bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enuresis and urinary incontinence in children and adolescents with spinal muscular atrophy
Authors: Von Gontard A. , Laufersweiler‐Plass C. , Backes M. , Zerres K. , Rudnik‐Schöneborn S. 
Published: March 2003

Objective To assess the rate and type of urinary incontinence in a large sample of children and adolescents with spinal muscular atrophy (SMA), a genetic disorder characterized by loss of motor function caused by anterior horn degeneration. Patients, subjects and methods The study included 96 severely incapacitated patients with SMA (aged 6.0–18.11 years) who were examined in detail, including a structured interview (Kinder‐DIPS), the Child Behaviour Checklist (CBCL) and a specific questionnaire for urinary incontinence. They were compared with two control groups of unaffected siblings and normal children. Results In all, 29% of the patients were wet at night and/or during the day; mostly younger children with SMA types I and II only were affected. The results of the interview were more reliable than the CBCL. The specific questionnaire revealed a variety of possible functional and neurogenic forms of wetting, including nocturnal enuresis, voiding postponement, dysfunctional voiding, stress, symptomatic (urinary tract infections, UTIs) and neurogenic incontinence. Many patients were constipated, soiled or had UTIs. The rate of behavioural problems was twice as high (32%) as normal (15%; CBCL). Conclusion Children with SMA have a high rate of urinary incontinence which is often overlooked, and not diagnosed and treated adequately. These problems should be addressed routinely by paediatricians in children referred to paediatric urological specialists.
Evaluation of cellular tumour rejection mechanisms in the peritumoral bladder wall after bacillus Calmette‐Guérin treatment
Authors: Saint F. , Patard J.J. , Groux Muscatelli B. , Lefrere Belda M.A. , Gil Diez de Medina S. , Abbou C.C. , Chopin D.K. 
Published: March 2003

Objective To compare the immunological status of normal and peritumoral bladder walls, and to characterize immunocompetent cells before and during intravesical instillations of bacillus Calmette‐Guérin (BCG). Patients and methods Twenty‐three patients with superficial urothelial bladder carcinoma (stages pTa to pT1, grades 1–3) were treated with six weekly instillations of 150 mg of BCG (Pasteur strain). Biopsies of cystoscopically normal bladder wall were taken before, 3 weeks and 3 months after BCG instillation. The controls comprised bladder biopsy specimens from 13 brain‐dead ventilated kidney donors. Local infiltrating cell types, i.e. lymphocyte infiltrates (CD4, CD8, CD20, CD3, interleukin‐2‐receptor‐positive, natural killer, γδ), macrophages and dendritic cells, adhesion and costimulatory molecules (ICAM‐1 and B7‐BB1) and major histocompatibility complex (MHC) class I and class II antigens were assessed using semi‐quantitative immunohistochemical analysis. Results Before BCG the peritumoral bladder wall had fewer macrophages than control bladder wall. BCG treatment restored normal numbers of macrophages and enhanced T helper lymphocytes, B lymphocytes, natural killer cells, activated lymphocytes, dendritic cells, normal MHC class I, adhesion (ICAM‐1) and costimulatory (B7‐BB1) expression. The enhancement of these immunological variables was transient, with a return to baseline 3 months after BCG instillation. Conclusions These results support the concept that there is a host‐immune escape associated with bladder cancer. BCG therapy may temporarily restore impaired tumour rejection mechanisms in the peritumoral bladder wall, suggesting a need for maintenance therapy after the first course of BCG.
The role of 18fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours
Authors: Spermon J.R. , De Geus‐Oei L.F. , Kiemeney L.A.L.M. , Witjes J.A. , Oyen W.J.G. 
Published: March 2003

Objective To investigate the role of 18fluoro‐2‐deoxyglucose positron emission tomography (FDG‐PET) in the initial staging of clinical stage I and II nonseminomatous germ cell tumours (NSGCTs) and in re‐staging (non)seminomatous GCTs after chemotherapy. Patients and methods FDG‐PET studies were undertaken in 50 patients. FDG uptake was interpreted visually and when possible the standardized uptake value was determined. A FDG‐PET scan was taken in five patients with clinical stage I and in seven with stage II NSGCT. The scans were validated by histology. Stage I patients underwent a retroperitoneal lymph node dissection because of vascular invasion in the primary tumour. Thirty‐eight scans were taken after completing chemotherapy (28 NSGCTs and 10 seminomatous GCTs), and validated by histology or clinical follow‐up. Results In stage I NSGCT, FDG‐PET staging was equivalent to computed tomography (CT) staging. One small lesion, consisting of mature teratoma, was missed by both FDG‐PET and CT. In stage II NSGCT, FDG‐PET missed two lesions (mature teratoma and retroperitoneal mass with a small component of embryonal cell carcinoma) whereas CT correctly classified all. In 20 of 28 patients with NSGCT, histology was obtained after chemotherapy. In one of three patients with viable tumorous residual mass the FDG‐PET scan was clearly positive; in four of 12 with mature teratoma and inflammation components retroperitoneally, the FDG‐PET was also positive. In contrast, eight patients with solitary mature teratoma had a negative PET result. In four of five patients with necrosis after chemotherapy the PET result was correctly negative. All eight patients on surveillance had a negative PET scan and were free of disease at median (range) of 14 (8–18) months. Interestingly, of the 12 patients with a correct negative PET result, 11 had no mature teratoma in their primary tumour. Nine of 10 patients with SGCT were correctly staged. Two FDG‐PET studies showed increased uptake; in one, a viable seminomatous mass was found and in the other there was inflammation in the residual mass. In all other patients the FDG‐PET scan correctly predicted absence of viability in the residual mass. Conclusions In primary staging, FDG‐PET has no benefit over CT. In re‐staging, a negative FDG‐PET result predicts fibrotic residual mass in seminomatous GCT. Moreover, it could be useful to predict fibrotic residual mass in NSGCT in those patients with no teratoma component in their primary tumour.
Contribution of grade, vascular invasion and age to outcome in clinically localized renal cell carcinoma
Authors: Griffiths D.F.R. , Verghese A. , Golash A. , Kynaston H.G. , Matthews P.N. , Hart A.J.L. , Court J.B. 
Published: March 2003

Objective  To determine the relative prognostic importance of microvascular invasion in apparently localized renal cell carcinoma (RCC). Patients and methods A retrospective clinical and pathological review was conducted of 176 consecutive patients identified from pathology records who had a nephrectomy for RCC with a median follow‐up of 44 months. Vascular invasion was recorded and categorized by the level of microvascular invasion (MVI), renal vein invasion (RVI) and inferior vena cava invasion (IVCI). Tumour type, grade and size were also assessed. These variables were assessed by univariate and multivariate analysis to determine their effect on disease‐free survival. Results  In the univariate analysis tumour size, grade, vascular invasion and young age each predicted reduced disease‐free survival. On multivariate analysis for all 176 patients, grade, vascular invasion and young age were the significant independent predictors of reduced disease‐free survival. In a subgroup of 149 patients from whom those with very high risk determinants were excluded (those with grade 4 tumours and/or IVCI) most of the risk of metastasis could be accounted for by vascular invasion and young age alone (MVI vs no vascular invasion, hazard ratio 3.18, 95% confidence interval 1.29–7.84; RVI vs no vascular invasion 2.41, 0.989–5.89; and age per year 0.963, 0.94–0.992). Conclusions  Grade, vascular invasion and young age are the main independent predictors of relapse in clinically localized RCC after nephrectomy. For most patients, who do not have very high risk indicators, the main adverse predictors are vascular invasion and young age. These findings are important when selecting patients for trials of adjuvant therapy and have implications for pathological staging.
The effect of Phyllanthus niruri on urinary inhibitors of calcium oxalate crystallization and other factors associated with renal stone formation
Authors: Freitas A.M. , Schor N. , Boim M.A. 
Published: March 2003

Objective To evaluate the effect of an aqueous extract of Phyllanthus niruri (Pn), a plant used in folk medicine to treat lithiasis, on the urinary excretion of endogenous inhibitors of lithogenesis, citrate, magnesium and glycosaminoglycans (GAGs). Materials and methods The effect of chronic (42 days) administration of Pn (1.25 mg/mL/day, orally) was evaluated in a rat model of urolithiasis induced by the introduction of a calcium oxalate (CaOx) seed into the bladder of adult male Wistar rats. The animals were divided into four groups: a sham control (16 rats); a control+Pn (six); CaOx+water instead of Pn (14); and CaOx+Pn (22). Plasma and urine were collected after 42 days of treatment for biochemical analysis and the determination of urinary excretion of citrate, magnesium and GAGs. The animals were then killed and the calculi analysed. Results The creatinine clearance or urinary and plasma concentrations of Na+, K+, Ca2+, oxalate, phosphate and uric acid were unaffected by Pn or the induction of lithiasis. Treatment with Pn strongly inhibited the growth of the matrix calculus and reduced the number of stone satellites compared with the group receiving water. The calculi were eliminated or dissolved in some treated animals (three of 22). The urinary excretion of citrate and magnesium was unaffected by Pn treatment. However, the mean (sd) urinary concentration of GAGs was significantly lower in rats treated with CaOx+Pn, at 5.64 (0.86) mg/g creatinine, than when treated with CaOx + water, at 11.78 (2.21) mg/g creatinine. In contrast, the content of GAGs in the calculi was higher in the CaOx + Pn rats, at 48.0 (10.4) g/g calculus, than in the CaOx + water group, at 16.6 (9.6) g/g calculus. Conclusion These results show that Pn has an inhibitory effect on crystal growth, which is independent of changes in the urinary excretion of citrate and Mg, but might be related to the higher incorporation of GAGs into the calculi.
Influence of nitric oxide signalling pathways on pre‐contracted human detrusor smooth muscle in vitro
Authors: Moon Annick 
Published: March 2003

Objectives To assess the effects of nitric oxide (NO) donors on human detrusor strips in vitro under conditions which attempt to mimic those occurring in vivo during the tonic phase of bladder contraction, as NO may promote relaxation by modulating parasympathetic excitation contraction coupling. Materials and methods With ethical approval from the local ethics committee, human detrusor tissue was obtained from a heterogeneous clinical group after obtaining informed consent. Detrusor strips were dissected and mounted in a 1‐mL, superfused organ bath. After pre‐contraction with carbachol, the effect of NO donors, sodium nitroprusside (SNP) and S‐nitro‐N‐acetylpenicillamine, a cell‐permeable cyclic nucleotide analogue (dibutyl‐cGMP), and inhibitors (methylene blue and ibuprofen) on isometric tension were assessed. All drugs were dissolved in Tyrode solution (pH 7.4), passed through a thermostatically controlled (36 °C) warming jacket and bubbled with 95% O2/5% CO2. Results Both NO donors and db‐cGMP evoked a complex response in pre‐contracted tissue, i.e. relaxation, contraction or a transient relaxation followed by contraction. Inhibition of soluble guanylyl cyclase significantly attenuated NO‐mediated contraction, indicating the involvement of cGMP, but this inhibition did not significantly affect the relaxant response. The relaxant response was also potentiated by ibuprofen. SNP and db‐cGMP evoked similar responses, although the occurrence of the responses (relaxation, contraction or biphasic) was significantly different in normal and pathological human detrusor. Conclusion NO donors and db‐cGMP modulate carbachol‐evoked contraction of human detrusor smooth muscle in vitro. There is probably a NO/cGMP signalling pathway, with inhibition of endogenous cGMP by methylene blue, suggesting that SNP evokes contraction via cGMP. However, NO donors and db‐cGMP evoked a complex response (relaxant, contractile or biphasic), suggesting that NO and cGMP may also act independently and/or via several pathways.
Antisense Bcl2 oligonucleotide in cisplatin‐resistant bladder cancer cell lines
Authors: Hong J.H. , Lee E. , Hong J. , Shin Y.J. , Ahn H. 
Published: March 2003

Objective  To determine the change of expression of Bcl2 in cisplatin‐resistant bladder cancer cell lines and the reversibility of chemoresistance to cisplatin with antisense oligonucleotide against Bcl2, as higher expression of Bcl2 is associated with drug resistance in many different cancer cell lines. Materials and methods  In the cisplatin‐resistant bladder tumour cell lines T24R1 and T24R2, the expression of Bcl2 was determined by reverse transcription‐polymerase chain reaction and Western blot assay, and antisense oligonucleotide targeting of the Bcl2 coding sequence was administered with lipofectin. Results  The expression of Bcl2 mRNA and protein was greater in T24R1 and T24R2 cells than in the parent T24 cells. Short‐term exposure to cisplatin up‐regulated Bcl2 mRNA and protein expression in parent T24 cells. Treatment with antisense oligonucleotide down‐regulated Bcl2 protein expression and significantly enhanced the cytotoxicity of cisplatin. Conclusions  Up‐regulation of Bcl2 protein expression might be one of the mechanisms of cisplatin resistance in bladder cancer cells, and antisense Bcl2 oligonucleotide may be helpful in chemotherapy for bladder cancer by reversing cisplatin resistance.
Changing treatments for primary urolithiasis: impact on services and renal preservation in 16 679 patients in Western Australia
Authors: Holman C.D.J. , Wisniewski Z.S. , Semmens J.B. , Bass A.J. 
Published: March 2003

Objectives  To examine changing treatments for the primary presentation of urinary lithiasis and their effects on re‐admissions, repeat procedures, cumulative hospital use and renal preservation. Patients and methods  Linked hospital morbidity records were used to identify first‐time admissions for renal and ureteric calculi from 1980 to 1997 in the population of Western Australia. The cases were followed to mid‐1999 and actuarial methods used to estimate risks of further hospital admissions and procedures, including the loss of a renal moiety. Results  Between 1980 and 1997 the total rate of inpatient procedures for urinary stones more than doubled, at a time when the rate of first‐time hospital admissions increased by only 13% and the conservative management of stones remained constant at ≈ 59%. The predominant procedure for stone management was initially open lithotomy, replaced in the early 1980s by percutaneous nephrolithotomy and soon supplemented by extracorporeal shock wave lithotripsy (ESWL). The changes in technology led to a four‐fold increase in procedural re‐admissions within 30 days of primary separation. This was a result of repeated, staged or postponed interventions, often involving the use of stents or a second treatment with ESWL. The risk of surgical intervention decreased from 48% to 32%, whilst the cumulative length of stay over the first year decreased from 7.8 to 3.9 days. The risk of kidney loss declined significantly from 2% to <0.1% during the period. Conclusions  The main reason for more interventions were short‐term procedural re‐admissions. ESWL reduced the need for invasive procedures and decreased cumulative hospital stay, despite more re‐admissions. Renal preservation improved by a factor of 10.
End‐to‐end urethroplasty: long‐term results
Authors: Micheli E. , Ranieri A. , Peracchia G. , Lembo A. 
Published: March 2003

Objective  To retrospectively review patients with strictures (<3 cm) of the bulbous urethra who had undergone urethroplasty with excision of the stenotic segment and end‐to‐end anastomosis. Patients and methods The review included 74 patients (all men, mean age 39 years, range 18–70) treated between 1989 and 1999 for strictures 5–30 mm long. Forty‐one of the patients (55%) had been treated previously, 39 endoscopically (urethrotomy and/or dilatation) and two surgically. Surgical access was perineal, with the patient in an exaggerated lithotomy position; the stenotic segment was excised and the stumps spatulated for end‐to‐end anastomosis. The mean (range) duration of surgery was 140 (75–280) min. There were no complications during or after surgery, and none related to the duration in the lithotomy position. Results  At a mean follow‐up of 60 months, 93% of the patients had no recurrence of the stricture and were therefore considered cured. There were no treatment‐related complications. Conclusion  End‐to‐end anastomosis is confirmed as the treatment of choice for short bulbous urethral strictures, giving cure rates close to 100%.
The ‘top 10’ urological procedures: a study of hospital episodes statistics 1998–99
Authors: Lee F. , Patel H.R.H. , Emberton M. 
Published: March 2003

Objective  To summarize the urological procedures recorded in Hospital Episodes Statistics (HES, 1998–99) and to examine the accuracy of coding and HES. Materials and methods

Data on the 10 commonest urological procedures from the Department of Health website (
www.doh.gov.uk/hes ) were extracted, summarized and presented. Results  Urethral catheterization, endoscopic procedures on the bladder, prostate, urethra and ureter (excluding ureteric stone extraction), minor open procedures on the foreskin and the vas, bladder instillation, extracorporeal shockwave lithotripsy and prostatic biopsy are the 10 commonest procedures, according to finished consultant episodes. There is published evidence that the data from coding and HES are not completely accurate. Conclusion  This study highlights shortfalls in the HES data (1998–99) which may directly affect the funding of urological services.
The effect of perioperative distal vasal lavage on subsequent semen analysis after vasectomy: a prospective randomized controlled trial
Authors: Pearce I. , Adeyoju A. , Bhatt R.I. , Mokete M. , Brown S.C.W. 
Published: March 2003

Objective To determine the effect of perioperative distal vasal lavage with 50 mL of normal saline on subsequent time to azoospermia after vasectomy. Patients and methods Seventy‐two patients were prospectively enrolled and randomized to undergo vasectomy with or without vasal lavage. Infertility rates at 8, 10 and 12 weeks were compared for both groups and for those undergoing the procedure under local or general anaesthesia. Patient compliance for returning postoperative semen for analysis was also assessed. Results There was no statistically significant difference in infertility rates at 8, 10 or 12 weeks after vasectomy with or without vasal lavage. Vasectomies performed under local and general anaesthesia had comparable rates of infertility at 12 weeks after surgery. Compliance in providing semen for analysis was poor. Conclusions The routine adoption of distal vasal lavage during vasectomy for contraception cannot be recommended. As compliance in providing semen for analysis was poor, the clinician has a responsibility to remind the patient of the consequences of such action.
Immunohistochemical detection of the 150‐kDa oxygen‐regulated protein in bladder cancer
Authors: Asahi H. , Koshida K. , Hori O. , Ogawa S. , Namiki M. 
Published: March 2003

Objective To investigate the relationship between the expression of the 150‐kDa oxygen‐regulated protein (ORP150, which functions as a molecular chaperone in the endoplasmic reticulum for the folding and trafficking of newly synthesized proteins) and the aggressiveness of bladder cancer, and the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs), as the former is a secreting protein through the endoplasmic reticulum and the latter are closely involved in tumour invasion.Materials and methods Thirty‐nine cystectomy specimens, comprising 12 superficial (pT1) and 27 invasive (pT2–pT4) tumours, were immunohistochemically analysed using antibodies against ORP150, VEGF, MMP‐1, MMP‐2 and MMP‐9. Staining was scored from 0 to 3, according to the ratio of positively staining cells.Results Staining was positive (score 1–3) for ORP150 in 10 of 12 superficial and 25 (93%) of the invasive tumours, with a significantly higher staining score for stage T4 than stage T1 tumours. The trend was the same for the staining score of MMP‐2, and there was a significant correlation between ORP150 and MMP‐2 expression.Conclusions The expression of ORP150 was common in bladder cancer, with a tendency for greater expression in higher stages. The significant correlation between ORP150 and MMP‐2 expression suggests that ORP150 acts as a molecular chaperone for MMP‐2 secretion and thus tumour invasion.
Orchidectomy after chemotherapy for patients with metastatic testicular germ cell cancer
Authors: Geldart T.R. , Simmonds P.D. , Mead G.M. 
Published: March 2003

Objective To evaluate the contribution of routine orchidectomy in the management of patients who present with advanced, metastatic, testicular germ cell cancer and who are treated with initial chemotherapy.Patients and methods Sixty consecutive patients presenting with metastatic testicular germ cell cancer and treated with initial chemotherapy followed by orchidectomy were identified. The results from a clinical and pathological review of these patients are presented. The pathological findings at orchidectomy were compared with the pathological findings from metastatic masses resected after chemotherapy, and are reviewed with the clinical outcome.Results Of the 60 orchidectomy specimens after chemotherapy, 24 (40%) contained significant histological abnormalities comprising residual invasive germ cell cancer, intratubular germ cell neoplasia and/or mature teratoma. The remaining 36 (60%) orchidectomy specimens contained fibrous scarring with or with no necrosis. Six (10%) orchidectomy specimens contained residual invasive germ cell cancer, three nonseminomatous germ cell cancer (NSGCT) and three seminoma. The patients with residual invasive NSGCT present within the testis had evidence of residual invasive NSGCT within extragonadal masses resected after chemotherapy; all three have relapsed and died from chemorefractory progressive disease.Conclusion Orchidectomy after chemotherapy is recommended in all patients undergoing primary chemotherapy, as a significant proportion (40%) are left with histological abnormalities that predispose to subsequent relapse. Persistence of invasive NSGCT at the site of the primary tumour after chemotherapy is associated with persistence of invasive disease at other metastatic sites and is a poor prognostic finding.