bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal penile and urethral development subsequent to vascular insult in the last trimester of gestation: an experimental study in goat fetuses*
Authors: KIZILCAN F. , KARNAK I. , TANYEL F.C. , CAKAR N. , BUYUKPAMUKCU N. , HICSONMEZ A. 
Published: November 2008

Objective To investigate a possible mechanism (the vascular theory) in the development of congenital anomalies of the penis and urethra in the fetus of the goat.Materials and methods Fifteen male Angora goat fetuses underwent an operation at 110–114 days of gestation whereby branches of the internal pudendal artery within the superficial compartment of the perineum were ligated. Five male fetuses served as controls in which the perineum was explored with no ligation.Results Five treated and three control live offspring were delivered spontaneously. Although no genitourinary anomalies were observed on gross examination, histopathological examination of the penises of treated animals revealed smaller penises with increased fibrosis.Conclusion A defective vascular supply can partly explain the morphogenesis of some aspects of the congenital anomalies of the penis and urethra.
Staging problems in the pre‐operative chemotherapy of Wilms' tumour
Authors: ZOELLER G. , PEKRUN A. , LAKOMEK M. , RINGERT R. H. 
Published: November 2008

Objective To determine the effect of the International Society of Paediatric Oncology (SIOP) Wilms' tumour protocols (pre‐operative chemotherapy based on clinical and radiological findings, with no prior tumour verification by open or needle biopsy) on subsequent intra‐operative tumour diagnosis and staging.Patients and methods The diagnosis and staging of possible Wilms' tumour by clinical, ultrasonographic and radiological assessment were compared with the intra‐operative findings in 14 consecutive children (1–12 years of age) treated between 1989 and 1994.Results A diagnosis of Wilms' tumour was histologically verified in 11 of 14 children. In two children, verification was not possible due to complete necrosis of the tumour following pre‐operative chemotherapy. In a 12‐year‐old boy with an estimated stage IV disease due to a solitary lung metastasis, a renal cell carcinoma was revealed in the nephrectomy specimen while subsequent thoracotomy revealed dysmorphic but not malignant tissue. The estimated tumour stage was correct with regard to localized or metastatic disease in nine of 11 children with histologically confirmed Wilms' tumour, while in two children with an estimated stage II tumour, liver metastases were found intra‐operatively and the tumour was upstaged to IV.Conclusion Exact tumour diagnosis and staging was difficult in these patients. Although the accuracy of tumour staging depends on the sensitivity of radiological and ultrasonographic examinations, difficulties in tumour diagnosis may be overcome by biopsies of the primary tumour. The justification of upstaging a low‐stage I/II tumour to stage III, provoking a more intense post‐operative treatment, should be proven by prospective randomized studies. The decision to perform a primary tumour biopsy would be facilitated if possible subsequent deterioration of outcome could be excluded.
Concepts in the surgical technique of one‐stage hypospadias correction
Authors: JOSEPH V.T. 
Published: November 2008

Objective To report on a single‐stage technique for hypospadias repair based on the combination of several features of established methods and to emphasize the importance of identifying and excising the chordee that is almost always present in the tissues proximal to the urethral opening to ensure the complete correction of this deformity.Patients and methods Over a 3‐year period, 84 boys (age range from 8 months to 14 years) underwent a single‐stage repair of proximal hypospadias. Chordee was corrected by excising fibrotic tissue representing the atretic corpus spongiosum proximal to the urethral opening. The neourethra was constructed using the epithelium distal to the urethral opening and part of the dorsal prepuce.Results Satisfactory results were obtained in 79 patients with a single procedure. Only five patients had fistulae and of these, four were closed successfully during the same hospital stay.Conclusion Proximal hypospadias can be corrected using the single‐stage technique described, with satisfactory results in most cases. Fistulae are uncommon and can be closed by a primary procedure performed in the post‐operative period.
Urodynamic assessment in the laser treatment of benign prostatic enlargement
Authors: TE SLAA E. , DE WILDT M.J.A.M. , ROSIER P.F.W.M. , WIJKSTRA H. , DEBRUYNE F.M.J. , DE LA ROSETTE J.J.M.C.H. 
Published: November 2008

Objective To determine if bladder outlet obstruction can be adequately relieved after laser prostatectomy.Patients and methods Since November 1992, a total of 105 patients underwent laser treatment of the prostate because of complaints related to benign prostatic enlargement (BPE). To date, urodynamic data from a study of pressure flow analysis are available for 79 patients both at baseline and at 6 months after treatment. Patients were evaluated using changes in symptoms (IPSS symptom score), peak flow rate (Qmax), post‐voiding residual volume (PVR), detrusor pressure at maximum flow (Pdst at Qmax), and the linear passive urethral resistance relation (LPURR). Moreover, patients with minimal bladder outlet obstruction were compared to patients with severe bladder outlet obstruction.Results There was a significant improvement in mean IPSS score from 21.3 at baseline to 5.3 at the 6‐month follow‐up. The Qmax improved from 7.9 mL/s to 17.8 mL/s, and the PVR decreased from 91.6 mL to 15.6 mL. At baseline, > 80% of the patients were considered obstructed according to the analysis of pressure flow, whereas 6 months after laser treatment, only 5% of the patients were still considered obstructed. A comparison of the outcome between minimally obstructed patients and severely obstructed patients showed comparable improvements.Conclusion Laser therapy of the prostate was, according to urodynamic parameters, capable of relieving outlet obstruction and minimally obstructed patients also showed a significant relief of outlet obstruction.
Regression to the mean occurs in measuring peak urinary flow
Authors: PRESCOTT R.J. , GARRAWAY W.M. 
Published: November 2008

Objective To investigate the anomalous rises in maximum urinary flow rates seen in a prostate‐diagnostic clinic.Subjects and methods The study comprised 1994 men aged 40–79 years registered at five health centres in Central Scotland, participating in a study of the natural history of benign prostatic hyperplasia (BPH), who completed a urodynamic assessment on up to three occasions: in the community, on referral to a prostate‐diagnostic clinic and at a one‐year follow‐up.Results Subjects referred to the diagnostic clinic on the basis of maximum flow rate (Qmax < 15 mL/s) and/or urinary symptomatology showed a mean increase in Qmax (P < 0.001) when tested at the clinic and at the one‐year follow‐up. In health centres which referred men to the clinic with no pre‐selection, there were no significant changes in Qmax.Conclusion Regression to the mean occurs when patients are selected on the basis of a low Qmax. The use of isolated low values of Qmax in the process of diagnosing BPH should be avoided.
Transrectal and transurethral hyperthermia versus sham treatment in benign prostatic hyperplasia: a double‐blind randomized multicentre clinical trial
Authors: ABBOU C. C. , PAYAN C. , VIENS‐BITKER C. , RICHARD F. , BOCCON‐GIBOD L. , JARDIN A. , BEURTON D. , DUC A. LE , FERMANIAN J. , THIBAULT P. ,   THE FRENCH BPH HYPERTHERMIA GROUP
Published: November 2008

Objective To compare the safety and efficacy of hyperthermia for the treatment of benign prostatic hyperplasia (BPH), by either the transrectal or transurethral approach, relative to sham treatment.Patients and methods. Two hundred patients from seven urological departments were randomized and treated in a single centre. Principal inclusion criteria were a peak iow rate (PFR) <15 mL/s and residual urine < 300 mL/s. Comparisons were made between transurethral hyperthermia (TUH) and transurethral sham (TUS) and between transrectal hyperthermia (TRH) and transrectal sham (TRS) 12 months after treatment. Outcome was assessed by improvements in the Madsen score and PFR, and the incidence of side‐effects.Results After 12 months, 145 patients were evaluated; 12 patients withdrew during treatment, 43 withdrew during follow‐up and two were lost to follow‐up. Withdrawals were mainly due to side‐effects during treatment (17% in the TRH and 1.5% in the TUH group) and to a lack of improvement during follow‐up (14% in the TUH group, 19% in the TUS, 15% in the TRH and 10.5% in the TRS group received other treatments for BPH). Complications during treatment consisted mainly of local pain, urethral bleeding, urethral pain and acute retention, and were five times more frequent in the TRH than the TUH group (34% versus 6%). There was no improvement in PFR after TUH and TRH (response <20%). Only TUH improved the Madsen score (TUH, + 50% and TUS, +17%).Conclusion. Hyperthermia was not an effective treatment for BPH.
Fracture of polyurethane double pigtail stents: an in vivo retrospective and prospective fluoroscopic study
Authors: EL‐SHERIF A. 
Published: November 2008

Objective To study the behaviour of pigtail polyurethane ureteric stents during breathing and change in body habitus and thereby explain some side‐effects of stenting, particularly spontaneous stent fracture.Patients and methods The study comprised retrospective evaluation of records and radiographs of seven patients (five men and two women, mean age 41; SD 10.9 years) who were admitted with fractured polyurethane pigtail stents, and a prospective fluoroscopic study of the behaviour of 14 stents in 12 patients (11 men and one woman; mean age 40; SD 9.3 years) during breathing, spinal flexion, extension and rotation.Results Five of the seven pigtail stents fractured where the stent crossed the lateral edge of psoas muscle, 7–10 cm below the renal coil of the stent. The sixth stent was fractured at its lower third and the seventh fractured just proximal to the stent's bladder coil. The prospective study revealed a 20–80° bend in the upper third of 11 of the 14 stents and a 35° bend in the lower third of two stents. A 1–5 cm craniocaudal movement and a 0–2 cm vertical movement of the stents occurred during breathing and spinal flexion and extension. There were no changes in stent configuration during spinal lateral rotation or at the sacral promontary. The bend in the upper third of the ureter was profound in two stents whose vertical movement was restricted by other conditions.Conclusion As the kidney‐to‐bladder distance shortens during inspiration and spinal flexion, the stent adapts by bending and/or moving. Fracture of the stent may be caused by repeated mechanical stress, particularly across the side‐holes, and by diminution of its tensile strength by depolymerization during long indwelling times. Large polyurethane stents tended to bow, displacing the upper ureter anteriorly, while small, soft stents conformed to the anatomical course of the ureter, suggesting that they should be used after open or endoscopic surgery to the upper two‐thirds of the ureter. Stress on the stent can be minimized by choosing the correct length, particularly where vertical stent movement is limited by other conditions.
Race affects access to nephrectomy but not survival in renal cell carcinoma
Authors: Zini Laurent , Perrotte Paul , Capitanio Umberto , Jeldres Claudio , Duclos Alain , Arjane Philippe , Villers Arnauld , Montorsi Francesco , Patard Jean‐Jacques , Karakiewicz Pierre I. 
Published: November 2008

OBJECTIVESTo assess whether, in contemporary patients with renal cell carcinoma (RCC), access to nephrectomy is the same between the Blacks and Whites, and that there is no difference in mortality after stratification for treatment type.PATIENTS AND METHODSThe effect of race has received little attention in RCC; only two reports have addressed and suggested the presence of racial disparities, including access to nephrectomy and survival after nephrectomy, where Black patients were disadvantaged relative to Whites. We used the Surveillance, Epidemiology and End Results data from 12 516 patients of all stages diagnosed and treated for RCC between 2000 and 2004. The effect of race (Black vs White) on nephrectomy rate was addressed in logistic regression and binomial regression models, and Cox regression models tested the effect of race on overall survival.RESULTSBlack patients were 50% less likely to have a nephrectomy than their White counterparts. However, race had no effect on overall survival when the entire cohort was assessed, as well as in subgroups of patients with or without nephrectomy.CONCLUSIONSAlthough race is a determinant of access to nephrectomy, it should not be interpreted as a barrier to care, as survival was unaffected by race in patients having a nephrectomy or not. Instead, race might represent a proxy of comorbidity and life‐expectancy, which represent surgical selection criteria for nephrectomy.
Adjuvant radiotherapy after radical prostatectomy shows no ability to improve rates of overall and cancer‐specific survival in a matched case‐control study
Authors: Porter Christopher R. , Capitanio Umberto , Perrotte Paul , Walz Jochen , Isbarn Hendrik , Kodama Koichi , Gibbons Robert P. , Correa Jr Roy , Karakiewicz Pierre I. 
Published: November 2008

OBJECTIVETo assess the effect of adjuvant radiotherapy (aRT) on the rate of cancer‐specific and overall survival after radical prostatectomy (RP) in a group of patients with a long‐term follow‐up, as there is controversy about the benefit of aRT after RP for prostate cancer when endpoints beyond biochemical and local recurrence are considered.PATIENTS AND METHODSWithin a study cohort of 752 patients treated with RP, 118 (15.7%) received aRT; these patients were matched with controls who did not receive aRT after RP. Exact matches were made for pT stage, RP Gleason sum, surgical margin status, age (±10 years), year of surgery (±10 years) and delivery of hormonal therapy. Kaplan‐Meier and life‐table analyses were used to assess overall and cancer‐specific survivalRESULTSThe median (range) follow‐up was 11.4 (0.1–41) years. The 10‐ and 20‐year overall survival after RP in those with no aRT were, respectively, 81.1% and 44.8%, vs 75.5% and 40.0% in the aRT group (P = 0.1). The corresponding probabilities for cause‐specific survival were, respectively, 97.3% and 89.0% vs 86.3% and 69.3% (P < 0.001). There was no statistically significant difference in the overall and cause‐specific survival between the groups after matching (hazard ratio 0.9, log rank P = 0.6; and 2.1, log rank P = 0.1, respectively).CONCLUSIONSOur analysis showed that, in a matched case‐control study, aRT has no effect on overall and cancer‐specific survival. Further randomized long‐term studies are necessary to confirm these results.
Temporal differentiation and maturation of regenerated rat urothelium
Authors: Roth Christopher C. , Bell Cardin H. , Woodson Benjamin , Schultz Andrew D. , Palmer Blake W. , Frimberger Dominic , Fung Kar‐Ming , Lin Hsueh‐Kung , Kropp Bradley P. 
Published: November 2008

OBJECTIVETo determine if porcine small intestinal submucosa (SIS)‐regenerated urothelium expresses markers of urothelial differentiation, uroplakin and zona occludens‐1 (ZO‐1), and whether their expression correlates with the histological appearance of the urothelium.MATERIALS AND METHODSIn all, 15 rats underwent partial cystectomy and bladder replacement with SIS. Regenerated bladders were harvested at either 2, 7, 14, 28, or 56 days after SIS grafting. Histological examination with haematoxylin and eosin staining was conducted to assess tissue regeneration. Immunohistochemistry was performed with uroplakin and ZO‐1 antibodies.RESULTSBy 14 days after SIS grafting, the urothelial layer was completely confluent over the SIS. Expression of uroplakin and ZO‐1, evident at 2 days after SIS grafting, progressed from a cytoplasmic pattern of expression to a mature pattern of cytoplasmic and membrane expression by 56 days after SIS grafting.CONCLUSION In vivo tissue regeneration produces histologically and phenotypically mature urothelium within 2 weeks of SIS implantation. Regeneration of functional urothelium is probably essential for the subsequent development of the remaining bladder.
Serological evidence of infections and Type 2 diabetes: the Multiethnic Study of Atherosclerosis
Authors: Lutsey P. L. , Pankow J. S. , Bertoni A. G. , Szklo M. , Folsom A. R. 
Published: November 2008

AbstractAims  Prospective studies have identified chronic inflammation as a risk factor for Type 2 diabetes. However, it is not known whether infection by specific pathogens or having a greater ‘pathogen burden’ is associated with diabetes. The aim of this study was to examine the cross‐sectional relation of seropositivity to five pathogens (Chlamydia pneumoniae, cytomegalovirus, Helicobacter pylori, hepatitis A virus, herpes simplex virus) and prevalent diabetes.Methods  Baseline data from a random sample of MultiEthnic Study of Atherosclerosis (MESA) participants (n = 1000; age 45–84 years) were used. Diabetes was defined by American Diabetes Association 2003 criteria, and ‘pathogen burden’ by the number of pathogens (0–5) for which an individual was seropositive. Logistic regression was used to test differences in diabetes prevalence by seropositivity. Linear regression was used to explore associations between pathogen seropositivity and the inflammation markers C‐reactive protein, interleukin‐6 and fibrinogen.Results  Diabetes prevalence was 12.7%, whereas seropositivity for C. pnuemoniae was 76%, cytomegalovirus 77%, H. pylori 45%, hepatitis A 58% and herpes simplex virus 85%. Seventy‐two percent were seropositive for three or more pathogens. In crude analyses, the prevalence of diabetes was higher among those with a pathogen burden of three or more, and with seropositivity to cytomegalovirus, H. pylori, hepatitis A and herpes simplex virus. After adjustment for demographic covariates (particularly race), all associations became non‐significant. Pathogen seropositivity was also not related to inflammation marker levels.Conclusions  Following demographic adjustments, no associations were observed between infection by several pathogens and diabetes status, suggesting no aetiological role for them in the occurrence of diabetes.
A double‐blind, randomized, placebo‐controlled trial of the short‐term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle‐aged, centrally obese men
Authors: Nagpal J. , Pande J. N. , Bhartia A. 
Published: November 2008

AbstractAim  To determine the short‐term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle‐aged, centrally obese men.Subjects and methods  A double‐blind randomized controlled trial was conducted at a tertiary care facility in which 100 male volunteers aged ≥ 35 years received three doses of vitamin D3 (120 000 IU each; supplemented group) fortnightly or placebo (control group). Hepatic fasting insulin sensitivity [homeostasis model assessment (HOMA), quantitative insulin‐sensitivity check index, HOMA‐2], postprandial insulin sensitivity [oral glucose insulin sensitivity (OGIS)], insulin secretion (HOMA%B, HOMA2‐%B), lipid profile and blood pressure were measured at baseline and at 6 weeks’ follow‐up.Results  Seventy‐one of the recruited subjects completed the study (35 in supplemented group, 36 in control group). There was an increase in OGIS with supplementation by per protocol analysis (P = 0.038; intention‐to‐treat analysis P = 0.055). The age‐ and baseline 25‐hydroxyvitamin D level‐adjusted difference in change in OGIS was highly significant (mean difference 41.1 ± 15.5; P = 0.01). No changes in secondary outcome measures (insulin secretion, basal indices of insulin sensitivity, blood pressure or lipid profile) were found with supplementation.Conclusion  The trial indicates that vitamin D3 supplementation improves postprandial insulin sensitivity (OGIS) in apparently healthy men likely to have insulin resistance (centrally obese but non‐diabetic).
Antiplatelet therapy, Helicobacter pylori infection and complicated peptic ulcer disease in diabetes: The Fremantle Diabetes Study
Authors: Schimke K. , Chubb S. A. P. , Davis W. A. , Phillips P. , Davis T. M. E. 
Published: November 2008

AbstractAims  To assess whether, based on its relationship with complications of peptic ulcer disease (PUD), directed Helicobacter pylori serological screening is justified in diabetic patients prior to commencement of antiplatelet therapy.Methods  We analysed data from the longitudinal, community‐based Fremantle Diabetes Study (FDS). The present substudy included (i) 1301 patients (91.2% of the total FDS sample; mean age 62.0 ± 13.3 years, 49.5% male) with available sera from baseline assessment between 1993 and 1996, and (ii) a subset of 40 patients admitted to hospital for complicated PUD (bleeding and/or perforation) between baseline and end of June 2006. All hospital admissions for complicated PUD in the population of Western Australia were identified over the same period. Helicobacter pylori IgG antibodies were measured in all patients at baseline and in the subset at the FDS visit prior to hospital admission.Results  Helicobacter pylori seropositivity was present in 60.6% of FDS patients at baseline and was independently associated with increasing age and non‐Anglo‐Celt/non‐Asian ethnicity. There were 2.9 (95% confidence interval 2.1, 3.9) first admissions for complicated PUD per 1000 patient‐years, an incidence more than seven times that in the local general population. Independent baseline predictors of hospital admission were increasing age, serum urea, non‐aspirin anticoagulant therapy, sulphonylurea therapy, peripheral arterial disease and diabetic retinopathy, but not aspirin use, H. pylori seropositivity or their interaction.Conclusions  There are diabetes‐specific risk factors for complicated PUD, including sulphonylurea use and vascular complications. Knowledge of H. pylori serological status does not predict complicated PUD in diabetes regardless of use of antiplatelet therapy.
Decreased circulating CD34+ cells are associated with progression of diabetic nephropathy
Authors: Makino H. , Okada S. , Nagumo A. , Sugisawa T. , Miyamoto Y. , Kishimoto I. , Kikuchi‐Taura A. , Soma T. , Taguchi A. , Yoshimasa Y. 
Published: November 2008

AbstractAims  Circulating progenitor cells such as CD34+ cells play a key role in maintenance of vascular endothelial function and neovascularization, and a decrease in the number of CD34+ cells is associated with cardiovascular disease. However, the contribution of circulating progenitor cells to microvascular disease, such as diabetic nephropathy, is unclear. This study was therefore designed to clarify the association between diabetic nephropathy and circulating CD34+ cells.Methods  We measured circulating CD34+ cell numbers in 85 Type 2 diabetic patients aged 40–70 years with normo‐ and microalbuminuria and determined the association with urinary albumin excretion rate (UAER).Results  The number of circulating CD34+ cells significantly correlated with log UAER (r = –0.289, P = 0.008). Furthermore, in patients with low numbers of CD34+ cells (0.68 > cells/µl, lowest quartile of CD34+ cell number) UAER increased significantly after 12 months compared with baseline [from 34.3 ± 7.0 to 53.6 ± 10.8 mg/g creatinine (gCr), P < 0.05], whereas in patients with a high number of CD34+ cells (1.0 < cells/µl, highest quartile of CD34+ cell number) UAER did not change (from 16.7 ± 4.8 to 20.1 ± 3.0 mg/gCr).Conclusions  These results suggest that a decreased number of circulating CD34+ cells is involved in the progression of diabetic nephropathy and may be a predictor of the disease.