bluuebunny/crossref_metadata_2025_split huggingface dataset:
Segmental up‐regulation of transforming growth factor‐β in the pathogenesis of primary megaureter. An immunocytochemical study
Authors: NICOTINA P.A. , ROMEO C. , ARENA F. , ROMEO G. 
Published: November 2003

Objective To examine the maturational‐delay hypothesis of primary megaureter (PM), i.e. that the condition arises by a segmental maturational delay of the ureteric wall that can resolve spontaneously within the first year of life, using comparative immunocytochemistry of ureters resected from infants and from homologous pre‐natal ureters.Materials and methods Seventeen distal urinary tracts were obtained from children with PM who were referred for surgery (aged 6 months to 8 years, mean 2.1 years). These were compared with ureteric buds obtained from 11‐week‐old human and 11‐ to 38‐week‐old calf fetuses. The samples were immunostained using a monoclonal antibody specific for transforming growth factor β (TGF‐β).Results The histological appearances of the narrowed ureteric segments from patients under 18 months old were like the fetal ureteric buds at 26–38 weeks of gestation. Positive TGF‐β immunoreactions were detected in the longitudinal muscle layer in the ureter from patients 6–12 months old. Such reactions weakened progressively in those patients older than 1 year, becoming negative in all children older than 3 years. The TGF‐β immunolabelling in resected ureters was closely similar to that in fetal ureters from 20 to 26‐week old calves.Conclusions From these results, PM should be ascribed to a segmental developmental delay of the terminal ureter arising at about 20 weeks of gestation, with a possible pathogenetic involvement of autocrine TGF‐β overexpression.
The source of urinary nitrosamines in patients with enterocystoplasties
Authors: Creagh T.A. , Picramenos D. , Smalley E.T. , Walters C.L. , Mundy A.R. 
Published: November 2003

Objective  To assess the factors influencing urinary nitrosamine production in patients with enterocystoplasties. Patients, subjects and methods  The study comprised 100 patients with an enterocystoplasty, 20 patients with interstitial cystitis, 30 with infective cystitis and 120 control subjects drawn from hospital staff and out‐patients. Urinary nitrosamine levels were measured and the urine samples cultured for micro‐organisms. Results  Nitrosamine levels were significantly higher only in patients with enterocystoplasties who also had higher urinary white cell counts or significant bacteriuria. Conclusion  Patients with an enterocystoplasty and significant bacteriuria are most at risk from potential nitrosamine‐induced epithelial injury.
Interposition of ileum in the ureter: a clinical study with
Authors: Shokeir A.A. 
Published: November 2003

Objective  To present the long‐term results of the interposition of ileum in the ureter. Patients and methods An ileal loop was interposed to replace a long defect of the upper ureter, with preservation of lower ureteric continuity, in nine patients (mean age 35 years, range 18–58). Patients were followed regularly for a mean of 5.2 years (range 2–7) and assessed using renal ultrasonography, isotopic renography and intravenous urography. Results Urinary drainage was satisfactory and renal function and configuration were improved. None of the patients experienced metabolic acidosis or electrolyte disturbances despite receiving no medication. Conclusion These results were encouraging and further clinical experience is needed to confirm that ileal interposition of the ureter is a safe and effective procedure.
A placebo‐controlled study of intravesical pentosanpolysulphate for the treatment of interstitial cystitis
Authors: Bade J.J. , Laseur M. , Nieuwenburg A. , Th. van der Weele L. , Mensink H.J.A. 
Published: November 2003

Objective To evaluate the therapeutic efficacy of intravesical pentosanpolysulphate (PPS) compared with placebo in patients with interstitial cystitis (IC).Patients and methods Twenty patients who fullfilled the diagnostic criteria for IC participated in a double‐blind placebo‐controlled study; 10 received intravesical PPS (300 mg in 50 mL of 0.9% sodium chloride) applied twice a week for 3 months and the other 10 received a placebo. Symptomatic relief and objective variables (bladder capacity voiding volumes and urinary frequency) were assessed after 3 months and the long‐term outcome of those continuing treatment was determined.Results Of the patients treated with PPS, four gained significant symptomatic relief compared with only two receiving placebo. Only the urodynamic bladder capacity showed a statistically significant increase in patients treated with PPS (P=0.047). At 18 months from the start of the study, the symptoms were relieved in eight patients while still receiving PPS instillations and in four without treatment.Conclusions These results suggest that intravesical PPS is an effective option for the treatment of IC and shows that the intravesical application of PPS is a safe treatment with no important side‐effects.
Experience with an assay for prostate‐specific antigen and transrectal ultrasonography in the diagnosis of prostate cancer
Authors: Heman‐Ackah C.A. , Festenstein J.B. , Hibbert P. , Harvey D.J. , Bunce C.J. , Gelister J.S.K. 
Published: November 2003

Objective To assess the detection of prostate cancer using the Ciba Corning ACS 180 prostate‐specific antigen (PSA) assay and transrectal ultrasonography (TRUS) in a district general hospital. Patients and methods In a preliminary study, the serum PSA level in 130 patients was measured using both the Ciba Corning and the Hybritech Tandem‐R PSA assay and the results assessed using linear regression analysis. A further study comprised 204 consecutive patients who underwent TRUS and biopsy. The histology of the prostatic biopsies was analysed according to the pre‐biopsy PSA level (Ciba Corning assay), digital rectal examination (DRE) and TRUS findings. Results The PSA levels measured using the Ciba Corning assay were about 50% higher than those using the Hybritech Tandem‐R assay. Of 204 men who had TRUS and biopsy, 56 (28%) had detectable prostate cancer, but no patient with a PSA of <6.0 ng/mL had. Five of 47 (11%), 21 of 83 (25%) and 30 of 65 (46%) patients with PSA levels in the range 6.1–15, 15.1–30 and >30 ng/mL, respectively, had cancer detected. When the DRE was negative, 18 of 111 (16%) patients had a positive biopsy, compared with 38 of 93 (41%) patients when the DRE was positive (P<0.001). In men with a PSA level of 6.1–15.0 ng/mL, positive biopsies were found in 3% when the DRE was negative, compared with 27% when it was positive (P<0.025). A TRUS abnormality was detected in 54 of 204 (26%) patients, of whom 25 (46%) had positive biopsies. Of these 54, there were 43 with hypoechoic lesions, of whom 22 (51%) had positive biopsies. The cancer detection rate was higher when both TRUS and DRE were positive (62%), with the highest detection rate (86%) occurring when the PSA level was also >30.0 ng/mL. When the DRE was positive, cancer was detected in 21 of 34 (62%) patients with a positive TRUS, but only in 17 of 59 (29%) patients with a negative TRUS (P<0.005). However, when the DRE was negative there was no significant difference in the cancer detection rates for TRUS‐positive and TRUS‐negative patients, where four of 20 and 14 of 91 (15%) patients were found to have cancer, respectively. Conclusions The positive biopsy rates in this study were comparable with those from similar studies using other PSA assays. When the DRE was negative there was a low detection rate for cancer of 3% for men with PSA levels of 6.1–15.0 ng/mL. In patients with an elevated PSA level but a negative DRE, the positive biopsy rate for TRUS‐negative patients did not differ from TRUS‐positive patients, indicating the importance of random systematic biopsies.
Long‐term follow‐up of men undergoing modified inguinal lymphadenectomy for carcinoma of the penis
Authors: Colberg J.W. , Andriole G.L. , Catalona W.J. 
Published: November 2003

Objective  To determine the long‐term outcome of men with carcinoma of the penis with clinically negative lymph nodes undergoing a modification of the standard inguinal lymphadenectomy. Patients and methods  The study included nine men (mean age 56.2 years, range 41–72) with squamous cell carcinoma of the penis who underwent a modified inguinal lymphadenectomy. Results  Of the nine patients, three had histologically positive lymph nodes; none of the patients with positive or negative nodes had evidence of recurrent disease. All patients were alive within a follow‐up of 13–108 months (mean 67.5). Early post‐operative complications occurred in two patients with skin‐flap necrosis, one with prolonged lymphatic drainage and one with a delayed groin lymphocele and cellulitis. Conclusion  The modified inguinal lymphadenectomy is a reasonable alternative to surveillance and may accurately identify men with positive nodes. Long‐term survival and low morbidity seem to justify this approach in men with squamous cell carcinoma of the penis and clinically negative inguinal lymph nodes.
The significance of serum alkaline phosphatase bone isoenzyme in prostatic carcinoma with bony metastasis
Authors: Chen S.‐S. , Chen K.‐K. , Lin A.T.L. , Chang Y.‐H. , Wu H.H.H. , Hsu E.H.S. , Chang L.S. 
Published: November 2003

Objective To evaluate the clinical significance of serum alkaline phosphatase (ALP), ALP bone isoenzyme (ALPb) and prostate specific antigen (PSA) levels in predicting bony metastasis in prostatic carcinoma.Patients and methods The levels of serum ALP, ALPb and PSA were assessed in 32 patients with prostatic carcinoma and bony metastasis (group 1), 31 with prostatic carcinoma without bony metastasis (group 2), and 31 with benign prostatic hyperplasia (group 3). Bony metastases were detected using whole‐body bone scintigraphy and ALPb was estimated electrophoretically before surgical or medical treatment. The levels of the three markers were compared for their ability to predict bony metastasis.Results In groups 1, 2 and 3, respectively, the mean (sd) serum levels of ALP were 304 (322.2), 76.6 (47.5) and 63.8 (14.7) IU/L, of ALPb were 79.9 (76.9), 23.6 (9.9) and 25.3 (9.0) IU/L and of PSA were 478.1 (352.2), 46.9 (32.1) and 8.1 (1.8) ng/mL. The differences in serum ALP and ALPb between groups 1 and 2, and between groups 1 and 3 were significant (P < 0.05), but not those between groups 2 and 3. The positive predictive value (PPV) for bony metastasis in patients with prostatic carcinoma was 91.3% (21/23) and 100% (18/18) and the negative predictive value (NPV) was 71.8% (28/39) and 68.9% (31/45) for ALP and ALPb, respectively.Conclusion Both serum ALP and ALPb were increased significantly in patients with prostatic carcinoma with bony metastasis. The level of ALPb had a higher PPV and specificity for bony metastasis than had the level of ALP, but a lower NPV and sensitivity than ALP or PSA (at PSA levels>20 ng/mL).
The incidence of post‐vasectomy chronic testicular pain and the role of nerve stripping (denervation) of the spermatic cord in its management
Authors: Ahmed I. , Rasheed S. , White C. , Shaikh N.A. 
Published: November 2003

Objective To assess the incidence of chronic post‐vasectomy testicular pain (CPTP) and evaluate the use of denervation of the spermatic cord in its management.Patients and methods A retrospective postal survey of 560 patients (mean age 36 years, range 25–55; mean time since vasectomy 19 months, range 8–39) who underwent vasectomy between July 1992 and December 1994 was carried out to determine the incidence of CPTP. A prospective study was conducted in a further group of 17 patients (mean age 43 years, range 34–60), who had had CPTP for at least one year, to evaluate the effectiveness of nerve stripping of the spermatic cord in relieving pain.Results Of 396 replies, 108 (27.2%) patients complained of some testicular pain following their vasectomy operation. In 88 (82%) of these 108 patients the pain was brief and was not defined as CPTP, while 20 (19%) patients had pain for >3 months; 33 (31%) patients required analgesics to control the pain. Of the 17 patients who underwent spermatic cord denervation, 13 reported complete relief of pain at their first follow‐up visit and were discharged. Four patients had a significant improvement in the symptom score and were satisfied with the results.Conclusions There is a small but significant incidence of CPTP and patients should be warned of this possibility when counselled before operation. Denervation of the spermatic cord seems to be a viable surgical option for patients with CPTP who fail to respond to conservative measures.
Tumour control according to pathological variables in patients treated by radical prostatectomy for clinically localized carcinoma of the prostate
Authors: van den Ouden D. , Hop W.C.J. , Kranse R. , Schröder F.H. 
Published: November 2003

Objective To evaluate the diagnosis, outcome and final pathology of radical prostatectomy for prostate cancer performed by urologists in a clinic where six urologists perform a total of 50 radical prostatectomies a year, using radical prostatectomy specimens processed routinely.Patients and methods Radical prostatectomy was performed in 273 patients who were followed prospectively. The radical prostatectomy specimens were evaluated for pathological stage, histological grade, capsular perforation, positive lateral and apical margins of resection, seminal vesicle invasion, perineural invasion and vascular invasion; the lymph node status was also determined. The relationship between these variables and clinical progression, local recurrence, distant metastases, biochemical progression, overall survival and cancer‐specific survival was assessed.Results All evaluated variables were significantly predictive for clinical and biochemical progression in the univariate analyses, and all but perineural invasion and lymph node status for cancer‐specific survival. Multivariate analysis showed vascular invasion to be the most important prognostic variable, followed by capsular perforation, positive margins of resection and poorly differentiated carcinoma. The overall results for the evaluated variables were comparable to the results from centres with greater experience.Conclusions The outcome of treatment in this small clinic was similar to that from larger clinics with more experience. The routine evaluation of the radical prostatectomy specimens identified pathological variables which were important prognostic factors, with vascular invasion, capsular perforation, positive margins of resection and poorly differentiated carcinoma being the most significant. The extent of vascular invasion should be part of the routine evaluation of radical prostatectomy specimens.
Results of the Mitrofanoff procedure in urinary tract reconstruction in children
Authors: Süzer O. , Vates T.S. , Freedman A.L. , Smith C.A. , Gonzalez R. 
Published: November 2003

Objectives To evaluate the success and long‐term complications associated with the use of continent catheterizable conduits based on the Mitrofanoff principle in children.Patients and methods The records of 43 patients (21 female and 22 male) who underwent the construction of a continent catheterizable stoma based on the Mitrofanoff principle between 1987 and 1996 were reviewed retrospectively. The mean age at surgery was 10 years (range 3–21) and the mean follow‐up was 3 years (range 0.5–6.5). Twenty‐eight of the 43 children underwent augmentation cystoplasty in conjunction with the Mitrofanoff procedure, using ileum in 17, sigmoid in seven, caecum in two and stomach in one; detrusormyectomy was performed in one child. Fifteen patients had only a continent catheterizable stoma formed. The most common type of conduit was appendicovesicostomy (36 of 43 children); other conduits were constructed with ureter (four), tapered ileum (two) and fallopian tube (one).Results Stomal continence was achieved in 42 of 43 patients (98%). The most common late complication was difficulty in catheterization, which occurred in 14 patients (32%). Stomal prolapse requiring revision occurred in one patient (2%). Conduit dilatation was initially attempted in all patients with difficult catheterization, although it failed in 11 who then required surgical revision. Therefore, the overall revision rate was 28% (12 of 43). The site of stomal placement (umbilical or abdominal) did not significantly influence the risk of difficulty with catheterization.Conclusion The Mitrofanoff procedure can simplify catheterization in children who are dependent upon intermittent catheterization. The vermiform appendix appears to be the best source for constructing the conduit. While stomal continence is excellent, conduit stenosis remains a frequent complication regardless of stomal location.
A prospective, randomized trial comparing continuous bladder drainage with catheterization at abdominal hysterectomy
Authors: DOBBS S.P. , JACKSON S.R. , WILSON A.M. , MAPLETHORPE R.P. , HAMMOND R.H. 
Published: November 2003

Objective To compare the infection rate and post‐operative morbidity between in‐dwelling urinary catheterization and ‘in‐out’ catheterization at the time of routine total abdominal hysterectomy.Patients and methods The study comprised 100 patients who were blindly randomized to have either an indwelling Foley catheter or an ‘in‐out’ catheterization at the time of surgery. Follow‐up data on the retention of urine, urinary symptoms and infection were obtained.Results Of the 95 patients with complete data, 36% of those undergoing in‐out catheterization had urinary retention after operation, requiring bladder emptying, compared with 4% of those receiving an indwelling catheter (P<0.001). In addition, 29% of the catheterized group had urinary tract bacteriuria compared with 13% of the uncatheterized group (P<0.025).Conclusion This randomized controlled trial showed that in‐out urinary catheterization at the time of routine abdominal hysterectomy was associated with a significantly higher incidence of post‐operative urinary retention compared with in‐dwelling catheterization, and may have implications for long‐term bladder function.
The highly specialized vocal tract of the male Mongolian gazelle (Procapra gutturosa Pallas, 1777 – Mammalia, Bovidae)
Authors: Frey R. , Gebler A. 
Published: November 2003

AbstractThe entire head and neck of a wild adult male Mongolian gazelle (Procapra gutturosa) was dissected with special reference to its enlarged larynx. Two additional adult male specimens taken from the wild were analysed by computer tomography. The sternomandibularis, omohyoideus, thyrohyoideus and hyoepiglotticus muscles are particularly enlarged and improve laryngeal suspension and stabilization. The epiglottis is exceptionally large. A permanent laryngeal descent is associated with the evolution of an unpaired palatinal pharyngeal pouch. A certain momentary descent seems to occur during vocalization. The high lateral walls of the thyroid cartilage are ventrally connected by a broad keel. The large thyroarytenoid muscle is divided into two portions: a rostral ventricularis and a caudal vocalis muscle. A paired lateral laryngeal ventricle projects between these two muscles. The massive vocal fold is large and lacks any rostrally directed flexible structures. It is supported by a large cymbal‐like fibroelastic pad. Vocal tract length was measured in the course of dissection and in computer tomographic images. Two representative spectrograms, one of an adult male and one of a juvenile, recorded in the natural habitat of the Mongolian gazelle are presented. In the spectrograms, the centre frequency of the lowest band is about 500 Hz in the adult male and about 790 Hz in the juvenile. The low pitch of the adult male's call is ascribed to the evolutionary mass increase and elongation of the vocal folds. In the habitat of P. gutturosa a call with a low pitch and, thus, with an almost homogeneous directivity around the head of the vocalizing animal may be optimally suited for multidirectional advertisement calls during the rut. The signal range of an adult male's call in its natural habitat can therefore be expected to be larger than the high‐pitched call of a juvenile.
Seasonal changes in the lower jaw skeleton in male Atlantic salmon (Salmo salar L.): remodelling and regression of the kype after spawning
Authors: Witten P. Eckhard , Hall Brian K. 
Published: November 2003

AbstractThe return of Atlantic salmon (Salmon salar) to their home river for spawning coincides with drastic skeletal alterations in both sexes. Most prominent is the development of a kype (hook) at the tip of the lower jaw in males. Salmon that survive spawning have to cope with the kype throughout their life, unless it disappears after spawning, as was suggested in the early literature. To understand the fate of the kype skeleton, we compared morphological and histological features of kypes from pre‐spawned mature anadromous males (grilse) with post‐spawned males (kelts). The kype of male grilse is supported by fast‐growing skeletal needles that differ from regular dentary bone. In kelts, growth of the kype skeleton has stopped and skeletal needles are resorbed apically by osteoclasts. Simultaneously, and despite the critical physiological condition of the animals, proximal parts of the kype skeleton are remodelled and converted into regular dentary bone. Apical resorption of the skeleton explains reports of a decrease of the kype in kelts. The conversion of basal kype skeleton into regular dentary bone contributes to the elongation of the dentary and probably also to the development of a larger kype in repetitive spawning males.
Serotonin (5‐HT) transporter (SERT) function after graded destruction of serotonergic neurons
Authors: Montañez Sylvia , Daws Lynette C. , Gould Georgianna G. , Frazer Alan 
Published: November 2003

AbstractThe degree of occupancy of the serotonin transporter (SERT) by selective serotonin reuptake inhibitors (SSRIs) appears to be critical in determining therapeutic response. To gain insight into the extent of occupancy required to alter serotonergic neurotransmission we used high‐speed chronoamperometry to determine the extent of serotonergic destruction required to reduce the clearance of exogenously administered serotonin from extracellular fluid in the CA3 region of the hippocampus. Rats were pretreated with various doses of 5,7‐dihydroxytryptamine to produce either a low, intermediate or high loss of SERTs. Clearance of 5‐HT was reduced only in rats with > 90% loss of SERT. In these rats, there was also a trend for peak signal amplitudes to be greater. There was no significant difference in these parameters between the sham group and those with low or intermediate loss of SERTs. The SSRI, fluvoxamine, prolonged clearance of 5‐HT in sham, low and intermediate groups, whereas there was no effect of fluvoxamine in those rats with > 90% loss of SERT. Functional loss of SERT activity occurs when destruction of serotonergic innervation is greater than 90% but serotonin clearance and efficacy of fluvoxamine is maintained with as few as one fifth of a full complement of SERTs.