bluuebunny/crossref_metadata_2025_split huggingface dataset:
Superficial transitional cell carcinoma of the ureteral orifice: Higher risk of developing subsequent upper urinary tract tumors
Authors: CHOU ERIC CHIEH‐LUNG , LIN ALEX T , CHEN KUANG‐KUO , CHANG LUKE S 
Published: July 2006

Aim:  Reports specifically addressing transitional cell carcinoma (TCC) of the ureteral orifice are scarce. This paper presents our experiences of such tumors, including the characteristics of the disease and the incidence of subsequent upper urinary tract recurrence.Methods:  This study included 572 new cases of TCC of the urinary bladder diagnosed in our institute during a period of 5 years. Thirty‐one (5.4%) patients had superficial tumors involving ureteral orifices. All 31 patients underwent transurethral resection of the bladder tumors, including the involved ureteral orifices. After the surgery, patients received regular follow up with cystourethroscopy, urine cytology and periodic intravenous pyelography (IVP). Ureterorenoscopy was performed in cases of suspicious IVP or urine cytology findings.Results:  Thirty‐one patients with superficial tumors involving the ureteral orifice were followed up for 5–8 years or until death. The pathological stage was Ta in 16 cases and T1 in 15 cases. Bladder tumor recurrence was noted in three (18.8%) of the pTa patients and in seven (46.7%) of the pT1 patients. Subsequent upper urinary tract tumors developed in four (12.9%) patients between 33 and 67 months (mean: 33.5) after the first transurethral resection. All four cases of upper tract recurrence had pT1 primary bladder tumor, which recurred for 1–3 times (mean 1.8) before upper tract recurrence. None of these patients had ureteral stenting after bladder tumor resection. Three of four patients with upper tract recurrence had single lower ureteral tumor, while the remaining one patient had multiple tumors. Patients with subsequent upper urinary tract tumors underwent nephroureterectomy and bladder cuff excision. One died of the disease; the other three cases were free of the disease after the therapy.Conclusions:  Patients with primary superficial bladder transitional cell carcinoma involving the ureteral orifice have a higher risk of developing subsequent upper urinary tract tumors, particularly for pT1 primary bladder tumors. Frequent and close follow up is recommended.
Transobturatory tension‐free composite sling for urethral support in patients with stress urinary incontinence: Favorable experience after 1 year follow up
Authors: IGNJATOVIC IVAN , VUCKOVIC MAJA , SRZENTIC ZORAN 
Published: July 2006

Objective:  Symptomatic, anatomic and urodynamic results of a composite transobturatory tension‐free sling with an absorbable middle part, in patients with stress urinary incontinence (SUI), were studied.Methods:  A prospective study in 40 women with SUI was performed. Symptoms, urodynamics and anatomical improvements were evaluated separately. Surgery was performed with the transobturatory approach.Results:  All patients had both clinically and urodynamically confirmed SUI. Clinical outcome was favorable in 36/40 (90%) patients, after 1 year. Operation improved the position of the bladder neck (2.8 cm and 1.4 cm below the pubic bone, respectively) and significantly decreased mobility of the bladder neck during abdominal straining (3.3 cm and 1.7 cm, respectively). Both symptoms and quality of life were significantly improved 1 month after the surgery. Postoperative maximum flow was lower than the preoperative one but with borderline significance (25.8 and 23.7 mL/s; P = 0.05). Pressure flow study showed unobstructed voiding both preoperatively and postoperatively. Detrusor pressure at the maximum flow was increased (20, 4 and 22, 8 cmH2O, respectively) but not significantly.Conclusion:  Our results confirmed a high objective cure rate, improvement of symptoms and quality of life, and at the same time, corrected position of the bladder neck and unobstructed voiding.
Mathieu and Barcat repair with a V incision sutured meatoplasty for secondary hypospadias surgery
Authors: HAYASHI YUTARO , KOJIMA YOSHIYUKI , MIZUNO KENTARO , NAKANE AKIHIRO , MARUYAMA TETSUJI , KOHRI KENJIRO 
Published: July 2006

Aim:  Today single‐stage methods are more frequently selected for hypospadias repair than multistaged methods, but complications cannot always be avoided. We employed two kinds of meatal based flip‐flap urethroplasty procedures for those with an unsuccessful primary hypospadias repair.Patients and methods:  From 1997 to 2005, a meatal based flip‐flap urethroplasty was performed as a secondary hypospadias surgery on 17 patients. Basically we attempted the Mathieu repair, but when the wings of the glans were not generously widened and the urethral groove was not sufficiently deep we applied the Barcat procedure. While 11 patients were repaired with the Mathieu technique, six patients underwent the Barcat repair. The V incision sutured meatoplasty was added to obtain a natural ventral slit‐like meatus.Results:  Ten of the 11 patients who underwent the Mathieu repair had a good outcome, but one patient developed a urethrocutaneous fistula. None of the six patients repaired with the Barcat procedure encountered postoperative complications. Cosmetically, a vertical slit was constructed near the normal neomeatus with the Mathieu and V incision sutured (MAVIS) meatoplasty and the Barcat and V incision sutured (BAVIS) meatoplasty.Conclusions:  The Mathieu or the Barcat meatal based flip‐flap urethroplasty procedure is feasible as a salvage surgery for those with relatively short urethral defects and adequate mobile ventral skin if an exact procedure is selected. Excellent cosmetic results could be obtained by adding the technique of V incision sutured meatoplasty.
On the morphology of Acanthostomum spiniceps (Looss, 1896) and A. absconditum (Looss, 1901) (Digenea: Cryptogonimidae: Acanthostominae) with particular reference to the juvenile stage
Authors: Ibraheem Mohammed Hasan 
Published: July 2006

AbstractThe morphology of juvenile and adult stages of Acanthostomum spiniceps and A. absconditum, from bagrid fish of the river Nile in Egypt, was studied with both light and scanning electron microscopy. In early juveniles, circumoral spines are absent and the entire body surface is covered with tegumental spines. Late juveniles show gradual differentiation of the circumoral tegument into a collar of spines associated with a reduction in density of tegumental spines at the posterior extremity of the body. Genital primordia appear when juveniles are about 1.75 mm long. The distributions of tegumental spines on adult A. spiniceps and A. absconditum are similar. Spines are denser on the dorsal and ventral surfaces of the anterior and middle parts of the body and less dense towards the posterior end. The tegumental fold surrounding the ventral sucker of A. absconditum has spines while the fold of A. spiniceps lacks them. The most important morphological features differentiating both species are the number of circumoral spines, body shape, ratio of body length to width, sucker sizes, and the presence or absence of spines on the ventral sucker.
Histological variation along and ultrastructural organization of the epithelium of the ductus epididymidis of the fan‐throated lizard Sitana ponticeriana Cuvier
Authors: Akbarsha Mohammad A. , Kadalmani Balamuthu , Tamilarasan Veeramuthu 
Published: July 2006

AbstractThe epididymis of the fan‐throated lizard Sitana ponticeriana was subjected to light and transmission electron microscopic analysis to find the histological variation along the ductus epididymidis, describe the various cell types in the epithelium and compare the resulting descriptions with what is known for other reptiles and for amniotes. The ductus epididymidis of this lizard is differentiated along its length into four histologically distinct zones, initial segment, caput, corpus and cauda. The first three zones appear to be associated with secretion and absorption/endocytosis whereas the cauda appears to be concerned with absorption/endocytosis and storage. The epithelium consists of six different cell types, principal, narrow, apical, clear, basal and intraepithelial leucocytes as in the mammals. Principal cells, basal cells and intraepithelial leucocytes are present along the entire length. Narrow cells and apical cells are confined to the initial segment whereas clear cells occur in the cauda only. The principal cells from the initial segment to the corpus produce biphasic secretion granules measuring 1–2 µm in diameter. This paper reports on four histologically distinct zones along the length of the ductus epididymidis of the lizard S. ponticeriana and six different cell types in the lining epithelium.
Semicystic spermatogenesis and biflagellate spermatozoon ultrastructure in the Nile electric catfish Malapterurus electricus (Teleostei: Siluriformes: Malapteruridae)
Authors: Shahin Adel A. Basyouny 
Published: July 2006

AbstractSpermatogenesis and spermatozoon ultrastructure in the Nile electric catfish Malapterurus electricus are described using scanning and transmission electron microscopy. Although the testis organization conforms to the ‘unrestricted’ spermatogonial type, the species has a rare type of spermatogenesis not previously described among catfishes, ‘semicystic’, in which the cyst ruptures before the spermatozoon stage. Spermiogenesis also involves some peculiar features such as condensation of the chromatin in the posterior part of the nucleus to form a compact electron‐dense mass with some irregular electron‐lucent lacunae, while the uppermost part of the nucleus is a loose electron‐lucent area, absence of the nuclear rotation and, as a consequence, the centriolar complex and the initial segment of each flagellum arise directly in a position perpendicular to the basal pole of the nucleus, and occurrence of numerous vesicles in the midpiece. In addition, spermiogenesis includes migration of the diplosome and mitochondria to the basal pole of the nucleus, formation of two moderate nuclear fossae, each of which contains the centriolar complex, development of two independent flagella and elimination of the excess cytoplasm. The mature spermatozoon has a more or less round head with no acrosome or acrosomal vesicle, a long midpiece with numerous mitochondria and vesicles and two long tails or flagella having the classical axoneme structure of 9 + 2 microtubular doublet pattern and with no lateral fins and membranous compartment. These findings suggest that the ultrastructural features of spermiogenesis and spermatozoa of M. electricus are synapomorphies of types I and II spermiogenesis and spermiogenesis is closely similar to the type described in the Nile catfish Chrysichthys auratus.
Comparative morphology of mandibular structures in lycid larvae and its phylogenetic implications (Polyphaga, Hexapoda)
Authors: Kazantsev Sergey V. 
Published: July 2006

AbstractThe morphology of the larval mandibular structures of the family Lycidae (Polyphaga) is characterized by facultative dicondyly, posterior articulation with long mandibular rods, lateral location of the anterior condyle and its articulation with a paired non‐cranial structure. It is compared to that of Eucrustacea, Chilopoda, Entognatha, Microcoryphia and Zygentoma and found to be more reminiscent of the Entognatha. The phylogenetic implications of this conclusion are discussed, with the Pterygota and Dicondylia hypothesized to be non‐monophyletic.
Penicillamine administration reverses the inhibitory effect of hyperhomocysteinaemia on endothelium‐dependent relaxation in the corpus cavernosum in the rabbit
Authors: KOUPPARIS ANTHONY J. , JEREMY JAMIE , ANGELINI GIANNI , PERSAD RAJ , SHUKLA NILIMA 
Published: July 2006

OBJECTIVETo elucidate the role of copper in mediating the impact of homocysteine on vasculogenic erectile dysfunction (VED), by investigating the effect of dietary supplementation with the copper‐chelator penicillamine to rabbits rendered hyperhomocysteinaemic (HHC) with a methionine‐rich diet, as a raised plasma level of homocysteine might be a risk factor for VED.MATERIALS AND METHODSHomocysteine inhibits the nitric oxide (NO)‐dependent relaxation of the corpus cavernosum (CC), an effect which appears to be mediated via the generation of superoxide (O2·‐), and H2O2. Copper is a catalyst for the generation of H2O2 in the presence of homocysteine and in the presence of copper, H2O2 undergoes reactions resulting in the generation of O2·‐, which reacts with NO to produce peroxynitrite (ONOO‐), thereby reducing the bioavailability of NO and impairing NO‐mediated relaxation of CC. Smooth muscle strips from CC were obtained from two groups of adult New Zealand White rabbits, one rendered HHC with a diet supplemented with methionine (group 1) and another HHC group that had additional dietary supplementation with penicillamine (group 2). Tissue O2·‐ levels were measured in each group. After pre‐contraction with phenylephrine, relaxation responses of CC strips to carbachol were also assessed in both groups.RESULTSMethionine supplementation led to profound HHC in all rabbits. Penicillamine in group 2 reduced the total plasma Cu2+ compared to group 1. There was a markedly lower carbachol‐stimulated relaxation of CC from HHC rabbits in group 1, with a mean (sem) maximum relaxation of 37 (4)% (six samples), than in group 2, at 58 (6)%.CONCLUSIONThese data show that elevated levels in vivo of homocysteine in the rabbit markedly impair NO‐dependent relaxation of the CC. Furthermore, this effect appears to be augmented by copper. Further clinical studies on homocysteine and copper status in patients with VED are warranted.
Perineal lipoma in association with scrotal anomalies in children
Authors: PARK KWAN H. , HONG JEONG H. 
Published: July 2006

Authors from Korea present five children with perineal lipoma in association with a variety of scrotal anomalies. They speculate that the development of perineal lipomas is closely related to scrotal anomalies, and speculate as to the reason why.OBJECTIVETo analyse the characteristics of the perineal lipoma and speculate on its development, as an associated perineal lipoma is implicated in the occurrence of scrotal anomalies in children.PATIENTS AND METHODSFive children with a perineal lipoma in association with various scrotal anomalies were included in the study. We analysed the types of scrotal anomalies and their anatomical relationship with the perineal lipomas.RESULTSOne child had a supra‐inguinal ectopic scrotum, and the others had penoscrotal transposition, either symmetrical or asymmetrical; they included two who had an accessory scrotum combined with a perineal lipoma. The perineal lipoma was on the ipsilateral side of the upward‐positioned hemiscrotum in the ectopic scrotum or the asymmetrical penoscrotal transposition, or it was on the mid‐perineum in the symmetrical penoscrotal transposition.CONCLUSIONSThe perineal lipoma can be found combined with various scrotal anomalies, including ectopic scrotum as well as an accessory scrotum or penoscrotal transposition; this is the first report describing a perineal lipoma associated with an ectopic scrotum. We speculate that the development of the perineal lipoma is closely related to scrotal anomalies, which result from early division and/or abnormal migration of the labioscrotal swelling. The concomitant perineal lipoma might be formed during the process, and might affect abnormal scrotal development.
The proximal neurovascular plate and the tri‐zonal neural architecture around the prostate gland: importance in the athermal robotic technique of nerve‐sparing prostatectomy
Authors: TEWARI ASHUTOSH , TAKENAKA ATSUSHI , MTUI ESTOMIH , HORNINGER WOLFGANG , PESCHEL REINHARD , BARTSCH GEORG , VAUGHAN E. DARRACOTT 
Published: July 2006

OBJECTIVETo review the neural architecture around the prostate gland, as it is relevant for nerve‐sparing robotic prostatectomy, including in particular the anatomy of the proximal neurovascular tissue, the neurovascular bundle (NVB), and accessory neural pathways (ANPs).MATERIAL AND METHODSThe aims of this study were achieved in collaboration between the Cornell Institute of Robotic Surgery, New York, NY, USA and the Institute of Urology at the University of Innsbruck, Austria. The broad steps were: (i) anatomical studies of 10 fresh and two fixed male cadavers; and (ii) collection of videotape and still image data from 200 men undergoing radical prostatectomy by the athermal robotic technique at the Cornell Institute.RESULTSFrom a surgical standpoint there was a tri‐zonal neural architecture including the proximal neurovascular plate (PNP), the predominant NVB (PNB) and ANPs. The PNP was a mean (range) of 5 (3–10) mm lateral to the seminal vesicles, was 3 (2–7) mm thick, 7 (5–25) mm wide and 9 (4–30) mm long. It was within 6 (4–15) mm of the bladder neck, 5 (2–7) mm of the endopelvic fascia and overlapped 5 (0–7) mm of the proximal prostate. The PNB varied in shape and size from the proximal to distal end, was thickest at the base and most variable near the apex. In eight of 12 cases, there was a medial extension behind the prostate, which converged medially at the apex in four cases. ANPs were noted within the layers of levator fascia and/or lateral pelvic fascia on the anterolateral aspect in five cases and in three on the posterior aspect of the prostate. In nine cadavers, the proximal third of the prostate was covered by the PNP where these ANPs were most prominent. The ANPs formed a plexus on the posterolateral aspect of the apex in four cases.CONCLUSIONWe have created an anatomical map of neurovascular tissue relevant to robotic prostatectomy. A tri‐zonal neural architecture is described which has helped in standardizing the steps of robotic prostatectomy.
Management of renal cell carcinoma with vena cava and atrial thrombus: minimal access vs median sternotomy with circulatory arrest
Authors: WOTKOWICZ CHAD , LIBERTINO JOHN A. , SORCINI ANDREA , MOURTZINOS ARTHUR 
Published: July 2006

The topics covered in this section include renal, prostate, bladder and testicular cancer. As can be seen, these contributions come from all over the world and are of interest for several reasons. For example, the first paper, from the USA, describes the management of RCC with vena caval and atrial extension, using minimal access as against median sternotomy with circulatory arrest. Other more unusual subjects include RCC of native kidneys in renal‐transplant recipients and radical prostatectomy in patients with HIV.OBJECTIVETo review our experience with approaches for managing renal cell carcinoma (RCC) with venous thrombi extension at and above the level of the hepatic veins, comparing surgery and peri‐operative outcomes in patients with cardiopulmonary bypass (CPB) with deep hypothermic cardiac arrest (DHCA) either by minimal access (MA) or traditional median sternotomy (TMS).PATIENTS AND METHODSFrom 1986 to 2005, 50 radical nephrectomies with inferior vena cava (IVC) thrombectomies were performed at our institution using TMS (22 patients) and MA (28) techniques. Patient demographics were compared using Student’s t‐, Fisher’s exact and Pearson chi‐square tests. The duration of surgery, CPB, DHCA, mechanical ventilation, length of stay, and peri‐operative transfusion requirements, were compared using the Mann–Whitney U‐test. Estimates of survival were constructed using Kaplan–Meier curves and analysed with the log‐rank test. Subgroups were analysed excluding TMS patients undergoing concurrent coronary revascularization.RESULTSThere were no significant differences in patient demographics or comorbidities between the MA and TMS group. There were significant decreases in the MA vs the TMS group (P < 0.05) in the duration of surgery, mechanical ventilation, length of stay and peri‐operative transfusion requirements. When patients with coronary revascularization were excluded, the MA group had significant decreases (P < 0.05) in duration of surgery, hospital stay and transfusion requirements. Peri‐operative mortality was not statistically different between the TMS (14%) and MA (4%) patients. Overall and organ system‐specific complications also were not statistically different. The overall median survival in the TMS and MA groups was 0.62 and 2.84 years, respectively (P = 0.06, hazard ratio 2.02; 95% confidence interval, CI, 0.97–4.72). Patients with tumour thrombus extending into the right atrium had a median survival of 1.02 years, vs 2.84 years with no intracardiac extension (P = 0.15, hazard ratio 1.82, 95% CI 0.81–4.0).CONCLUSIONSMA surgical techniques in conjunction with DHCA for the treatment of RCC with extensive tumour thrombus provides quicker surgery and a shorter hospital stay. In addition there was less requirement for mechanical ventilation and transfusion than with TMS. Our findings suggest that MA techniques provide significant advantages over TMS.
Efficacy of type‐5 phosphodiesterase inhibitors in the drug treatment of premature ejaculation: a systematic review
Authors: McMAHON CHRIS G. , McMAHON CHELSEA N. , LEOW LIANG JOO , WINESTOCK CHRISTOPHER G 
Published: July 2006

The aim of this section is to produce shortened reviews for the reader, in a variety of subjects. Three of the four fulfil these criteria, covering the subject of imaging in paediatric urology, minimally invasive nephron‐sparing surgery, and the ever‐interesting and controversial subject of men’s health.The first review published in this issue is rather longer than usual and contains more references. It is my intention that occasionally we should publish such longer reviews, particularly as in this case when it is a systematic review of the literature, which would be somewhat difficult to shorten anyway. The question of premature ejaculation is of great general interest and this review investigates the efficacy of type‐5 phosphodiesterase inhibitors in the drug treatment of that condition.ABSTRACTThis review examines the role of nitric oxide (NO) as a neurotransmitter involved in the central and peripheral control of ejaculation, the methods of phosphodiesterase type 5 inhibitor (PDE5I) drug treatment studies for premature ejaculation (PE), the adherence of methods to the contemporary consensus of ideal PE drug trial design, the impact of methods on treatment outcomes and the role of PDE5Is in the treatment of PE. NO/cGMP transduction is involved in both the central and peripheral control of emission, but evidence for a direct central or peripheral effect of PDE5Is on ejaculation is speculative. Thirteen of the 14 studies reviewed failed to fulfil the evidence‐based medicine criteria for ideal PE drug trial design. Limitations of the studies include inadequately defined study populations, the lack of a double‐blind placebo‐controlled study design, and the absence of consistent objective physiological measures or sensitive, validated outcome assessment instruments as study endpoints. The broad range of intravaginal ejaculatory latency time (IELT) fold‐increases reported with PDE5Is, on‐demand selective serotonin re‐uptake inhibitor (SSRI) drugs, and combined PDE5I/on‐demand SSRIs is testament to the unreliability of data and conclusions from methodologically flawed studies. The one study that fulfilled the evidence‐based medicine criteria of an ideal clinical trial design reported that treatment with sildenafil failed to significantly increase baseline IELT, supporting our conclusion that there is no convincing evidence to support any role for PDE5Is in the treatment of men with lifelong PE and normal erectile function. However, there is limited evidence to support a potential role for PDE5Is alone or combined with daily or on‐demand SSRIs in the treatment of acquired PE in men with comorbid erectile dysfunction. Further controlled studies adhering to the contemporary consensus of ideal clinical trial design are required to clarify the role of PDE5Is in this subgroup of men with acquired PE.