bluuebunny/crossref_metadata_2025_split huggingface dataset:
OBSERVATIONS ON THE FUNCTION OF THE BLADDER NECK AND URETHRA IN THE DOG
Authors: ARDRAN G. M. , COPE V. , ESSENHIGH D. M. , TUCKEY M. 
Published: December 2008

SUMMARYObservations have been made of voiding in 10 dogs in response to direct bladder filling, and intravenous injection of carbachol or bethanechol before and after section of the urethra at the bladder neck.The isolated bladder is seen to be continent, and similar emptying pressures before and after urethral section at the bladder neck indicate that the primary functional sphincter of the bladder is in this region, and the urethra is unnecessary to maintain continence in the normal dog.The effects of carbachol and bethanechol are compared and it was found that in high doses carbachol causes distension of the posterior urethra with retention of urine due apparently to spasm of the external sphincter. When increasing doses of bethanechol were administered, the bladder emptied normally. This difference of action is probably due to the marked nicotinic effect possessed by carbachol.After division of the neck of the bladder both carbachol and bethanechol caused a vigorous detrusor contraction with a large rise in intravesical pressure, and complete urinary retention in five dogs. This observation is believed to be significant and is in accordance with Woodburne's (1960) hypothesis that longitudinal muscle fibres passing through the internal meatus into the urethra are responsible for opening the neck of the bladder.
CRYPTORCHIDISM IN UNIOVULAR TWINS
Authors: FARRINGTON G. H. 
Published: December 2008

SUMMARY

Four pairs of uniovular twins are described, in which one or both members presented with cryptorchidism.
The existing literature is discussed in the light of recent trends in diagnosis and treatment.
A plea is made for the further study of cryptorchidism in twins, especially with regard to fertility in adult life and to assist in the understanding of the aetiology of this condition.

I would like to express my gratitude to the Consultant Staff of St George's Hospital, London, and the United Norwich Hospitals for their permission to investigate and report upon their patients.
AN UNCOMMON ANOMALY OF POSITION OF THE PENIS 1
Authors: II HUGH H. YOUNG , GOODWIN WILLARD E. 
Published: December 2008

SUMMARYAn uncommon anomaly of position of the penis is described. The anatomical features are similar to those associated with exstrophy of the urinary bladder. In this patient the genitourinary system was intact except for the strange position of the penis. The penis pointed upward toward the patient's head and was held in that position by a fibrous band of tissue between the widely separated pubic bones. There was also a spread of the rectus muscles with a ventral hernia between them.The condition was corrected surgically, and the technique is described.Probably the cause of this condition is partial persistence of a cloacal membrane which existed to a lesser degree than in patients who have exstrophy of the urinary bladder with associated epispadias.
THE RENOGRAM AND ITS QUANTITATION
Authors: BROWN N. J. G. , BRITTON K. E. 
Published: December 2008

SUMMARYThe interpretation of the renogram is not straightforward. This is due to the complexity of the kidney and not to any complexity in the technique of renography. The commonly used empirical method of interpretation is discussed. The technique of Computer Assisted Blood Background Subtraction (C.A.B.B.S.) renography is described and a theory of the renogram is presented which leads to a rigorous method of quantitation. The ratio between the efficiencies with which the kidneys take up Hippuran can be obtained. This is equivalent to the ratio of the effective renal plasma flows. It is hoped to quantitate aspects of the mechanism of transport of Hippuran through the kidney in order to assess renal autoregulation and other aspects of nephron function.
PART I RADIOLOGY
Authors: HODSON C. J. , CRAVEN J. D. , LEWIS D. G. , CLARKE R. J. , Ross E. J. 
Published: December 2008

SUMMARYFollowing unilateral ligation and reanastomosis of a ureter in pigs a series of “acute” changes in overall renal size occur which may be of clinical importance.The accompanying “parenchymal” changes (macroscopic) of obstructive atrophy form the basis of a specific radiological picture similar to that found in man, which persists unchanged apart from some subsequent growth after obstruction is removed and which remains definable after a period of complete obstruction lasting only a few days.There is evidence that the intra–renal by–pass is operating towards the end of the second week.The sequence of events is altered in the presence of arterial disease, and partial instead of complete ureteric obstruction.
PART III RENAL ARTERY CHANGES IN EXPERIMENTAL HYDRONEPHROSIS, WITH SPECIAL REFERENCE TO RENAL ARTERY STENOSIS DUE TO FIBRO–MUSCULAR HYPERPLASIA
Authors: MATZ L. R. , HODSON C. J. , CRAVEN J. D. 
Published: December 2008

SUMMARYMain renal and pelvic artery branches of pigs were found to develop ruptures and deficiencies of the internal elastic lamina during experimental hydronephrosis. Arteries supplying the affected kidney were predominantly affected but in some instances the elastic laminae changes were present in the arteries supplying the contralateral kidneys.One obstructed kidney, known to be of normal size before ureteric ligation, was found to have renal artery stenosis due to fibromuscular medial hyperplasia. Evidence is presented that this may be causally related to ureteric obstruction.
Screening for Bacteriuria with a Dip‐stick Test for Urinary Glucose
Authors: MACKINNON A. E. , STRACHAN C. J. L. , SLEIGH J. D. , BURNS M. M. 
Published: December 2008

SummaryUriglox, a dip‐stick screening test for bacteriuria, and Uricult, a dip‐slide method of culture, were compared with semi‐quantitative culture by a standard technique.The dip‐stick test, carried out on 415 specimens of urine from out‐patients and 205 from in‐patients, gave negative results in over 40% of specimens shown to have bacteriuria on culture.The results of the 2 cultural methods were in close agreement.
The Pressure Exerted by the External Sphincter of the Urethra when its Motor Nerve Fibres are Stimulated Electrically
Authors: BRINDLEY G. S. , RUSHTON D. N. , CRAGGS M. D. 
Published: December 2008

SummaryIt is possible, through anal electrodes that we have designed specially for the purpose, to stimulate all the motor fibres of the pudendal nerves and thus cause maximal contractions of the muscles that they innervate. Anal and vaginal devices now in use for treating incontinence do not do this.The force exerted by the anal sphincter under tetanic stimulation of its motor nerve fibres is, during the first few seconds, greater for high than for low frequencies of stimulation. But the sphincter fatigues more at high frequencies, so that if the force is measured between the 3rd and the 10th minute of stimulation it is greater for 12 pulses/sec than for 54 pulses/sec; 24 pulses/sec gives intermediate force. The fatigue is almost complete in 2 minutes.The opening pressure for retrograde flow through the external sphincter of the urethra is roughly 120 mm Hg during prolonged maximal tetanic stimulation at 12 pulses/sec, and roughly 90 mm Hg during prolonged maximal stimulation at 54 pulses/sec.Stimulation through our anal electrodes with shocks large enough to cause maximal contraction of the pelvic floor muscles causes in both sexes, at 12 or 24 pulses/sec, complete inability to expel urine during at least 10 minutes. We give evidence that the inability is due to the contraction of the striated muscles that close the urethra, not to inhibition of detrusor contraction. The stimuli do tend to inhibit detrusor contraction, but this tendency can be overcome with practice.We confirm published observations that total bilateral pudendal block is compatible with continence and with voluntary micturition. Continence is sustained against 110 mm Hg lung pressure. Micturition, though possible, is slowed.
Invasive Potential of Superficial Bladder Cancer: A Study of the Relative Merits of Predictive Parameters
Authors: DAS G. , BUXTON N. J. C. , GLASHAN R. W. 
Published: December 2008

Summary— The indirect immunoperoxidase test to detect urothelial cell surface blood group antigens was performed in an attempt to assess the loss of these antigens as a prognostic predictor. In our technique A, B and O(H) blood group specific monoclonal antibodies were used. It was possible to perform the test satisfactorily on histological material from 55 cases which were superficial on presentation; 15 subsequently became invasive. The loss of surface antigens correlated well with histological grade—44.4% of G1, 87.2% of G2 and 94.1% of G3 tumours were antigen‐negative.The blood group phenotype of 114 patients was studied. In the group that subsequently became invasive, 14 of 26 (54%) were of blood group A phenotype compared with 37 of 88 (42%) in the non‐invasive category.Acetylation studies were performed on 47 cases. In the group that subsequently became invasive, 5 of 10 (50%) had the slow phenotype of the enzyme N‐acetyltransferase compared with 13 of 37 (35%) in the group that remained superficial.
Prophylactic Mezlocillin for Transurethral Prostatectomy
Authors: ALLAN W. R. , KUMAR A. 
Published: December 2008

Summary— In a randomised clinical trial of 100 consecutive patients treated by transurethral prostatectomy, half were given prophylactic intravenous mezlocillin. Blood cultures were obtained, the urine examined and the post‐operative progress of each patient was carefully followed.The results were analysed and a high incidence of bacteraemia and septicaemia was found. Single‐dose prophylactic mezlocillin was highly effective in preventing this complication.The presentation of septicaemia in mild and severe form is described and the aetiology discussed. Probable risk factors are identified and prophylactic and therapeutic measures described.
Further Evidence of Venous Outflow Restriction During Erection
Authors: JUENEMANN K.‐P. , LUO J.‐A. , LUE T. F. , TANAGHO E. A. 
Published: December 2008

Summary— To elucidate the effect of venous outflow restriction during erection, we studied eight dogs during artificial saline perfusion of the penis with and without neurostimulation to induce erection.With the infrarenal aorta clamped temporarily, saline infusion rates of 0.9 and 1.9 ml/min raised the mean intracorporeal pressure to 34 and 42 cm H2O, respectively, before stabilisation or return to baseline. When cavernous nerve stimulation was initiated, the mean intracorporeal pressure rose to 124 and 184 cm H2O (with infusion rates of 0.9 and 1.9 ml/min respectively) to induce full erection.Our results show that venous outflow restriction takes place during erection and that it is necessary not only to induce full erection but also to maintain it. Evaluation of venous competence is therefore essential during the investigation of impotence.
Measurement of Bladder Volume by Real‐time Ultrasound
Authors: KIELY E. A. , HARTNELL G. G. , GIBSON R. N. , WILLIAMS GORDON 
Published: December 2008

Summary— The accuracy of a non‐invasive method of measuring the volume of urine in the bladder using ultrasound was assessed 32 times in 18 patients with benign prostatic hypertrophy. A method originally used with B‐mode scanners was applied to images obtained with a real‐time scanner. Although the mean error of 8% of true volume (range ‐29% to +52%, standard deviation 23%) compared favourably with that of some series, the results were less accurate than those originally reported for this method using a B‐mode scanner.Real‐time ultrasound can provide an approximate measurement of bladder urine volume but is not sufficiently accurate in situations where more precise measurements of changes in residual urine are required.
Urinary symptoms in the community: how bothersome are they?
Authors: JOLLEYS J.V. , DONOVAN J.L. , NANACHAHAL K. , PETERS T. J. , ABRAMS P. 
Published: December 2008

Objectives To measure the level of reported urinary symptoms presumed to be associated with benign prostatic hyperplasia (BPH) among men aged 40 years and over in the community, and to assess how bothersome these symptoms are perceived to be.Subjects and methods All ambulant men aged 40 years and over who were registered in a general practice (703) were invited to attend the health centre to complete a questionnaire containing the Maine prostatectomy scale and the International Continence Society‐BPH questionnaire, and to undergo uroflowmetry.Results The prevalence of symptomatic BPH (as defined by a numerical score ≥11 on the Maine score, a urinary peak flow of<15 ml/s and failure to void ≥ 150 ml on three separate occasions) was 284/1000 for men aged 40 years and over. This prevalence increased from 179/1000 in men aged 40–49 to 500/1000 in men aged 70 years and over. The most commonly reported symptoms were those typically associated with BPH (terminal dribble, hesitancy, intermittency, urgency). The symptoms that caused men the greatest degree of bother were frequency, nocturia and those causing incontinence or social embarassment.Conclusion The high prevalence of urinary symptoms assumed to be related to BPH in men in the community does not necessarily suggest that these men will require treatment. Common symptoms, typically associated with BPH, were tolerated. Further research is required to investigate the natural history of urinary symptoms, the relationships between symptoms and baldder outflow obstruction secondary to BPH, and to determine the most appropriate management for men in the community, raging from ‘watchful waiting’ (monitoring without treatment) to medical or surgical treatment.
Experience with neoadjuvant diethylstilboestrol and radical prostatectomy in patients with locally advanced prostate cancer
Authors: APRIKIAN A. G. , FAIR W. R. , REUTER V. E. , SOGANI P. , HERR H. , RUSSO P. , SHEINFELD J. 
Published: December 2008

Objective To report our experience with neoadjuvant endocrine therapy and radical retropubic prostatectomy (RRP) in patients with locally advanced prostate cancer.Fifty‐five patients with prostatic adenocarcinoma (18 clinical stage B2/3, 27 clinical stage C, and 10 clinical stage DO) were treated with diethylstilboestrol (DES) 3 mg/d (median time 12 weeks, range 5–36) followed by pelvic lymph node dissection and planned RRP. Clinical response was monitored bi‐weekly with serum prostate‐specific antigen (PSA), serum acid phosphatase and digital rectal examination.Results The median pre‐treatment serum PSA was 20.4 ng/ml (range 1.2–620). The median post‐treatment, pre‐operative serum PSA was 0.4 ng/ml. Twenty‐seven (49%), 41 (75%) and 54 (98%) patients had serum PSA levels that were undetectable, <.0 ng/ml and <.0 ng/ml respectively. In 15 patients, transrectal ultrasound measurement of prostatic volume changes was performed, and all demonstrated prostate volume reduction (median reduction 35%, range 18–45). All 55 patients underwent pelvic lymphadenectomy, with 47 (85%) undergoing RRP. Of the eight patients not undergoing RRP, three had negative lymph nodes but prostate resection was not deemed feasible and five had nodal metastases as determined by frozen section analysis. Final pathological stage revealed the following distribution: organ confined tumours, 18 (33%): capsular perforation with negative surgical margins, seminal vesicles and lymph nodes, seven (13%); seminal vesicle and/or margin involvement with negative lymph nodes, 18 (33%): lymph node metastases, 12 (22%). Neither pre‐therapy serum PSA nor serum PSA response was predictive of final pathological stage. With a median follow‐up interval of 26 months (range 12–49), 21 patients (38%) have undetectable serum PSA without adjuvant therapy.Our results indicate that despite clinical evidence suggestive of downstaging, the majority of patients with locally advanced prostatic carcinoma managed with neoadjuvant DES and RRP continue to have pathological evidence of extraprostatic carcinoma.
Prognostic Significance of Potential Frailty Criteria
Authors: Rothman Marc D. , Leo‐Summers Linda , Gill Thomas M. 
Published: December 2008

OBJECTIVES: To determine the independent prognostic effect of seven potential frailty criteria, including five from the Fried phenotype, on several adverse outcomes.DESIGN: Prospective cohort study.SETTING: Greater New Haven, Connecticut.PARTICIPANTS: Seven hundred fifty‐four initially nondisabled, community‐living persons aged 70 and older.MEASUREMENTS: An assessment of seven potential frailty criteria (slow gait speed, low physical activity, weight loss, exhaustion, weakness, cognitive impairment, and depressive symptoms) was completed at baseline and every 18 months for 72 months. Participants were followed with monthly telephone interviews for up to 96 months to determine the occurrence of chronic disability, long‐term nursing home (NH) stays, injurious falls, and death.RESULTS: In analyses adjusted for age, sex, race, education, number of chronic conditions, and the presence of the other potential frailty criteria, three of the five Fried criteria (slow gait speed, low physical activity, and weight loss) were independently associated with chronic disability, long‐term NH stays, and death. Slow gait speed was the strongest predictor of chronic disability (hazard ratio (HR)=2.97, 95% confidence interval (CI)=2.32–3.80) and long‐term NH stay (HR=3.86, 95% CI=2.23–6.67) and was the only significant predictor of injurious falls (HR=2.19, 95% CI=1.33–3.60). Cognitive impairment was also associated with chronic disability (HR=1.82, 95% CI=1.40–2.38), long‐term NH stay (HR=2.64, 95% CI=1.75–3.99), and death (HR=1.54, 95% CI=1.13–2.10), and the magnitude of these associations was comparable with that of weight loss.CONCLUSION: The results of this study provide strong evidence to support the use of slow gait speed, low physical activity, weight loss, and cognitive impairment as key indicators of frailty while raising concerns about the value of self‐reported exhaustion and muscle weakness.
Learning from Small Change: Clerkship and the Labors of Convenience
Authors: Whitelaw Gavin Hamilton 
Published: December 2008

AbstractConvenience stores are atop the list of global retail chains blamed for homogenizing landscapes, deskilling labor, and eroding local cultural difference. Further still, their very ubiquity and “nonplace”‐ness is said to challenge conventional modes of ethnographic inquiry. In the following article, I move beyond such broad assumptions by examining how the convenience store constitutes a meaningful lifeworld and culturally embedded economic institution. Drawing on my training and experiences as a clerk, I explore in particular how impersonal familiarity is constructed and contested within the context of this retail environment.
Contact factor deficiencies and cardiopulmonary bypass surgery: detection of the defect and monitoring of heparin
Authors: Van Veen Joost Jair , Laidlaw Stuart , Swanevelder Justin , Harvey Nicholas , Watson Chris , Kitchen Steve , Makris Mike 
Published: December 2008

AbstractContact factor pathway deficiencies do not cause surgical bleeding but make heparin monitoring by the activated partial thromboplastin time (APTT) and activated clotting time (ACT) unreliable. Heparin monitoring during cardiopulmonary bypass (CPB) surgery in these patients is particularly challenging. Here we describe heparin monitoring during CPB using the chromogenic anti Xa assay in two patients with severe factor XII deficiency (FXII < 0.01 U/mL) and one patient with severe prekallikrein (PK) deficiency (PK < 0.01 U/mL). Anti Xa levels of the three patients during CPB varied between 3.8 and 4.8 U/mL in keeping with a control group (mean anti Xa 4.5 U/mL and ACT > 480 s). There were no bleeding or thrombotic complications. We also found that detection of severe PK deficiency by the APTT in the PK deficient patient was dependent on the reagent used and discuss the sensitivity of different APTT reagents for contact factor deficiencies. We conclude that the sensitivity of APTT methods for contact pathway deficiencies is highly variable and although insensitivity is not a clinical problem in terms of bleeding, it can be a cause of discrepancy between different APTT reagents and the ACT. This can lead to confusion about a possible haemorrhagic tendency and delays in surgery. If these patients need to undergo cardiac surgery requiring high dose heparin treatment, monitoring by chromogenic anti Xa assay is a good alternative.
SOME ISSUES IN THE USE, PERCEPTION, AND CONSTRAINTS OF CHOICE OF ACCOMMODATION OPTIONS FOR THE ELDERLY
Authors: Radford Anthony J. 
Published: December 2008

Choice with respect to relocation for the elderly is rarely simple. Individuals need to be able to make informed choices about relocation whenever they are mentally capable of doing so. When this is not possible it is equally important that the relatives and professionals who decide for them are in a position to make informed decisions. Choice is concerned with ‘notions’ as well as with ‘knowledge’. Successful relocation requires successful adaptation, and the older a person is the longer the process of adaptation and the less the likelihood of it being successful.This paper explores three areas:
The accommodation situation in South Australia today.
The thoughts of the elderly regarding their future accommodation.
Possible directions for future policy.
APPRAISAL OF LONGEVITY AND CONSIDERATION OF A NEW PARAMETER
Authors: Harwood Elsie , Enticknap L. E. 
Published: December 2008

ABSTRACTThe advanced ages and good health of many of the surviving members of the longitudinal study known as “Operation Retirement” prompted the researchers to initiate a study of longevity. One hundred and eleven subjects were interviewed intensively (average age 80) and life‐data and information of psychological concern were collated concerning panel members and their siblings and ancestors. Age at death and causes of death were generally reliably reported from family records, variously reaching back through two or three generations. Methodological problems caused the investigators to seek a new parameter, which they have called the Longevity Quotient (LQ), in some ways analogous to the Age‐Resistance Quotient established in relation to the UQOR retirement recreation guidance tests. For this purpose, a tabulation of life‐expectancy at birth had to be compiled, beyond the earliest birth dates available in the official Australian records. This will be discussed, in the explanation of the formula:Longevity Quotient (LQ) = Age of death/Life Expectancy at birth × 100Since the LQ cannot properly be estimated until death, the method has had to be applied tentatively in respect of panel members, but firmly in a comparison of IQs and LQs of deceased members of the panel.
AGEING POPULATIONS AND SOCIAL CARE: POLICY ISSUES
Authors: Graycar Adam , Harrison Jo 
Published: December 2008

ABSTRACTOfficial policy statements and parliamentary recommendations are re‐emphasizing the importance of community care for elderly people. This paper * examines questions of responsibility in the light both of demographic changes and the associated increases in dependency amongst the elderly in Australia. Definitional questions are raised in relation to the concept of community. The distinction between care in and by the community is probed in relation to evidence concerning the role of women in the provision of care. The responsibilities for provision which exist at the statutory, commercial, voluntary and informal levels are outlined. Actual allocation of fiscal resources to home support services is detailed and policy considerations which arise from this analysis are proposed.