bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low‐grade left varicocele in patients over 30 years old:the effect of spermatic vein ligation on fertility
Authors: Grasso M. , Lania C. , Castelli M. , Galli L. , Franzoso F. , Rigatti P. 
Published: March 2003

Objectives To evaluate the effect of spermatic vein ligation in patients over 30 years old and with low‐grade left varicocele, and thus help to establish whether such patients might benefit from surgery. Patients and methods A randomized study was conducted on 68 infertile patients (30–38 years old) with evidence of sperm abnormalities and who had low‐grade varicocele (grade I according to Hirsch), comparing left spermatic vein ligation with no treatment. The outcome was assessed by standard sperm analysis and eventual paternity. Results There was no improvement in sperm quality in either of the groups one year after surgery, and no significant difference in paternity. Conclusions Left spermatic vein ligation for low‐grade varicocele in patients more than 30 years old cannot be recommended.
Homologous bladder augmentation in dog with the bladder acellular matrix graft
Authors: Probst M. , Piechota H.J. , Dahiya R. , Tanagho E.A. 
Published: March 2003

Objective To determine the functional potential and antigenicity of the homologous bladder acellular matrix graft (BAMG) in a dog model. Materials and methods Seven mongrel dogs underwent partial cystectomy (20–50%) and grafting with an equal‐sized BAMG; two control animals underwent partial cystectomy (40%) only. The dogs were killed after 30 (one), 120 (one) and 210 days (five dogs). Blood samples were obtained before and at 1, 2, 4, 7, 14, 30, 90 and 210 days after surgery. The dogs underwent cystography, intravenous pyelography and ultrasonography before and after surgery, and on the day they were killed, with cystoscopy carried out just before death. The grafted tissue was assessed using routine and immunohistochemical techniques. Results All the dogs survived surgery; a complete blood cell count, chemical panel and white blood cell count showed no significant difference between the experimental and control animals. Cystography, cystoscopy and ultrasonography revealed no pathological changes in the upper urinary tract. After 7 months, the mean bladder capacity in the augmented dogs was significantly higher (P = 0.035) than in the controls (264 vs 172 mL). Histological evaluation showed an invasion of all bladder wall components during the first month; at 7 months, the morphological examination showed essentially complete regeneration. Conclusion In this dog model, the potential of the BAMG as a bladder augmentation graft was confirmed, having minimal antigenicity with maximal acceptance. The reconstructed bladder matched the morphological and functional properties of the normal bladder.
Cryoablation for clinically localized prostate cancer using an argon‐based system: complication rates and biochemical recurrence
Authors: De La Taille A. , Benson M.C. , Bagiella E. , Burchardt M. , Shabsigh A. , Olsson C.A. , Katz A.E. 
Published: March 2003

Objective To determine the complication rates and biochemical recurrence after cryoablation of the prostate, using an argon gas‐based system, in patients with localized prostate cancer. Patients and methods Between October 1997 and June 1999, 35 patients underwent cryoablation of the prostate (19 after radiation therapy failure and 16 as a primary treatment for localized prostate cancer). All patients had biopsy‐confirmed prostate cancer with no seminal vesicle invasion, negative bone scans and a negative lymph node dissection. Patients received 3 months of combined hormonal therapy before cryosurgery. One surgeon performed all the procedures. Biochemical recurrence was defined by an increase in prostate specific antigen (PSA) of ≥ 0.2 ng/mL above the PSA nadir. Results The complications were rectal pain (26%), urinary infection (3%), scrotal oedema (12%), haematuria (6%) and incontinence (6%). Complication rates were higher in those patients who failed after radiation therapy than in those who did not receive radiation (incontinence 11% vs 0%, rectal pain 37% vs 12%) but the difference was not statistically significant. Twenty‐two patients (63%) had an undetectable serum PSA nadir (< 0.1 ng/mL) after cryotherapy and 30 (84%) patients had a PSA value of < 1.0 ng/mL. After a mean follow‐up of 8.3 months (range 0.2–18), nine patients had biochemical recurrence. The biochemical recurrence‐free survival (BRFS) was 70% at 9 months. Patients who had an undetectable PSA nadir had a statistically higher BRSF at 9 months than did patients who had a detectable PSA nadir (89% vs 55%, respectively, P = 0.03). Similarly, patients with a preoperative serum PSA level of < 10 ng/mL had a statistically higher BRFS than patients who had a PSA level of > 10 ng/mL (86% vs 42% at 9 months, P < 0.001). Conclusion A PSA level before cryotherapy of < 10 ng/mL and an undetectable PSA nadir after cryotherapy were associated with the highest BRFS. Cryoablation of the prostate, with low morbidity, seems to be a viable option in managing patients by salvage therapy after radiation therapy and for the primary treatment of clinically localized prostate cancer.
Priapism in adult Nigerians
Authors: Aghaji A.E. 
Published: March 2003

Objectives To review the presentation and treatment of adult Nigerians with priapism.Patients and methods Thirty‐five men (mean age 35 years, range 20–54) were seen over a 12‐year period. All patients underwent an immediate modified or conventional cavernospongiosus shunt and were assessed at 2, 6 and 12 weeks after discharge for erection, orgasm and fibrosis of corpora cavernosa.Results Ten patients initially presented to traditional healers and 13 presented early to qualified medical practitioners, and were managed conservatively. As a result, 21 of the 35 patients presented to the author’s hospital 6–10 days after the onset of erection. Many did not realise that priapism was abnormal, or had no money to attend hospital. After surgical treatment detumescence was obtained in all patients and maintained. At 12 weeks, 14 patients had normal erections, 13 reduced erections and eight no erections. A local aphrodisiac was identified as the commonest predisposing factor, followed by sickle‐cell disease.Conclusion This study shows clearly that even if a patient with priapism presents late, vigorous treatment in the form of an adequate shunt should be undertaken as soon as possible, as this is the only chance the patient has to regain potency.
Bacillus Calmette–Guérin instillation treatment for carcinoma in situ of the upper urinary tract
Authors: Nishino Y. , Yamamoto N. , Komeda H. , Takahashi Y. , Deguchi T. 
Published: March 2003

Objective To analyse the efficacy and safety of bacillus Calmette–Guérin (BCG) perfusion treatment forcarcinoma in situ (CIS) of the upper urinary tract. Patients and methods Six patients with cytologically diagnosed CIS of the upper urinary tract were treated by BCG instillation via retrograde catheterization using a 6 F ureteric catheter or an 8 F indwelling JJ ureteric stent between the ureter and bladder. BCG (Tokyo 172 strain, 80 mg in 100 mL normal saline) was instilled weekly for 4 or 8 weeks. The efficacy and safety of the treatment was assessed. Results The mean (range) follow‐up was 22 (9–38) months; none of the patients died, and all were negative for cytology in urine collected from the upper urinary tracts. However, one patient had recurrent CIS in the prostatic urethra; the patient was treated by intravesical BCG instillation. In all patients, positive cytology became negative after one or two instillations of BCG. The ureter became stenotic in two patients. Although irritative symptoms occurred in all patients, such side‐effects disappeared in a few months and were not clinically significant. Conclusion In these six patients retrograde BCG instillation for CIS of the upper urinary tract was effective and safe. Based on the cytology results after only two BCG treatments, the dose or number of BCG instillations could possibly be reduced, but further study is needed.
Urinary tract abnormalities in children with acute focal bacterial nephritis
Authors: Uehling D.T. , Hahnfeld L.E. , Scanlan K.A. 
Published: March 2003

Objective To review the presentation, methods of diagnosis, and incidence of concomitant urological abnormalities in children with acute focal bacterial nephritis (AFBN, also known as lobar nephronia, a severe nonliquefactive infection involving one or more renal lobules). Patients and methods Sixteen children (age range 6 months to 9 years) diagnosed with AFBN over a 5‐year period were retrospectively reviewed. Their age, gender, presenting symptoms, presence of urinary tract abnormalities, radiological imaging and treatment were assessed. Results All 16 children received intensive intravenous and oral antibiotics. Ten required intervention for predisposing conditions including vesico‐ureteric reflux (four), bladder diverticulum (one), renal and peri‐rectal abscess (two), ureteric or bladder calculi (two), and renal mass (one). In addition, three children had reflux not requiring surgery; one had multiple renal calyceal diverticula, one had Hinman syndrome and one had leukaemia. Conclusion Acute focal bacterial nephritis is being diagnosed with increasing frequency through increasing awareness and advances in imaging modalities. Active urological evaluation is warranted because of the high incidence of urinary tract abnormalities. In addition to antibiotics, intervention was needed in most children in this series.
Genes upregulated during castration‐induced rat prostatic apoptosis: cloning and characterization of new cDNAs
Authors: Bruyninx M. , Ammar H. , Reiter E. , Cornet A. , Closset J. 
Published: March 2003

Objective To isolate new cDNAs corresponding to genes whose expression is increased during castration‐induced rat prostate apoptosis.Materials and methods Differential display of mRNAs from 3‐day castrated and normal rat ventral prostates was used to identify differentially expressed clones. Northern blots were hybridized to confirm the positive regulation of the candidates and to follow the change in their expression in the involuting rat prostate, and in thymocytes of dexamethazone‐treated rats.Results Five cDNAs were cloned: one encoding ribosomal protein L7, one coding for the insulin‐like growth factor binding protein‐3 (IGFBP‐3), and three whose products are unknown. After castration, all five genes had expression kinetics that closely paralleled the proportion of prostatic epithelial cells undergoing apoptosis. The gene encoding L7 and two of the unknown genes were also upregulated in glucocorticoid‐induced programmed death in thymocytes. In addition to the IGFBP‐3 gene, those coding for proteins IGFBP‐4, ‐5 and ‐6 were also overexpressed in the involuting prostate of androgen‐deprived rats.Conclusion Five new genes were identified that are up‐regulated during castration‐induced rat prostate apoptosis, three of which are potentially involved in the common intracellular pathway leading to programmed cell death.
Early catheter removal in 100 consecutive patients undergoing radical retropubic prostatectomy
Authors: Santis W.F. , Hoffman M.A. , DeWolf W.C. 
Published: March 2003

Objectives To investigate the outcome of 100 consecutive patients selected for early catheter removal after radical retropubic prostatectomy (RRP), where urethral catheter drainage is used routinely for 2–3 weeks.Patients and methods The study included 129 consecutive patients with clinically localized prostate cancer who underwent RRP. Catheters were removed in the clinic (with no radiographic studies) 8–9 days after RRP provided there was no evidence of urine leak, pelvic haematoma, rectal injury or severe obesity. The follow‐up (mean 21 months) results were available for 118 patients, 100 of whom were candidates for early catheter withdrawal. Their records were reviewed for evidence of complications, including urinary retention, anastomotic stricture formation and urinary incontinence.Results Urinary retention developed in two of the 100 patients, requiring simple catheter replacement. Nine patients developed bladder neck contracture requiring dilatation or incision. No patients developed anastomotic disruption, urinary tract infection or pelvic abscess. At the mean follow‐up of 21 months, 76% of patients were continent and did not require pads; 19% of patients had mild stress urinary incontinence requiring the use of  1 pad/day, 4% of patients had incontinence requiring 2–4 pads/day, and 1% of patients required > 4 pads/day.Conclusion With appropriate patient selection as described, catheters can be removed in the clinic (with no radiographic studies) 8–9 days after RRP, with no increased incidence of complications, including anastomotic stricture, retention or incontinence.
The morphological changes in rat bladder after photodynamic therapy with 5‐aminolaevulinic acid‐induced protoporphyrin IX
Authors: Grönlund‐pakkanen S. , Pakkanen T.M. , Talja M. , Kosma V.‐M. , Ala‐opas M. , Alhava E. 
Published: March 2003

Objective To assess the optimum light energy needed to induce only superficial bladder wall damage during photodynamic therapy (PDT) as a treatment for bladder cancer. Materials and methods The urinary bladder (with normal epithelium) of 64 female rats was treated with PDT using a continuous‐wave argon‐ion laser as an energy source and aminolaevulinic acid (ALA)‐induced protoporphyrin IX photosensitizer. Four hours after the intravenous administration of ALA (300 mg/kg) the bladders were intravesically exposed to light fluences of 20–80 J/cm2. The control rats received no ALA and were exposed to 20 J/cm2 light. After 1, 3, 7 and 21 days the animals were killed and the morphological changes in bladder wall analysed both macroscopically and using light and scanning electron microscopy. Results At the dose of ALA given, a fluence of 20–40 J/cm2 caused mainly superficial damage, whereas 80 J/cm2 produced full‐thickness injuries to the bladder wall. The maximum effect of PDT occurred after 1 and 3 days of irradiation. After 3 weeks of PDT the histology showed few full‐thickness injuries and only in those treated with 80 J/cm2 light. Conclusion These results indicate that PDT can be used to safely induce a selective superficial removal of bladder mucosa with no fibrotic effects on detrusor musculature, when optimum photosensitizing drug and fluences are used. These findings support the use of PDT in the therapy of superficial bladder cancer.
Electrophysiological recordings from the rat prostate gland in vitro: identified single‐cell and transepithelial (lumen) potentials
Authors: Szatkowski M. , Mycielska M. , Knowles R. , Kho A.‐L. , Djamgoz M.B.A. 
Published: March 2003

Objective To develop a preparation for the in vitro maintenance of the rat prostate gland and thus allow intracellular and transepithelial voltage measurements. Materials and methods Ventral prostate glands from male rats were dissected free of connective tissue, separated into smaller lobes and maintained in vitro at 30 °C. Voltages were recorded with sharp micropipettes in identified cellular and luminal compartments, differentiated by several electrophysiological and histological parameters, including intracellular staining. Results Intracellular epithelial membrane potentials (median −40 mV) and transepithelial or luminal potentials (mean −4.2 mV) were recorded successfully. Luminal epithelial cells were dye‐coupled. Prostate tissue could be maintained in vitro with no apparent electrophysiological or structural deterioration for up to ≈ 7 h. Conclusion Rat prostate tissue can be successfully maintained in vitro and electrophysiological recordings made from identified cellular compartments.
A new highly specific monoclonal antibody against placental alkaline phosphatase: a potential marker for the early detection of testis tumour
Authors: Nouri A.M.E. , Torabi‐Pour N. , Dabare A.A.N.P.M. 
Published: March 2003

Objective To develop specific monoclonal antibodies (mAbs) against human germ cell tumours. Materials and methods A single‐cell suspension obtained from tumour tissue fragments (consisting of both tumour and normal compartments) from a patient with seminoma was used as an immunogen. Spleen cells from immunized mice were used to develop mAbs. Tissue specificity, biochemical characteristics and competitive studies were analysed using immunocytochemical staining, dot blots and a Western blot analysis, to identify target antigen(s). Results The immunization protocol led to the development of 107 hybridomas, 90 of which were negative against the original tissue biopsies. The remaining 17 showed positivity against various tissue compartments. One selected mAb (ATC2) showed specific staining on germ cell tumours but not on normal tissues, and positive staining with some human tumour cell lines. The target antigen for ATC2 was confirmed to be placental alkaline phosphatase (PLAP) based on: Western blot analysis compared with commercially available PLAP; comparison of the data with another well‐known anti‐PLAP mAb (H17E2, although the two mAbs recognized different antigenic epitopes); heat resistance characteristics; high‐performance liquid chromatography of the ATC2 target antigen and purified PLAP. Conclusion The selected mAb ATC2 has high specificity for human germ cell tumours, the target antigen for ATC2 being PLAP, although the antigenic epitope(s) differ from those recognized by H17E2. Thus ATC2 may be useful for monitoring serum levels of PLAP in patients with testis cancer and may be relevant for detecting cancer cells in the semen of individuals with suspected testis cancer, particularly in those with equivocal findings on ultrasonography.
The development of a pig model to study fetal vesico‐ureteric reflux
Authors: Dewan P.A. , Ehall H. , Edwards G.A. , Macgregor D. 
Published: March 2003

Objective To develop a surgical protocol to induce vesico‐ureteric reflux (VUR) in utero by ablating the ureteric tunnel in a fetal pig model. Materials and methods Fetal surgery was conducted on nine sows, which were divided into three groups according to changes in the surgical protocol. Sows in groups 2 and 3 received different anaesthetics and antibiotics, and the operating theatre temperature was increased. In all cases, the intramural part of the ureter was unroofed in the fetuses, which were then returned to the uterus. Upon delivery, cystograms were taken in the male piglets, and the urinary tracts removed for anatomical and histological examination. Results All three sows in group 1 delivered healthy piglets, but the fetuses that had undergone surgery were mummified. In group 2 the animals survived the fetal intervention, as shown by ultrasonography after surgery, but the four sows aborted spontaneously within a week. In group 3, both sows delivered normally developed piglets, three of which had undergone ablation of the ureteric tunnel. VUR was present only in those renal units in which the ureteric tunnel was ablated, and this was associated with hydronephrosis, dilatation of the ureters and thinning of the renal parenchyma on gross pathological examination. Conclusions The fetal pig model of VUR not only appears to be feasible, but with similarities in renal anatomy and physiology also seems to be ideal for investigating fetal VUR.
Annual changes in the clinical features of prostatic adenocarcinoma in Taiwan
Authors: Wu T.T. , Huang J.‐K. 
Published: March 2003

Objective To determine, using a clinical and pathological database, the annual changes in the characteristics of adenocarcinoma of the prostate diagnosed in consecutive men in Taiwan. Patients and methods All prostatic adenocarcinomas newly diagnosed between 1991 and 1999 in our institution were analysed. Using logistic regression for dichotomous variables, the annual trends were assessed for changes in the percentage of T1c disease, incidental carcinoma, clinically localized disease and Gleason grade 4/5 cancers. The annual trends for changes in the pathological features of disease in patients treated by radical prostatectomy were also analysed. Results The study included 694 patients; the median age at diagnosis increased significantly (P = 0.004) and there was a significant increase in clinical T1c disease (relative risk, RR, 1.142, P = 0.022). There were also significant decreases in incidental carcinomas (RR 0.789, P < 0.001), patients with a serum prostatespecific antigen (PSA) level of > 20 ng/mL (RR 0.848, P < 0.001) and with Gleason grade 4/5 tumours (RR 0.919, P = 0.005). There was no significant change in the percentage of clinically localized disease. Radical prostatectomy was undertaken in 179 men; the annual incidence of lymph node metastases decreased significantly (P = 0.035) and there was a significant 19% increase in the RR of having organ‐confined disease (pT1–2N0M0) and a 19% decrease in Gleason grade 4/5 tumours. Conclusions These results may reflect the annual trends of prostate cancer in Taiwan in the period for which the PSA assay became available. The increasing application of PSA testing was associated with a significant increase in clinical T1c disease and decrease in incidental carcinoma. There was also a significant trend towards less aggressive cancers. Despite the dramatic increase in the annual detection rate, tumours were not detected at an earlier stage. However, for patients treated with radical prostatectomy, there was a significant change to earlier stage disease and fewer de‐differentiated cancers.
The development of the external urethral sphincter in humans
Authors: Ludwikowski B. , Oesch Hayward I. , Brenner E. , Fritsch H. 
Published: March 2003

Objective To assess the hypothesis that during fetal development, the external urethral sphincter changes from a concentric sphincter of undifferentiated muscle fibres to a transient ring of striated muscle which regresses caudo‐cranially in the posterior urethra during the first year of life, when the sphincter assumes its omega‐shaped configuration.Materials and methods The anatomy and development of the external urinary sphincter was assessed in human males and females during fetal life. Plastic‐embedded sections (transverse, sagittal and frontal planes; 300–700 µm) of the pelvis of 31 females and 31 males (9 weeks of gestation to newborn) were stained with azure II/methylene blue/basic fuchsin and viewed at × 4–80. The sections of interest were taken from the bladder neck to the perineum. The sections of the membranous urethra were reconstructed three‐dimensionally using a computer program.Results In both male and female an omega‐shaped external sphincter was apparent in all specimens at > 10 weeks of gestation. In the early fetal period (ninth week), there was undifferentiated mesenchyme; in this period the mesenchyme was more dense in the anterior part and loose in the posterior part of the urethra. In females, there was a close connection between the urethra and the anterior wall of the vagina.Conclusion The omega‐shaped configuration of the external urethral sphincter was recognisable from 10 weeks of gestation in both sexes. There was no suggestion of a change from a cylindrical to an omega‐shaped sphincter in the fetal period to birth. Also, a transient ‘tail’ posterior to the sphincter was not apparent. The rectovesical septum was well developed in neonates. There is no reason to assume that the development of the septum leads to an apoptosis of muscle cells in the posterior part of the external sphincter in males after birth. The anatomical development of the external sphincter does not explain transient outlet obstruction during fetal life. The function of the muscle may change during development because of neuronal maturation.