bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of streptozotocin‐induced diabetes on bladder and erectile (dys)function in the same rat in vivo
Authors: CHRIST GEORGE J. , HSIEH YI , ZHAO WEIXIN , SCHENK GREGORY , VENKATESWARLU KARICHETI , WANG HONG‐ZHAN , TAR MOSES T. , MELMAN ARNOLD 
Published: April 2006

OBJECTIVETo establish the methods, feasibility and utility of evaluating the impact of diabetes on bladder and erectile function in the same rat, as more than half of diabetic patients have bladder dysfunction, and half of diabetic men have erectile dysfunction, but the severity of coincident disease has not been rigorously assessed.MATERIALS AND METHODSIn all, 16 F‐344 rats had diabetes induced by streptozotocin (STZ), and were divided into insulin‐treated (five) and untreated (11), and compared with age‐matched controls (10), all assessed in parallel. All STZ rats were diabetic for 8–11 weeks. Cystometric studies were conducted on all rats, with cavernosometric studies conducted on a subset of rats.RESULTSThere were insulin‐reversible increases in the following cystometric variables; bladder weight, bladder capacity, micturition volume, residual volume, micturition pressure and spontaneous activity (P < 0.05, in all, one‐way analysis of variance, anova). Cavernosometry showed a diabetes‐related, insulin‐reversible decline in the cavernosal nerve‐stimulated intracavernosal pressure (ICP) response at all levels of current stimulation (P < 0.05, in all one‐way anova). Plotting erectile capacity (i.e. ICP) against bladder capacity showed no correlation between the extent of the decline in erectile capacity and the magnitude of the increase in bladder capacity.CONCLUSIONSThese studies extend previous work to indicate that the extent of diabetes‐related bladder and erectile dysfunction can vary in the same rat. As such, these findings highlight the importance of evaluating the impact of diabetes on multiple organ systems in the lower urinary tract. Future studies using this model system should lead to a better understanding of the initiation, development, progression and coincidence of these common diabetic complications.
Fluid shear stress‐induced nitric oxide production in human cavernosal endothelial cells: inhibition by hyperglycaemia
Authors: WESSELLS HUNTER , TEAL THOMAS H. , ENGEL KAREN , SULLIVAN CHRISTOPHER J. , GALLIS BYRON , TRAN KHOA B. , CHITALEY KANCHAN 
Published: April 2006

Associate EditorMichael G. WyllieEditorial BoardIan Eardley, UKJean Fourcroy, USASidney Glina, BrazilJulia Heiman, USAChris McMahon, AustraliaBob Millar, UKAlvaro Morales, CanadaMichael Perelman, USAMarcel Waldinger, NetherlandsOBJECTIVETo investigate whether fluid shear stress (FSS) induces endothelial nitric oxide synthase (eNOS) activity and NO production in isolated human corpus cavernosal endothelial cells (HCCECs), and whether this response is altered during hyperglycaemia in vitro, as haemodynamic signalling during penile erection induces eNOS‐mediated NO production in vivo.MATERIALS AND METHODSECs were cultured from HCC and characterized by the uptake of acetylated low‐density lipoprotein and the expression of von Willebrand factor, VE‐cadherin, CD31 and eNOS. HCCECs were exposed to FSS (1.2 Pa (12 dynes/cm2), 5 min) using a cone‐and‐plate viscometer in the presence or absence of high glucose (30 mm, 48 h). The phosphorylation of ser1177 on eNOS and total eNOS protein expression after FSS was examined by Western blot. NO in the conditioned media was assessed by measuring nitrate and nitrite levels.RESULTSCompared to static conditions, FSS induced a significant increase in the phosphorylation of eNOS on ser1177 in HCCECs, and the release of NO to the conditioned media. Treatment of HCCECs with high glucose levels did not alter the ratio FSS‐induced phosphorylated eNOS/total eNOS, but did result in the down‐regulation of total eNOS and significantly attenuated FSS‐induced NO release.CONCLUSIONThese in vitro data suggest that FSS contributes to eNOS activation and NO release in HCCECs, and supports in vivo reports suggesting a role for haemodynamic signalling in the erectile response. Treatment with high glucose levels prevented FSS‐induced NO release, suggesting a mechanism that may contribute to decreased erectile function associated with diabetes.
The influence of changes in extracellular and intracellular sodium concentration on detrusor contractility
Authors: BESARANI DLER , WU CHANGHAO , FRY CHRISTOPHER H. 
Published: April 2006

OBJECTIVETo determine the role of Na+‐Ca2+ exchange in the regulation of isolated detrusor smooth muscle contractility.MATERIALS AND METHODSIsolated guinea‐pig detrusor strips were used to record isometric tension generated by; (a) electrical‐field stimulation to elicit nerve‐mediated responses; and (b) adding carbachol or superfusing with a high‐K+ solution. The [Na+] gradient between extracellular and intracellular compartments was altered by: (i) reducing superfusate [Na+] in stages from 140.2 to 10.2 mm; (ii) addition of the cardiac glycoside strophanthidin (200 µm).RESULTSReducing extracellular [Na+] reversibly reduced the magnitude of nerve‐mediated contractions but increased the resting tension and magnitude of carbachol‐induced contracture. The mean (sd) [Na+] required for a half‐maximum effect on attenuating contractions, at 85.9 (6.2) mm, and developing contracture, at 59.1 (14.3) mm, were significantly different. The time constants of changes to nerve‐mediated contractions and carbachol contracture were also significantly different, at 147 (5) vs 1207 (386) s, respectively. These differences suggest that separate mechanisms influence nerve‐mediated contraction and contracture in low‐Na+ solutions. Exposure to the cardiac glycoside strophanthidin produced a similar effect to low‐Na+ solutions for carbachol contracture. Low‐Na+ solutions had no significant effect on contractures induced by high extracellular [K+].CONCLUSIONReducing the transmembrane [Na+] difference increases intracellular [Ca2+]. This increase is largely accommodated in intracellular stores, that can be released by exogenous carbachol. The results are consistent with the presence of a functional Na+‐Ca2+ exchanger in the surface membrane. The lack of effect of low‐Na+ solutions on contractures evoked by membrane depolarization is consistent with this conclusion. The reduction of the nerve‐mediated contraction by low‐Na+ solution might result from blockade of the nerve action potential.
Predictive factors of resolution of primary vesico‐ureteric reflux: a multivariate analysis
Authors: SILVA JOSE MARIA P. , DINIZ JOSE SILVERIO S. , LIMA ELEONORA M. , VERGARA RENATA M. , OLIVEIRA EDUARDO A. 
Published: April 2006

The two papers in this section evaluate different diseases in children, but the two subjects are of considerable importance: nocturnal enuresis and VUR.OBJECTIVETo identify independent factors predicting the resolution of primary vesico‐ureteric reflux (VUR) in a cohort of medically managed children.PATIENTS AND METHODSBetween 1977 and 2003, 506 children were diagnosed with VUR and were conservatively managed and prospectively followed. All of the children were maintained on antibiotic prophylaxis. Follow‐up imaging consisted of voiding cysto‐urethrography (VCUG) or a direct isotope cystogram at intervals of 2–3 years. The predictive factors used are based on the patient data at the time of entry in the protocol. The dependent variable was VUR resolution. The criterion for resolution was based on a single negative VCUG or direct isotope cystogram. A survival analysis identified variables significantly associated with VUR resolution. Cox's regression model was applied to identify variables independently associated with the dependent variable.RESULTSAfter adjustment, four variables remained as independent predictors of VUR resolution: nonwhite race, relative risk (95% confidence interval) of 1.5 (1.1–1.9; P = 0.009); mild grade of VUR, 3.3 (2.1–5.3; P < 0.001); absence of renal damage, 3.3 (2.4–4.5; P < 0.001); and absence of dysfunctional voiding, 2.0 (1.4–3.1; P < 0.001). For mild VUR, three variables were significantly associated: male gender, 1.7 (1.1–2.6; P = 0.012); absence of renal damage, 3.4 (1.8–6.4; P < 0.001); and unilateral VUR, 1.6 (1.1–2.3; P = 0.004). For moderate/severe VUR, three variables were significantly associated: nonwhite race, 1.7 (1.1–2.6; P = 0.01); absence of renal damage, 3.0 (2.0–4.4; P < 0.001); and absence of dysfunctional voiding, 2.8 (1.4–5.5; P = 0.004).CONCLUSIONFew factors are amenable to intervention to modify the natural history of VUR. According to our findings, there are only two possible interventions: avoiding renal scars and managing voiding dysfunction.
Efficacy and tolerability of tolterodine extended‐release in men with overactive bladder and urgency urinary incontinence
Authors: ROEHRBORN CLAUS G. , ABRAMS PAUL , ROVNER ERIC S. , KAPLAN STEVEN A. , HERSCHORN SENDER , GUAN ZHONGHONG 
Published: April 2006

A group of authors from the USA evaluated the efficacy and tolerability of tolterodine extended‐release on objective and subjective endpoints in men with an overactive bladder. They found that it significantly reduced incontinent episodes and improved patient perception of treatment benefit in men with an overactive bladderOBJECTIVETo evaluate the efficacy and tolerability of tolterodine extended‐release (ER) on objective and subjective endpoints in men with overactive bladder (OAB) and urgency urinary incontinence (UI).PATIENTS AND METHODSThis was a post hoc analysis of data collected from men with OAB enrolled in a 12‐week, double‐blind, placebo‐controlled trial of tolterodine ER (4 mg once daily; tolterodine ER registration trial) and included men with urinary frequency (≥8 micturitions/24 h) and urgency UI (≥5 episodes/week). UI episodes were assessed using 7‐day bladder diaries. Patient perception of treatment benefit was evaluated after 12 weeks. Adverse events (AEs) were recorded throughout the study.RESULTSIn all, 163 men with OAB (placebo, 86; tolterodine ER, 77; mean age 65 years) were evaluated. Baseline demographics and clinical characteristics were similar for the two treatment groups. Compared with placebo, tolterodine ER significantly reduced weekly UI episodes (median % change, −71% vs − 40%, P < 0.05; mean numeric change, − 11.9 vs −5.9, P = 0.02). Men receiving tolterodine ER had fewer micturitions/24 h, but this was not a significant difference from placebo (median % change, −12% vs − 4%, P = 0.22). Significantly more men treated with tolterodine‐ER (63%) than placebo‐treated men (46%) reported a benefit of treatment after 12 weeks (P = 0.04). The most commonly reported AEs associated with tolterodine‐ER vs placebo were dry mouth (16% vs 7%), constipation (4% vs 9%), dyspepsia (4% vs 1%), dizziness (5% vs 1%), and somnolence (3% vs 1%). One of the men receiving tolterodine ER had symptoms suggestive of urinary retention that led to his withdrawal from the study. None of the men had acute urinary retention requiring catheterization.CONCLUSIONIn men with OAB and urgency UI, tolterodine ER was well tolerated and significantly reduced episodes of urgency UI, and improved patient perception of treatment benefit.
Diagnostic utility of a p63/α‐methyl coenzyme A racemase (p504s) cocktail in ambiguous lesions of the prostate upon needle biopsy
Authors: MOLINIÉ VINCENT , HERVÉ JEAN MARIE , LUGAGNE PIERRE MARIE , LEBRET THIERRY , BOTTO HENRY 
Published: April 2006

OBJECTIVETo investigate the potential utility of a new combined immunostaining technique for diagnosing prostate cancer from histological analysis of needle biopsy specimens.MATERIALS AND METHODSTissue was immunostained with a combination of antibodies against a basal cell marker (p63), and an enzyme commonly overexpressed in prostate cancer (p504s), on 63 small prostate cancer foci (<1 mm) and 109 cases of ambiguous lesions observed in needle biopsies.RESULTSAfter p63/p504s immunostaining, 93% of the ambiguous lesions (102/109) were classified. The final diagnoses retained were: 92 prostate cancers, seven atypical small acinar proliferations suspected of being malignant but undiagnosed, 21 prostatic intraepithelial neoplasia, five atypical adenomatous hyperplasia, and 36 atrophic benign mimickers of cancer.CONCLUSIONSCombining p504s as a positive marker for prostate cancer and p63 as a negative marker might improve diagnostic performance, sensitivity and specificity, and lead to fewer false‐negative results. This simple immunostaining procedure should reduce the percentage of residual ambiguous lesions and the need for additional biopsies.
Flow meter urine testing: a practical proposition in patients attending for urodynamics?
Authors: HASHIM HASHIM , ABRAMS PAUL 
Published: April 2006

OBJECTIVETo find a practical way of detecting urinary tract infection (UTI) before invasive urodynamic testing, as UTIs after urodynamics are well documented, but there are no standard guidelines about when urine should be analysed before urodynamics.PATIENTS AND METHODSBefore urodynamics all patients are asked to provide a free urine flow; the patient is then catheterized to obtain a catheter‐specimen of urine that is tested for infection by a urine dipstick. If the dipstick is found positive for nitrites and/or leukocytes, the test is abandoned and the sample sent for microscopy, culture and sensitivity. In the present study, patients were asked to provide a free urine flow into the flowmeter as usual. Between patients, the flowmeter was washed with soap and water and dried, so that there would be no cross‐contamination between patients’ urine results. Urine was collected as usual and tested using a dipstick, the patient was then catheterized and another dipstick test done on the catheter specimen of urine (CSU), to compare results.RESULTSPairs of urine samples, when positive for nitrite were 100% consistent, and 89% of pairs positive for leukocytes were the same before and after catheterization. The remaining 11% (all women) of the positive leukocyte group had leukocytosis on testing the flowmeter urine but not on the CSU, possibly due to contamination from the vagina.CONCLUSIONTesting urine by dipstick in the sample from the flowmeter is a feasible option, thus saving the patient an inappropriate catheterization, with the risk of bacteraemia during urodynamics, and allowing the flowrate to be measured.
Differences in characteristics of nocturnal enuresis between children and adolescents: a critical appraisal from a large epidemiological study
Authors: YEUNG CHUNG K. , SREEDHAR BIJI , SIHOE JENNIFER D.Y. , SIT FRANCES K.Y. , LAU JOSEPH 
Published: April 2006

OBJECTIVETo evaluate any differences in the characteristics of primary nocturnal enuresis (PNE) between younger enuretic children and adolescents.SUBJECTS AND METHODSIn all, 21 000 questionnaires designed to determine the presence or absence of bed‐wetting, diurnal incontinence, frequency of wetting, systemic illness, and family history, were sent to children aged 5–19 years from 67 kindergartens, primary schools and secondary schools randomly selected by a computer from different areas in Hong Kong. In addition, questions were asked to evaluate when and how the parents became aware that bed‐wetting is a significant medical problem deserving attention in children after the age of 5 years.RESULTSOf the 21 000 questionnaires distributed, 16 512 (78.6%) were completed. Among the respondents, 512 children (302 boys, 210 girls) had PNE; of these, 106 (20.7%) also had daytime incontinence. There was a marked reduction in the overall prevalence of PNE with advancing age. At 5 years old, 16.1% of children had PNE (20.7% boys, 10.8% girls; at age 9 and 19 years, 3.14% and 2.2% of children had PNE, respectively. However, this reduction was significantly more apparent among those with mild enuretic symptoms (wet <3 nights/week) than in those with more frequent bed‐wetting. Furthermore, younger enuretic children behaved very differently from adolescents and older patients. As age increased there was a significant tendency towards more severe enuretic symptoms. At age 5 years, 14.3% of enuretic children wet 7 nights/week, compared with 48.3% at age 19 years (P < 0.001). In addition, significantly more adolescent boys aged >10 years had daytime urinary incontinence than had enuretic children aged ≤ 10 years (32% vs 14.6%, respectively, P < 0.001). Most (89%) parents only became aware that bed‐wetting was a significant medical problem deserving attention through material in the mass media over the past 3–4 years.CONCLUSIONSThe present finding suggesting that PNE spontaneously resolves with increasing age probably applies only to those with mild enuretic symptoms. There are significant differences in characteristics between younger enuretic children and older subjects. As age increases there is an increasing proportion of enuretic patients with more severe bed‐wetting. Enuretic children aged >10 years and adolescents have significantly more daytime urinary symptoms and incontinence. The previously reported low prevalence of PNE in Hong Kong was probably due to parental indifference to the problem.
Laparoscopic radical prostatectomy: minimum 3‐year follow‐up of the first 100 patients in the UK
Authors: EDEN CHRISTOPHER G. , MOON DANIEL A. 
Published: April 2006

OBJECTIVETo present the results of the first 100 patients in the UK treated by laparoscopic radical prostatectomy (LRP) and with at least 3 years of follow‐up, as LRP continues to develop as a minimally invasive alternative to open radical prostatectomy.PATIENTS AND METHODSIn all, 100 patients (mean age 62 years, range 52–72) had a transperitoneal LRP by one surgeon during a 25‐month period from 2000 to 2002. Most (78%) patients had a prostate‐specific antigen level of 4–10 ng/mL, clinical stage T1 disease (62%), and Gleason 6 on biopsy (50%). Sixty‐four patients had unilateral or bilateral nerve preservation and 14 had pelvic lymphadenectomy.RESULTSThe mean operative duration was 245 min, with a 1% conversion rate. Three patients received a blood transfusion and three had major complications, including a rectal injury. The positive margin rate was 16% and correlated with pathological variables. At ≥ 3 years of follow‐up (mean 3.7) the overall survival rate was 99% and the biochemical progression‐free survival was 88% in all patients, at 90% for pT2 and 75% for pT3. Ninety patients used 0–1 pads/day (84% pad‐free) and 60 undergoing nerve preservation retained erectile function.CONCLUSIONThis series includes the first results for LRP with a ≥ 3‐year follow‐up reported from the UK, with oncological control and morbidity comparable to those in previously published open and laparoscopic series. The history of open radical prostatectomy suggests that as the technique of LRP develops and experience with it increases, these results are likely to improve.
What is the optimum dose of type A botulinum toxin for treating neurogenic bladder overactivity?
Authors: RUFFION ALAIN , CAPELLE OLIVIER , PAPAREL PHILIPPE , LERICHE BEATRICE , LERICHE ALBERT , GRISE PHILIPPE 
Published: April 2006

OBJECTIVETo assess the effects of two doses of botulinum toxin A (Dysport®, Ipsen‐Biotech, France; 500 and 1000 Speywood units, SU) injected into the bladder for treating incontinence due to a neurogenic overactive bladder.PATIENTS AND METHODSIn an open‐label, prospective study between October 2002 and May 2004, in two centres, we analysed the effects of successive doses of 500 and 1000 SU of Dysport, endoscopically injected into the detrusor muscle. At each step, patients (26 women and 19 men) were re‐evaluated at 1 month (clinical evaluation and pressure‐flow study). If there was a ‘good’ clinical response (complete absence of urinary leakage) the patient was observed until incontinence recurred; otherwise a further injection was administered at a higher dose.RESULTSThe mean (sd, range) follow‐up was 22 (0.75, 5–31) months; 11 of the 45 patients (24%) did not respond primarily at 1 month for both doses. The analysis of the two curves of survival with no re‐injection of Dysport showed a statistically longer action at 1000 SU (P = 0.016). However, in this group there was one patient with general muscle weakness and asthenia, which could have been related to the injection.CONCLUSIONSThe optimum dose of Dysport for incontinence secondary to a neurogenic overactive bladder is not yet defined; 1000 SU probably has a more prolonged effect than 500 SU but exposes the patient to major complications. Further studies evaluating the clinical effect of 750 SU of Dysport are necessary.
Incidental renal tumours: the frequency of benign lesions and the role of preoperative core biopsy
Authors: VASUDEVAN ARVIND , DAVIES ROBERT J. , SHANNON BEVERLEY A. , COHEN RONALD J. 
Published: April 2006

OBJECTIVETo determine the incidence of benign renal lesions in incidentally discovered small renal tumours, increasingly detected by the widespread use of abdominal imaging, and to evaluate whether preoperative renal core biopsy is effective in identifying benign lesions.MATERIALS AND METHODSIn a retrospective study, renal core biopsies for incidental tumours over a 5‐year period were analysed. The biopsies were correlated with the final pathology of the nephrectomy specimens, or with patient follow‐up if nephrectomy was avoided.RESULTSOf 70 diagnostic core biopsies, a third of cases were considered benign. The sensitivity and specificity for both benign and malignant lesions when compared to definitive pathology was 100% in all cases subjected to nephrectomy. Of the 30 non‐diagnostic biopsies, three were proved to be benign, and 18 likely to be benign. The only complication of renal biopsy was one case of bleeding after biopsy.CONCLUSIONA higher than previously anticipated proportion of incidentally detected small renal masses are benign. Given the high sensitivity and specificity, there is value in taking a core biopsy of small incidental renal lesions, a procedure with a low complication rate (1%). When analysed by a pathologist familiar with renal biopsy, this might avoid radical nephrectomy in many patients.