≥ 5 mm at a subsequent scan, but 53.3% with a dimension of ≥ 5 mm at the first scan also measured ≥ 5 mm at the subsequent scan.Conclusion It is possible to assess the growth and size of the fetal kidney according to gestational age but this does not apply to the renal pelvis. A renal pelvic dimension of > 5 mm at any gestational age is unusual and dilatation beyond this level should prompt a detailed post‐natal urological investigation.