bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of androgens on the expression of nitric oxide synthase mRNAs in rat corpus cavernosum
Authors: Park  , Kim  , Kim  , Paick  
Published: March 2003

ObjectiveTo examine the effects of androgens on erectile response and the expression of nitric oxide synthase (NOS) isoform mRNAs in the penile corpus cavernosum of castrated rats.Materials and methodsThe study comprised 50 adult male Sprague‐Dawley rats in five groups: sham controls; castrated; castrated and receiving testosterone; castrated and receiving dihydrotestosterone (DHT); castrated and receiving testosterone and 5α‐reductase inhibitor (finasteride). Androgen replacements were administered via implants of silicone tubing. After 7 days, some animals underwent electrical stimulation of the cavernosal nerves and the remainder were used for further analysis. NOS activity was measured in the soluble fraction of the corpus cavernosum, using the Griess reaction. Total RNA was isolated and nNOS and eNOS mRNA expression examined using semiquantitative reverse‐transcriptase polymerase chain reaction.ResultsCastration caused a marked decrease in erectile response and the ratio of maximal intracavernosal pressure (ICPmax) to systemic blood pressure (SBP), although both testosterone and DHT effectively restored the response to normal. NOS activity and the amount of nNOS mRNA were reduced in castrated rats but restored by androgen replacement. Although there was no significant difference in NOS activity between the androgens, nNOS mRNA expression was higher in rats treated with DHT. There were no effects of androgen in rats treated with finasteride, as the ICPmax/SBP ratio, NOS activity and amount of nNOS mRNA decreased. eNOS mRNA expression was independent of androgen.ConclusionsAndrogens enhance nNOS gene expression in the penile corpus cavernosum of rats, suggesting that they play an important role in maintaining NOS activity. Of the two androgens, DHT was more potent.
Paternity after bilateral vasectomy
Authors: Verhulst  , Hoekstra  
Published: March 2003

ObjectivesTo determine whether the occurrence of recanalization depends on the technique of vasectomy.Materials and methodsA survey was conducted among Dutch urologists using a questionnaire in which information was gathered about the surgical procedure, postoperative complications, results of semen analysis after vasectomy, time between vasectomy and occurrence of paternity, results of semen analysis after paternity, performance of revasectomy, results of histological examination of the revasectomy specimen and whether the event had changed the protocol of the urologists.ResultsIn all, 32 cases of paternity after vasectomy were registered. Surgical techniques and the criteria for a successful vasectomy differed among the responding urologists. There was a difference in time to paternity between men who did and did not correspond with the criteria. In most cases, semen analysis after paternity showed numerous motile sperm. Six men initiated litigation after paternity and the vasectomy protocol was modified by five urologists.ConclusionPaternity consequent on recanalization can occur at any time after bilateral vasectomy and does not depend on the surgical procedure or criteria for sterility. Because of the major consequences of paternity after vasectomy for both the man and urologist, accurate information about the possibility of recanalization should be given to the man beforehand.
Optimal conditions for the long‐term modulation of the micturition reflex by intravesical electrical stimulation: an experimental study in the rat
Authors: Jiang  , Lindström  
Published: March 2003

ObjectiveTo determine whether induced bladder contractions influence the modulation by intravesical electrical stimulation (IVES) of the micturition reflex in anaesthetized rats, and to identify the optimal IVES frequency and duration.Materials and methodsSeventy‐six adult female rats, anaesthetized by α‐chloralose, were divided into four groups to study the effect of: (i) IVES in combination with bladder contractions; (ii) bladder contractions alone; (iii) IVES frequency; and (iv) IVES duration. IVES was administered using a catheter electrode in the bladder. The effect of various IVES procedures was evaluated by determining the micturition threshold volume obtained from repeated cystometries before and after stimulation.ResultsAdministering IVES with standard parameters induced a significant decrease in the micturition threshold volume for about an hour. There was no difference in outcome between IVES with the bladder filled and contracting during the stimulation or empty and not contracting. Imposed bladder contractions per se had no effect on the micturition threshold volume. IVES at low frequencies (≤20 Hz) had a better modulatory effect than higher frequencies and the optimum duration of IVES was 5 min.ConclusionsEvoked bladder contractions did not improve the IVES‐induced modulation of the micturition reflex. These findings might help to improve the clinical application of the IVES procedure.
The management of brain metastasis in nonseminomatous germ cell tumours
Authors: Mahalati  , Bilen  , Özen  , Aki  , Kendi  
Published: March 2003

ObjectiveTo review our experience of patients with brain metastases from nonseminomatous germ cell tumours (NSGCTs) and to indicate important clinical observations.Patients and methodsBetween 1990 and 1996, 167 patients with metastatic NSGCT were treated in our department; 11 had brain metastases (eight with solitary metastases and three with multiple lesions, mean age 27 years, range 18–41). These patients were treated initially with either; cisplatin, bleomycin, etoposide and/or cisplatin, vincristin, methotrexate, bleomycin, actinomycin‐D, cyclophosphamide, etoposide and intrathecal methotrexate chemotherapy protocols. Six patients received chemotherapy alone, one had chemotherapy plus radiotherapy and four had all three treatments. Patients with brain metastases were classified according to mode of presentation, and their treatments and outcomes analysed.ResultsTen patients presented with symptoms related to intracranial lesions, e.g. intractable headache, seizures, severe vomiting, hallucinations and hemiparesis. All patients with brain metastasis had bulky thoracic disease. The incidence of clinical brain metastases in patients with advanced thoracic disease was 32% (11/34). Four patients with brain metastases at presentation were alive after 3, 12, 34 and 47 months. The only patient with isolated brain relapse died within 7 months, despite combined treatment. Two of the five patients who developed brain metastases during the course of the disease are alive with no evidence of disease at 3 and 6 months after salvage chemotherapy.ConclusionPatients with single brain metastasis seem to have a better prognosis in the present than in other reported series. Chemotherapy was used initially, followed by surgery and radiotherapy in those who did not achieve complete remission with chemotherapy. Patients with progressive disease and multiple brain metastasis do not seem to benefit from initial surgical resection. Importantly, a significant proportion (32%) of patients with bulky lung metastases had or subsequently developed brain metastases. Thus it is suggested that routine cranial imaging should be performed in patients with bulky thoracic disease.
Diagnosis and prediction of recurrence and progression in superficial bladder cancers with DNA image cytometry and urinary cytology
Authors: Desgrippes A. , Izadifar V. , Assailly J. , Fontaine E. , Beurton D. 
Published: March 2003

ObjectiveTo investigate the roles of urinary cytology and image cytometric analysis of nuclear DNA ploidy pattern in the diagnosis and prediction of recurrence and/or progression of superficial bladder cancers. Patients and methodsAliquots of catheterized urine from 92 patients with primary (23) or previous (69) superficial bladder cancers were assessed using urine cytology and image‐analysis cytometry independently. ResultsOf the 23 primary superficial transitional cell carcinomas (TCCs), 11 (48%) were detected by urinary cytology while 12 (52%) were detected by image‐analysis cytometry (P > 0.05) and 13 (57%) were revealed by combined cytology and cytometry. Of 42 recurrent superficial TCCs, 29 (69%) were detected by urinary cytology, whilst 19 (45%) were diagnosed by cytometry (P < 0.05) and 29 (69%) by combined cytology and cytometry. The degree of ploidy in relation to pathological stage and/or grade showed an increasing frequency of aneuploid pattern in more invasive and undifferentiated tumours, but with no statistical significance (P > 0.05). The positivity of DNA image cytometry had no significant association (P > 0.05) with tumour recurrence and/or progression. ConclusionsDNA image cytometry can provide a limited but not significant advantage over urinary cytology in the detection of primary superficial TCCs, but it does not seem to be indicated for the prediction of tumour recurrence and/or progression.
Cremaster muscles obtained from boys with an undescended testis show significant neurological changes
Authors: Tanyel F.C. , Erdem S. , Büyükpamukçu N. , Tan E. 
Published: March 2003

Objective To compare cremaster muscles (CMs) obtained from boys with inguinal hernia, hydrocele or an undescended testis and those obtained from girls with inguinal hernia, thus defining the changes associated with each clinical condition. Materials and methods CM samples were obtained from 26 boys and three girls with inguinal hernia, and 18 boys who had undergone surgery for an undescended testis (12) or hydrocele (six). The samples were frozen in isopentane cooled in liquid nitrogen and were processed for sectioning by cryostat. Sections (12 µm) were stained with a several histochemical stains. The presence of central nuclei, fibre splitting, basophilic fibres, fibre necrosis, inflammatory changes, small angular fibres, fibre hypertrophy, grouped atrophy, and endo‐ and perimysial fibrosis were evaluated. From each specimen, 200 fibres were also analysed morphometrically using a computerized image analysis system. Results Neurogenic changes were apparent in all the CMs from patients with an undescended testis but none of the samples obtained from girls showed any changes. While only two specimens of 26 from boys with inguinal hernia (8%) had evidence of neurological alterations, eight CM (31%) had general changes. The mean (SD) fibre diameters did not differ significantly among the groups with inguinal hernia, hydrocele and undescended testis, at 23.0 (8.6), 24.4 (4.5) and 23.0 (10.5) µm, respectively. Conclusion Cremasteric muscles associated with an inguinal hernia or an undescended testis differ; neurogenic changes were detected within all the CM of boys with an undescended testis. These changes in the CM may have influenced the location of the testis.
The effectiveness of terazosin, an α1‐blocker, on bladder neck obstruction as assessed by urodynamic hydraulic energy
Authors: Yamanishi T. , Yasuda K. , Sakakibara R. , Hattori T. , Tojo M. 
Published: March 2003

Objective To investigate the effectiveness of terazosin, an α1‐adrenoceptor blocking agent, on bladder neck obstruction (BNO), by assessing the urodynamic hydraulic energy profile. Patients, subjects and methods The study included 17 men (mean age 60.1 years, range 24–84), comprising 11 patients with BNO (mean age 66.5 years) and six normal volunteers (mean age 48.1 years). A five‐transducer microtip catheter was used to measure the pressure in the bladder and at the bladder neck, and in the membranous and bulbous urethra during voiding. All the subjects then received terazosin, 1 mg/day orally for 2 weeks, and were re‐assessed. Results The bladder neck diameter at maximum flow significantly (P < 0.02) increased in the 11 patients with BNO after treatment with terazosin. The relative hydraulic energy profiles before terazosin treatment showed the greatest hydraulic energy loss between the membranous and the bulbous urethra in the normal subjects, and between the bladder neck and the membranous urethra in the men with BNO. After terazosin treatment, the greatest energy loss was between the membranous and the bulbous urethra in men with BNO, similar to that in the normal controls, i.e. the whole profile of relative hydraulic energy became normal. Conclusion Terazosin was effective in opening the bladder neck and improving the hydraulic energy profile in men with BNO.
The effect of pregnancy and delivery on the function and ultrastructure of the rat bladder and urethra
Authors: Bakircioglu M.E. , Sievert K.‐D. , Lau A. , Lin C.‐S. , Lue T.F. 
Published: March 2003

Objective To examine the effect of pregnancy and delivery on the function and ultrastructure of the bladder and urethra in rats. Material and methods The study comprised six virgin and 18 pregnant rats; both groups underwent cystometry (at the 19th day of gestation, and 2 days and 6 weeks after parturition). Tissues from the bladder and urethra were collected for electron microscopy, western blotting and immunostaining for caveolin‐1 and caveolin‐3. Results The bladder capacity was greater and the modified leak‐point pressures lower in pregnant and 2‐day postpartum rats than in virgin and 6‐week postpartum rats. The residual volume was significantly higher in the pregnant group. Electron microscopy showed more sarcolemmal caveolae in the smooth muscle cells of both the bladder and urethra of virgin rats than in the other groups. Lipid droplets and subsarcolemmal mitochondria accumulated in pregnant and 2‐day postpartum rats. Caveolin‐1 protein was detected in the cytoplasmic membrane of urethra and bladder smooth muscle cells. Caveolin‐3 was detected in the membrane of striated muscle in the intrinsic sphincter. Western blotting showed increased caveolin‐1 protein expression in the bladder and urethra of 2‐day postpartum rats; in contrast, levels of caveolin‐1 were lower in pregnant rats than in virgin and 6‐week postpartum rats. Conclusions During pregnancy there was a significant decrease in sarcolemmal caveolae and caveolin‐1 in the smooth muscle cells of the rat bladder and urethra. The changes in caveolae and the membrane protein caveolin may play a role in the functional changes associated with pregnancy and after delivery.
Is bowel preparation useful before radiography of the renal tract in patients with spinal cord injury?
Authors: Subramonian K. , McNaught J. , Spencer N. , Harrison S.C.W. 
Published: March 2003

Objectives To assess, in a blinded study, the usefulness of bowel preparation in improving the quality of radiography of the renal tract in patients with spinal cord injury (SCI). Patients and methods Plain abdominal radiographs of 56 patients with SCI were selected; 24 of the patients had received bowel preparation and 32 had not. The films were independently assessed by one radiologist and one urologist unaware of the treatment and identity of the patients. Each film was divided into five regions of interest and scores of 1–4 (1 for least and 4 for best visibility) assigned to each area. In films with a low aggregate visibility score ( 12), the cause of poor visibility was assessed in relation to faecal residue and gas. Results The difference between the overall mean visibility score for bowel‐prepared and unprepared patients was not statistically significant. In films with poor visibility, gas shadows predominated over bowel shadows in the bowel‐prepared group, although this trend was not statistically significant. Of the five areas, the bladder was scored as being the most clearly seen in both groups. Conclusions These findings suggest that bowel preparation does not increase the diagnostic value of radiographs of the renal tract in patients with SCI.
Artificial sphincter insertion after radiotherapy: is it worthwhile?
Authors: Manunta A. , Guillé F. , Patard J.J. , Lobel B. 
Published: March 2003

Objective To determine the influence of radiotherapy on the outcome of artificial urinary sphincter implantation.Patients and methods A series of 72 men who had an artificial urinary sphincter inserted were reviewed retrospectively, analysing in detail the information from 15 patients with a past history of pelvic radiotherapy.Results In those who had undergone radiotherapy, the complication rate was higher, both for re‐operation (eight of 15) and infection (three); 11 of the 15 patients were continent after surgery, compared with 51 (89%) of the 57 in the unirradiated group.Conclusions An artificial sphincter can be inserted after pelvic radiotherapy reasonably successfully, but at the cost of a high complication and re‐operation rate. Patients with a previous history of radiotherapy should be informed of the higher risk of surgical revision associated with insertion of the prosthesis.
Early observations of the effect of extracorporeal shockwave lithotripsy on blood pressure: a prospective randomized control clinical trial
Authors: Elves A.W.S. , Tilling K. , Menezes P. , Wills M. , Rao P.N. , Feneley R.C.L. 
Published: March 2003

Objective To determine, in a randomized controlled clinical trial, the effect of extracorporeal shock wave lithotripsy (ESWL) on blood pressure. Patients and methods The trial included 228 patients with small (< 15 mm) asymptomatic calyceal stones who were randomised to undergo ESWL (113 patients) or to an untreated (observed) control group (115 patients). Blood pressure was recorded at randomization using a standardized protocol. Patients undergoing ESWL received a mean (
sd) of 5281 (3462) shocks over a mean of 1.75 sessions on one of two lithotripters. Patients were then followed annually, assessing blood pressure and changes in medication. Data were analysed on an intention‐to‐treat basis. Results At randomization, 43% of patients in the control group and 53% in the ESWL group were hypertensive. Of the 228 randomized, 200 patients completed at least one annual follow‐up, of whom 192 (93 in the control and 99 in the ESWL group) had their blood pressure recorded. The mean follow‐up was 2.2 years; 35 (37%) patients in the control and 46 (46%) in the ESWL group were hypertensive (P = 0.19). Seven (7%) patients in the control group and 11 (11%) in the ESWL group were newly diagnosed to be hypertensive (P = 0.35). Conclusions In this randomized controlled clinical trial there was no evidence that ESWL causes changes in blood pressure.
The effectiveness of tenoxicam vs isosorbide dinitrate plus tenoxicam in the treatment of acute renal colic
Authors: Kekeç Z. , Yilmaz U. , Sözüer E. 
Published: March 2003

Objective To determine the effectiveness of isosorbide dinitrate in combination with tenoxicam compared with tenoxicam alone for the relief of acute renal colic. Patients and methods Fifty patients with acute renal colic were randomly and in a double blind fashion divided into two treatment groups of 25 each. Group 1 received tenoxicam (40 mg intravenously) and group 2 received tenoxicam (40 mg intravenously) plus sublingual isosorbide dinitrate (5 mg). The patients were compared for visual pain scores, heart rate and blood pressure between and within the groups before and after treatment. Results Comparing the groups, group 2 had significantly lower pain scores after treatment (P < 0.05) but no other variables were significantly different (P > 0.05 for each). Within the groups the pain scores were significantly lower after treatment in both groups (P < 0.05). Group 2 also had a significantly lower heart rate and blood pressure after treatment (P < 0.05). There were no side‐effects caused by tenoxicam and isosorbide dinitrate in either group. Conclusion The use of tenoxicam alone or combined with isosorbide dinitrate was effective in relieving of renal colic, but the relief obtained with the combination was significantly greater than tenoxicam alone.
Bladder calculi in children who perform clean intermittent catheterization
Authors: Barroso U. , Jednak R. , Fleming P. , Barthold J.S. , González R. 
Published: March 2003

Objective To examine the role of clean intermittent catheterization (CIC) as a possible predisposing risk factor for bladder calculi, assessing risk factors in patients with and without bladder augmentation, and to evaluate management options for bladder calculi in these patients. Patients and methods The records of 403 patients who were using a regimen of CIC between January 1981 and March 1998 were reviewed to identify those forming bladder calculi; stones were diagnosed in 28 patients. The patients were categorized as: group 1, patients with no bladder augmentation who catheterized urethrally (227, group 1a) or via a Mitrofanoff conduit (18, group 1b); group 2, patients with augmented bladders who catheterized urethrally (100, group 2a) or via a Mitrofanoff conduit (58, group 2b). The incidence of bladder calculi in each group was determined and compared statistically where applicable. The success of the treatment options for stone management was reviewed. Results Bladder calculi developed in 5% of patients in group 1a, 8% in group 2a, 11% in group 1b, and 10% in group 2b; the incidence of calculi was not significantly different among the groups. Of these patients, 18 (64%) were asymptomatic at the time of diagnosis and significant bacteriuria was found in 23 (88%). Difficulty in catheterizing either the Mitrofanoff conduit or the native urethra was reported in 14 (50%) of these patients. Calculi were more often solitary (71%) and typically composed of struvite or apatite. Calculi were managed by open cystolithotomy in 15 patients (54%) and endoscopically in 13 (46%). Stones recurred in nine patients (32%) after treatment, comprising four of six patients treated endoscopically with electrohydraulic lithotripsy and in five of 15 after open cystolithotomy. The mean interval to recurrence was 22.8 months. Conclusion These results suggest that patients on a regimen of CIC are at risk of developing bladder calculi but the incidence of calculi is not influenced by bladder augmentation. The presence of a Mitrofanoff conduit was associated with a slightly increased incidence of calculus formation. Open cystolithotomy was associated with a lower stone recurrence rate but there were too few patients to draw definitive conclusions.