bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bladder functional outcome after delayed vesicostomy closure and antireflux surgery in young infants with ‘primary’ vesico‐ureteric reflux
Authors: Podesta M.L. , Ruarte A. , Herrera M. , Medel R. , Castera R. 
Published: March 2003

Objective To evaluate bladder function by conventional urodynamic investigations in young infants with primary vesico‐ureteric reflux (VUR) who had undergone an initial temporary cutaneous vesicostomy followed by later antireflux surgery and vesicostomy closure.Patients and methods From 1983 to 1990, nine boys (10–360 days old) with primary VUR were treated with an initial vesicostomy, followed by delayed closure of the vesicostomy and the simultaneous surgical correction of reflux. Severe VUR was detected bilaterally in seven and unilaterally in two infants at the time of the initial diagnosis. The mean (

sd, range) age at vesicostomy was 12.4 (8, 3–23) months and the duration of bladder defunctionalization 38.7 (25.5, 18–90) months. All patients were assessed urodynamically after closing the vesicostomy, using rapid‐fill cystometry with normal saline solution at room temperature. The mean (range) age at the time of urodynamic testing was 7.3 (5–15) years; the mean (

sd, range) follow‐up was 10.1 (4.1, 5–17) years.Results Six boys with bilateral VUR underwent successful ureteroneocystostomy; nephroureterectomy was required in one patient. In two patients the VUR resolved with time. After re‐functionalization, the mean (

sd, range) maximum cystometric capacity, expressed as a percentage of the mean bladder capacity for age, was 1.4 (0.5, 0.6–2.2)%. In three patients the bladder capacity was higher ( 40%) than expected for age, while one had diminished (< 70%) bladder capacity. The mean (range) end‐filling detrusor pressure was 14.5 (5–42) cmH2O and the mean (

sd, range) compliance 24 (13.9, 4–44) mL/cmH2O. Two patients had a compliance of < 10 mL/cmH2O, one of whom had associated unstable detrusor contractions of 90 cmH2O. The mean (

sd, range) detrusor voiding pressure at peak flow was 47.3 (16.8, 5–76) cmH2O. One patient had a residual urine volume of 8% of bladder capacity. At the follow‐up, only one patient (aged 5 years) with detrusor instability had urinary incontinence.Conclusion This study shows that the bladder of young infants with primary VUR treated with temporary vesicostomy regained normal function after re‐functionalization of the lower urinary tract.
Effect of different 5‐hydroxytryptamine receptor subtype antagonists on the micturition reflex in rats
Authors: Testa R. , Guarneri L. , Angelico P. , Velasco C. , Poggesi E. , Cilia A. , Leonardi A. 
Published: March 2003

Objective To evaluate the effects of antagonists of different subfamilies of 5‐hydroxytryptamine (5‐HT) receptors on bladder function in anaesthetized and conscious rats. Materials and methods The urinary bladder of female anaesthetized rats was catheterized urethrally and filled with physiological saline until spontaneous bladder contractions occurred. Infravesical pressure was measured by a pressure transducer and displayed continuously on a chart recorder. The time of bladder quiescence (to the disappearance of rhythmic contractions) after injection with different compounds tested was recorded. Conscious rats underwent cystometry with chronically (infravesical) implanted catheters to continuously record bladder capacity (evaluated as amount of saline infused between voiding cycles) and maximal voiding pressure. The affinity for the human recombinant serotoninergic 5‐HT1A subtype (inhibition of specific binding of [3H]8‐hydroxy‐2‐(di‐n‐propylamino) tetralin) and the effects on the [35S]guanosine 5′‐(γ‐thio) triphosphate (GTPγS) binding in HeLa cells was also evaluated. Results Among the compounds tested, only 4‐(2′‐methoxy‐phenyl)‐1‐[2′‐(n‐2′′‐pyridinyl)‐p‐iodobenzamido]‐ethyl‐piperazine (p‐MPPI) and methiothepin showed nanomolar affinity for the 5‐HT1A receptors, the former being a neutral antagonist and the latter an inverse agonist in the [35S]GTPγS binding model. Intravenous injection of low doses of p‐MPPI and methiothepin induced a dose‐dependent disappearance of isovolumic bladder contractions in anaesthetized rats (> 10 min). At the highest doses, the dose‐response curves were bell‐shaped. The amplitude of bladder contractions was not markedly altered. The tested antagonists of 5‐HT2, 5‐HT3, 5‐HT4, and 5‐HT6 serotoninergic subtypes were poorly active or inactive in the model. Similarly, these compounds were inactive on cystometry in conscious rats, whereas p‐MPPI and methiothepin induced a consistent increase in bladder capacity. Methiothepin also decreased the voiding pressure, whereas p‐MPPI did not affect this variable. Conclusions These findings confirm that only selective 5‐HT1A receptor antagonists have favourable effects on the bladder, inducing an increase in bladder capacity with no derangement of bladder contractility.
Capsaicin receptor VR1 and ATP‐gated ion channel P2X3 in human urinary bladder
Authors: Yiangou Y. , Facer P. , Ford A. , Brady C. , Wiseman O. , Fowler C.J. , Anand P. 
Published: March 2003

Objectives To determine the presence, distribution and molecular forms of the vanilloid receptor VR1, and confirm the presence and distribution of the ATP‐gated ion channel P2X3 in the human urinary bladder. Materials and methods Normal urinary bladder tissues were obtained at postmortem from four subjects. Eight urinary bladder biopsies were also taken from patients with detrusor hyper‐reflexia treated with intravesical resiniferatoxin. The specimens were studied using affinity‐purified specific antibodies to VR1 and P2X3 by Western blotting and immunocytochemistry, and compared with immunostaining using antibodies to the pan‐neuronal marker PGP 9.5 and Schwann cell marker S‐100. Results VR1‐ and P2X3‐immunoreactive fine nerve fibres were scattered throughout the suburothelium of the normal bladder and cystoscopic biopsies, and traversed the muscle layer. They had a similar distribution to PGP 9.5‐immunoreactive fibres, but there were fewer, suggesting localization in subsets of axons. Western blot studies showed an expected 100‐kDa VR1 protein and a P2X3‐immunoreactive 66‐kDa protein. Conclusion VR1 and P2X3 are present in the human urinary bladder and may contribute to distinct pathophysiological states of bladder overactivity, in accord with their differential expression in sensory neurones. Intravesical vanilloids act via VR1 and are effective in the treatment of detrusor hyper‐reflexia. P2X3 may represent a selective therapeutic target for other causes of overactive bladder.
The use of renal scintigraphy in assessing the potential for recovery in the obstructed renal tract in children
Authors: Thompson A. , Gough D.C.S. 
Published: March 2003

Objective To assess the value of renal scintigraphy with 99mTc‐dimercaptosuccinic acid (DMSA) in predicting functional recovery after the surgical relief of obstructed kidneys in children. Patients and methods Forty‐three children underwent surgery to relieve upper urinary tract obstruction; 37 had pelvi‐ureteric junction obstruction and six had vesico‐ureteric junction obstruction. The indication for surgery was a combination of an obstructed renogram with symptoms of either pain or pyelonephritis. Most children (41) had < 40% function on the affected side before surgery, with just two having hyperfunction (> 55%). In all patients intravenous urography before surgery showed hydronephrosis, and a micturating cystogram was used to exclude coexisting reflux in the presence of an associated megaureter. Diuretic renography (using 99mTc‐mercaptoacetyl triglycine or 123I‐hippuran) and DMSA scintigraphy were both carried out before surgery and the renography repeated 6 months afterward. Results The renographic drainage curves improved from obstructed to unobstructed or ‘dilated unobstructed’ on all postoperative studies. Regression analysis showed that preoperative DMSA scan was an excellent predictor of outcome (P < 0.001) whilst the preoperative renogram was a relatively poor predictor of the functional result. In four patients where the initial renographic function was < 10%, DMSA scintigraphy predicted correctly the capacity for recovery in three and the inability to improve in the fourth. Conclusion Before surgery, DMSA scintigraphy in children with upper urinary tract obstruction is a more useful estimate of probable long‐term renal function than value from diuresis renography. If there is doubt about the desirability of reconstructive surgery, a DMSA scan may eliminate the need for more invasive methods of estimating recovery, e.g. a period of nephrostomy drainage.
Acute urinary retention: defining the need and timing for pressure‐flow studies
Authors: Dubey D. , Kumar A. , Kapoor R. , Srivastava A. , Mandhani A. 
Published: March 2003

Objective To investigate the utility of ‘late’ pressure‐flow studies in predicting the outcome of prostatectomy for acute urinary retention. Patients and methods Fifty‐eight patients with acute urinary retention were prospectively assessed using the International Prostate Symptom Score and pressure‐flow studies at a median (range) of 24 (13–60) days after the episode of retention, and before transurethral resection of the prostate. Bladder outlet obstruction and bladder contractility were graded using a modified adaptation of Schäfer's passive urethral linear resistance relation. Results Fifty‐six (97%) patients generated a voluntary detrusor contraction, with a mean (range) detrusor pressure at maximum flow of 72.7 (5–144) cmH2O, and 43 (75%) patients were deemed to be obstructed. Eight (16%) patients failed to void after prostatectomy and required clean intermittent catheterization. There were statistically significant differences between successful and unsuccessful patients in mean (sd) age, at 66.30 (6.9) vs 78.8 (2.6) years (P = 0.001), detrusor instability (49% vs 0%, P = 0.01), inability to void during pressure study (8% vs 75%, P = 0.001), and maximal detrusor pressure in the voiding phase, at 80 (36.0) vs 19 (11.2) cmH2O (P = 0.001). Conclusions In patients with acute urinary retention, pressure‐flow studies undertaken after a period of adequate bladder rest (> 3 weeks) are useful in predicting the surgical outcome. Old age, absence of bladder instability, inability to void during the pressure‐flow study and a maximal detrusor pressure of < 20 cmH2O are associated with a poor outcome after prostatectomy.
The clinical and radiological findings in boys with endoscopically severe congenital posterior urethral obstruction
Authors: Imaji R. , Dewan P.A. 
Published: March 2003

Objective To assess the clinical and radiological spectrum in boys with endoscopically severe posterior urethral obstruction, as there is a broad clinical spectrum which does not always correlate with the cystoscopic findings. Patients and methods Between December 1990 and July 2000, 39 boys (newborn to 12 years old) underwent cystoscopy to investigate a urethral anomaly and were found to have a severe obstructing posterior urethral membrane. Their voiding cystograms, video‐recorded cystoscopy and presenting signs were reviewed. Results Of the 39 boys assessed, a voiding cystogram and presenting signs were available in 36. Of these 36 boys, three cystograms were initially reported as normal, eight showed posterior urethral dilatation as the only feature, and the remainder had more severe bladder and upper tract changes. Fourteen were diagnosed after identifying antenatal hydronephrosis, four presented with voiding dysfunction, one with haematuria and 17 were found after investigation of a urinary tract infection. Conclusions This study shows that a congenital posterior urethral membrane that has only a small posterior defect endoscopically can have a wide clinical and radiological spectrum. The difference in outcome may be caused by variations in the response of the bladder to the obstruction, resulting in a different effect on the upper tracts.
Male‐to‐female transsexualism: a technique, results and long‐term follow‐up in 66 patients
Authors: Krege S. , Bex A. , Lümmen G. , Rübben H. 
Published: March 2003

Objective To report experience of a new surgical technique in male‐to‐female transsexual patients, the complications, and the functional and psychosocial long‐term results. Patients and methods From April 1995 to July 2000, 66 male patients underwent gender‐transforming surgery at our institution and were registered prospectively. The operation should result in a normal appearing introitus, a vaginoplasty allowing for sexual intercourse and a sensitive clitoris. This was achieved by preserving the neurovascular bundle. The glans was transformed into a clitoris, the phallic cylinder used as a vagina and labia were formed from the scrotal folds. Results Major complications during, immediately and some time after surgery occurred in nine of the 66 patients (14%), including severe wound infections in six, a rectal lesion in three, necrosis of the glans in three and necrosis of the distal urethra in one. Minor complications, e.g. meatal stenosis in seven patients, occurred in 24 (36%) of patients. Ten patients with insufficient penile skin had the phallic cylinder augmented with a free‐skin mesh graft, but in three of these patients an ileal augmentation was finally constructed because scarring occurred at the suture line between the penile skin and the augmented graft. A long‐term follow‐up questionnaire about the functional and psychosocial aspects was completed by 31 patients. More than 90% of the patients were satisfied with the cosmetic result and capacity for orgasm; 58% reported having sexual intercourse. Conclusion Male‐to‐female surgery can achieve excellent cosmetic and functional results. Although the operative technique is partly standardized, surgery remains challenging because of several possible complications. None of the present patients claimed to regret their decision to undergo gender‐transforming surgery.
Establishment of a testicular carcinoma cell line producing α‐fetoprotein
Authors: Ueno M. , Nakashima J. , Ohigashi T. , Deguchi N. , Ban S. , Akita M. , Murai M. 
Published: March 2003

Objective To characterize a newly established human testicular carcinoma cell line that continuously produces α‐fetoprotein (AFP), and to investigate the effects of retinoic acid on AFP production. Materials and methods A 24‐year‐old man underwent a radical orchidectomy for a right testicular tumour and was found to have two separate metastatic lesions in the lungs, both of which were removed surgically. The cancer cells were isolated from one of the tumours, which was composed of undifferentiated germ cells and produced AFP; the cells were cultured in a monolayer. This cell line was designated as KU‐MT. Results The cell line was successfully maintained both in athymic nude mice and in culture. Histological examination showed that the xenografted tumours were composed of cells in the reticular, solid and glandular patterns of a yolk sac tumour, and of embryonal carcinoma cells. These cells immunostained positively for AFP. On electron microscopy, the extracellular deposition of a basement lamina‐like substance, a typical feature of yolk sac tumour, was detected. The AFP production in mice correlated well with the tumour weight of the xenograft. The cultured KU‐MT cells were oval to polygonal in morphology and grew exponentially, with a population doubling time of ≈ 2 days. Chromosomal analysis showed a modal number of 57 with consistent structural abnormalities of +add(1)(p13), del(1)(q32), del(2)(q31), add(6) (q21), +add(9)(p22), add(11)(p15), and add(14)(p11). Reverse‐transcription polymerase chain reaction analysis showed that the retinoic acid receptors (RAR)‐α, RAR‐γ, and retinoid X receptor‐α were present in the cells. The expression of AFP mRNA was up‐regulated in response to all‐trans‐retinoic acid; treatment with this agent caused morphological changes and induced apoptosis in the cells. Conclusions This newly established cell line provides a reproducible model system that should offer a good insight into the differentiation of testicular carcinoma.
The urethral plate – does it grow into the genital tubercle or within it?
Authors: Penington E.C. , Hutson J.M. 
Published: March 2003

Objective To determine whether the urethral plate grows into the genital tubercle or develops within it. Materials and methods Sprague‐Dawley rat embryos were examined at 11–21 days of gestation and compared with available human embryo sections. Rat embryos were examined by a combination of light microscopy, dissection, serial histological section and immunohistochemistry. Results In rat embryos the urethral plate extended to the tip of the genital tubercle from the earliest stages of genital tubercle development. The plate formed from adherence in the sagittal plane of the inner walls of the primitive cloacal cavity. The urethral plate continued to extend to the tip of the genital tubercle throughout penile development in the male and developed a lumen ahead of the advancing perineal mesenchyme. In the female the perineal side of the urethral plate disintegrated by massive apoptosis. This loss of perineal substance allowed the genital tubercle to collapse on itself and left the urogenital opening at the base of the genital tubercle. Human embryos also showed the presence of the urethral plate at the tip of the genital tubercle throughout genital tubercle development. Conclusion The urethral plate forms ab initio within the genital tubercle and extends to the tip; it does not grow into the genital tubercle as is often described. The contribution of ectodermal ingrowth to urethral development at the tip of the penis is minimal.
Prognostic value of the Gleason score in prostate cancer
Authors: Egevad L. , Granfors T. , Karlberg L. , Bergh A. , Stattin P. 
Published: March 2003

Objective To investigate the prognostic value of the Gleason score in prostate cancer. Patients and methods A consecutive series of 305 men with prostate cancer diagnosed at transurethral resection (1975–1990) and with no curative treatment was analysed. There was no assessment of prostate‐specific antigen level during this period. The mean (range) age at diagnosis was 73.7 (52–95) years and the mean follow‐up was 6.4 (0–22) years. The influence of Gleason score and the percentage of the specimen area with tumour (% cancer) on disease‐specific survival were assessed using Kaplan–Meier analyses. Results Of 305 cancers, 22% had a Gleason score of 4–5, 29% of 6, 18% of 7 and 32% of 8–10. At the follow‐up, 89% of the men had died, of whom 42% had died from prostate cancer. The disease‐specific 10‐year survival was 56%. The disease‐specific mean survival (DSMS) for Gleason score 4–5, 6, 7 and 8–10 was 20, 16, 10 and 5 years, respectively (P < 0.001). The DSMS did not differ significantly between Gleason 4 and 5 or between 8–10. There was a trend towards shorter survival for Gleason 4 + 3=7 (DSMS 9 years) than GS 3 + 4=7 (DSMS 13 years; P = 0.16). Gleason score and % cancer were independent predictors of DSMS (P < 0.001). Conclusion The long‐term prognosis of prostate cancer on deferred treatment is predicted well by the Gleason score. Four prognostic categories of prostate cancer are suggested, i.e. Gleason score 4–5, 6, 7 and 8–10.
Paediatric penile trauma
Authors: El‐Bahnasawy M.S. , El‐Sherbiny M.T. 
Published: March 2003

Objective  To report our experience with paediatric penile trauma in a retrospectively evaluated series. Patients and methods

The records of 64 boys (mean age 7 years,
sd 4) who were hospitalized over the last 20 years because of penile trauma were reviewed. The cause of trauma was circumcision in 43 (67%), a human hair‐tie strangulation injury in 10 (16%), an animal attack in four (6%), a bicycle accident in four (6%), a zipper injury in two (3%) and electrical injury in one (2%). Patients were managed according to the severity of the injury. Eight (12%) with minimal skin loss or meatal injury underwent primary skin closure or meatoplasty; 40 (62%) with urethrocutaneous fistulae underwent repair and five (8%) with a glans hanging on a thin pedicle had the glans and the urethra reconstructed. Patients with partial or complete amputation of the glans (10) underwent primary haemostasis and meatoplasty; the penis was lengthened in one. One child with complete avulsion of the penis underwent perineal urethrostomy. Results

Fifty‐four patients (84%) were followed for a mean (
sd ) of 5.7 (4) years; there were good cosmetic and functional results in 45 (83%). Fifteen patients are now adults; 13 (86%) reported normal sexual function. Of the 40 patients assessed with circumcision‐related injuries, six (15%) had functional disability (short penis in one and fistulae in five). Of the 10 patients with a hair‐tie injury, none lost their glans. Of the four injuries caused by animal attacks, three had poor results (emasculation in one, short penis in one and severe curvature in the remaining patient). There was no functional disability in the remaining forms of trauma. Conclusions  In our region, ritual circumcision and hair‐tie strangulation injuries are the most common causes of penile trauma in children. Good functional and cosmetic results are possible in most cases. However, animal attacks are associated with the highest rate of long‐term functional and cosmetic disability.
Polyphenols in red wine inhibit the proliferation and induce apoptosis of LNCaP cells
Authors: Romero I. , Páez A. , Ferruelo A. , Luján M. , Berenguer A. 
Published: March 2003

Objective To assess the effect of five polyphenol constituents of red wine (quercetin, morin, rutin, gallic acid and tannic acid) on the proliferation of LNCaP cells, and to quantify the extent of apoptosis with each polyphenol. Materials and methods LNCaP cells (500) were cultured in microtitre plates and treated with gallic acid, tannic acid, quercetin (1, 5 and 10 µmol/L), rutin and morin (25, 50 and 75 µmol/L). A colorimetric immunoassay was then used to determine the extent of proliferation at 24, 48, 72 and 96 h, and a cell‐death detection assay to assess apoptosis at 24, 48 and 72 h. Results Gallic and tannic acid (5 and 10 µmol/L), morin (50 and 75 µmol/L), quercetin (5 and 10 µmol/L) and rutin (50 and 75 µmol/L) all significantly inhibited (P<0.05) cell proliferation compared with the control. Apoptotic indexes were significantly greater (P<0.01) in the presence of gallic (5 and 10 µmol/L) and tannic acid (5 and 10 µmol/L), and rutin (75 µmol/L, P<0.05) than in the control. The apoptotic effect of morin (75 µmol/L), although significant (P<0.01), only appeared at 72 h. Conversely, while significant (P<0.05) quercetin (5 and 10 µmol/L) had a transient (first 48 h) apoptotic effect compared with the control. Conclusion Quercetin, rutin, morin, gallic acid and tannic acid inhibited the growth of LNCaP cells at different concentrations, and induced apoptosis. The results provide a strong rationale for studying the in vivo effects of these compounds.