bluuebunny/crossref_metadata_2025_split huggingface dataset:
Q‐flap reconstruction of panurethral strictures
Authors: Morey A.F. , Tran L.K. , Zinman L.M. 
Published: March 2003

Objective To review our experience with an extended Q‐shaped penile skin flap for the reconstruction of panurethral strictures. Patients and methods Between 1991 and 1999, 15 men with extensive strictures underwent a single‐stage urethral reconstruction with a distal circumferential penile skin flap incorporating a ventral midline extension (Q‐flap). None had undergone previous urethroplasty nor had any been circumcised. Results The Q‐flap provided a pedicled strip of penile skin with a mean (range) length of 17 (15–24) cm; no additional graft materials were necessary. Excellent results were obtained in 10 patients; in the remainder, complications included recurrent stricture (in two) and (in one patient each) a cerebral vascular accident, urethrocutaneous fistula, meatal stenosis, femoral neuropathy and prolonged catheterization for focal extravasation. Conclusion The Q‐flap provides an abundant hairless penile skin flap that enables single‐stage panurethral reconstruction while eliminating the additional time and morbidity of harvesting further grafts.
The influence of a high‐oxalate/low‐calcium diet on calcium oxalate renal stone risk factors in non‐stone‐forming black and white South African subjects
Authors: Lewandowski S. , Rodgers A. , Schloss I. 
Published: March 2003

Objective To evaluate the influence of a high‐oxalate/low‐calcium diet on calcium oxalate stone risk factors in both black South Africans (who are largely immune to kidney stones) and white South Africans (in whom stones are more common). Subjects and methods Urinary and dietary variables were examined in 11 black and 11 white South African men. None of the subjects had had a kidney stone or any metabolic illness. Their normal domestic food intake was assessed using a semiquantitative food frequency questionnaire. Subjects were given a standardized high‐oxalate/low‐calcium diet for 3 days; 24‐h urine samples were collected before the protocol and during the final day. The samples were analysed using routine modern laboratory techniques. The urine analysis data were used to calculate the Tiselius risk index and the relative urinary supersaturations of calcium oxalate, uric acid and calcium phosphate. Results Urine analysis showed an intriguing anomaly; black subjects had significantly higher urinary pH and oxalate values than whites (6.50 vs 6.21 and 0.23 vs 0.14 mmol/24 h, respectively), while their urinary citrate was lower (1.47 vs 3.69 mmol/24 h). In addition, the Tiselius risk index and relative supersaturation of calcium oxalate were higher in black subjects. These results are contrary to those which might have been reasonably expected when comparing stone‐free and stone‐prone groups. After the dietary protocol, the only urinary variable which changed significantly was urinary oxalate, which increased by 57% in whites. Conclusion Factors which are conventionally used to assess stone risk (pH, oxaluria, citraturia, relative supersaturation) are not helpful in identifying why South African blacks are relatively immune to stones. We suggest that relatively lower oxalate absorption rates may be a physiological feature of this racial group.
Functional evaluation of tubularized‐incised plate repair of midshaft‐proximal hypospadias using uroflowmetry
Authors: Marte A. , Di Iorio G. , De Pasquale M. , Cotrufo A.M. , Di Meglio D. 
Published: March 2003

Objective To determine objectively, using uroflowmetry, the functional results of the tubularized‐incised plate urethroplasty to repair midshaft‐proximal hypospadias.Patients and methods Twenty‐one patients (mean age 4 years, mean follow‐up 1.8 years) were selected from those undergoing surgery between January 1996 and January 1998 at our institution. All patients had midshaft‐proximal hypospadias and were treated using the Snodgrass technique. Patients were included if they were able to void volitionally and had no fistula. The flow pattern, maximum (Qmax) and mean flow rate (Qave) were measured; the results were expressed as percentiles and compared with published values from normal children. The Qmax and Qave were considered normal if > 25th percentile, as equivocally obstructed when in the 5–25th percentile and obstructed if < 5th percentile.Results Fourteen patients were considered normal, four as equivocally obstructed and three as obstructed. Of the second group, one patient had a urethral diverticulum at the native meatus (confirmed by voiding cysto‐urethrography) and the remaining three patients had meatal stenosis that responded to dilatation, with normal flow in two and improvement in the other. Of the obstructed group, one patient responded to dilatation and two underwent meatoplasty.Conclusion The tubularized‐incised plate repair provides satisfactory functional results for midshaft‐proximal hypospadias; uroflowmetry is an important noninvasive tool to evaluate this technique. A long‐term follow‐up is needed to confirm these results.
Tumour angiogenesis and Ki‐67 expression in phaeochromocytoma
Authors: Ohji H. , Sasagawa I. , Iciyanagi O. , Suzuki Y. , Nakada T. 
Published: March 2003

Objective To determine the expression of CD34 (to evaluate vascularity) and Ki‐67 (as a proliferative index) in a variety of phaeochromocytomas and thus assess the utility of these markers as possible predictors of malignancy. Patients and methods Deparaffinized tissue sections from 21 patients with benign and four with malignant phaeochromocytoma were assessed immunohistochemically to evaluate microvascular counts (using CD34 antigen) and the proliferative index (Ki‐67 antigen, monoclonal antibody MIB‐1). Results There was no statistical association between high microvascular counts and malignancy, but there was between the MIB‐1 score and malignancy (P < 0.001). Conclusions A high MIB‐1 score in phaeochromocytoma suggests malignant behaviour in the component cells. The MIB‐1 score may be a useful indicator for diagnosing malignant phaeochromocytoma.
Low frequency of microsatellite instability in hereditary prostate cancer
Authors: Åhman A.‐K. , Jonsson B.‐A. , Damber J.‐E. , Bergh A. , Grönberg H. 
Published: March 2003

Objective To investigate whether there is widespread microsatellite instability (MSI) in families with hereditary prostate cancer (HPC). Patients and methods Eighty‐four prostate tumours from 80 Swedish men in 35 families with HPC were screened for genetic instability at microsatellite marker loci BAT‐25, BAT‐26, BAT‐34C4, D2S123 and D17S250. Results MSI was detected in only five individuals from different families. Three tumours (4%) were unstable at more than two MSI loci and hence classified as high‐frequency MSI (MSI‐H) according to a previous definition. Interestingly, two of the MSI‐H tumours were from patients in families with both HPC and familial colon cancer. Conclusions Widespread MSI is a rare event in hereditary prostate cancer, indicating that defective DNA mismatch repair is not an important element in the genesis of HPC.
The long‐term results of Anderson–Hynes pyeloplasty
Authors: O'Reilly P.H. , Brooman P.J.C. , Mak S. , Jones M. , Pickup C. , Atkinson C. , Pollard A.J. 
Published: March 2003

Objectives To examine the durability of open pyeloplasty for pelvi‐ureteric junction obstruction. Patients and methods The records of 56 Anderson‐Hynes pyeloplasties undertaken by two surgeons between 1981 and 1994 were examined. Attempts were made to trace all patients and for them to undergo diuretic renography to examine the current status of the operated renal unit. Results In all, 41 evaluable patients were identified; 24 agreed to return for reassessment. The mean (range) time from surgery was 10.6 (6–19) years. The results showed an improvement over the preoperative split renal function in 19 patients (79%) and an improvement in drainage in 23 (96%). Conclusions The Anderson–Hynes pyeloplasty is an excellent procedure for treating pelvi‐ureteric junction obstruction, and produces a lasting improvement in function and drainage in most patients. It is the ‘gold standard’ against which newer techniques should be compared.
Characteristics of protein excretion in patients with acute urinary retention
Authors: Mustonen S. , Ala‐Houhala I.O. , Tammela T.L.J. 
Published: March 2003

Objective To evaluate changes in protein leakage in the glomerular filtration barrier, and in the ability of the tubule to reabsorb proteins during and after acute urinary retention (AUR). Patients and methods Glomerular and tubular function was investigated in 24 men during AUR (mean age 68 years, mean retention time 31 h and mean retention volume 1140 mL) who were then followed for 6 months by measuring the urinary excretion of glomerular and tubular proteins, and the glomerular filtration rate (GFR). Retention was relieved by inserting a suprapubic catheter and the cause of retention treated one month later. No patient had a previous renal disease or diabetes. Results During AUR, and after 1 and 6 months, albuminuria was detected in 100%, 92% and 54% of patients, and increased excretion of α1‐microglobulin in 52%, 36% and 58%, of IgG in 79%, 58% and 40%, and of IgG4 in 67%, 42% and 20%, respectively. The mean GFR was normal during retention and during the follow‐up. Conclusion AUR causes disturbances in both the glomerular filtration and tubular reabsorption of proteins. Albuminuria and increased excretion of IgG, IgG4 and α1‐microglobulin occurred in most patients during AUR. After relieving retention, the albuminuria and elevated α1‐microglobulin excretion persisted, indicating slight glomerular dysfunction and a permanent defect in the proximal tubule to reabsorb proteins. This could be caused partly by previous chronic obstruction. AUR should be relieved immediately and the basic cause treated effectively to prevent further deterioration of renal function.
Use of cyanoacrylate tissue adhesive under a diaper
Authors: Ferlise V.J. , Ankem M.K. , Barone J.G. 
Published: March 2003

Objective To examine the utility of cyanoacrylate tissue adhesive (Dermabond, Ethicon, Somerville, NJ, USA; an effective means of epithelial skin closure) under a diaper (i.e. constantly exposed to bodily fluids) in 25 children (not toilet‐trained) undergoing inguinal surgery. Patients and methods A retrospective review of charts between July 1998 and July 2000 was used to identify children who were not toilet‐trained and who had undergone inguinal surgery (e.g. orchidopexy, hernia and hydrocele repair). In addition to the type of surgery, the method of closure was also assessed; in all cases reported the subcutaneous tissues were approximated with 4/0 polyglactin suture. From July 1998 to October 1999 all epithelial skin was closed with 5/0 poliglecaprone, benzoin, sterile strips and collodion; from October 1999 to July 2000 all skin was closed with cyanoacrylate tissue adhesive. Results The chart review identified 45 boys (mean age 15.3 months, range 1–26) of whom 26 (57%) had undergone either inguinal hernia or hydrocele repair, and 19 (42%) who had undergone orchidopexy. These procedures resulted in a total of 52 incisions in the 45 children. Of the 52 incisions, 27 were closed with suture and 25 with cyanoacrylate adhesive. All patients were followed up at 2 weeks; there were no instances of infection or wound dehiscence in either group. The incisions were cosmetically identical at 3 months of follow‐up. Conclusion Cyanoacrylate adhesive is a safe and effective method of skin closure that can be used under a diaper.
Castration‐induced reduction of vascular endothelial growth factor expression in benign human prostate tissue is lost in advanced prostate cancer
Authors: Häggström S. , Stattin P. , Wikström P. , Bergh A. , Damber J.‐E. 
Published: March 2003

Objective To determine the role of vascular response in the castration‐induced regression of benign and malignant human prostate tissue, as recent studies show that castration rapidly decreases blood flow and induces endothelial cell death, which may be important for subsequent epithelial cell death and involution of the glandular tissue of the prostate. Materials and methods The expression of vascular endothelial growth factor (VEGF) and its receptors was analysed using the quantitative reverse transcriptase‐polymerase chain reaction, in benign and tumour areas of core biopsies taken before, and ≈ 1 week after castration therapy. The castration‐induced VEGF response was related to therapy‐induced changes in tumour cell apoptotic index and subsequent response in serum prostate‐specific antigen (PSA). In another set of patients, serum VEGF was quantified by enzyme‐linked immunosorbent assay before, and at 3–6 months after castration therapy. Results VEGF mRNA was down‐regulated after castration in benign prostate tissue (P  0.05), whereas in tumour tissue, VEGF levels were reduced in some of the patients but unchanged or increased in others. In most patients whose tumour tissue responded with VEGF reduction, there was a corresponding increase in tumour cell apoptosis. Serum VEGF levels were not significantly changed after castration. Almost all patients responded with a substantial reduction in serum PSA after castration. Conclusion Castration reduces VEGF mRNA expression in benign prostate tissue and generally in those prostate tumours where castration also induces tumour cell apoptosis. This suggests that a therapy‐induced down‐regulation of VEGF could be important for tumour cell death.
Murine renal cell carcinoma: evaluation of a dendritic‐cell tumour vaccine
Authors: Chagnon F. , Thompson‐Snipes L. , Elhilali M. , Tanguay S. 
Published: March 2003

Objective To use a murine model of renal cell carcinoma (RCC), Renca, to aid in developing a dendritic cell (DC)‐mediated tumour vaccine for RCC; as conventional therapy has been unsuccessful for RCC and therapy using immune modulators has had limited success, novel therapies enhancing further the immune system must be developed. Materials and methods DCs were obtained from mouse bone marrow enriched for the haematopoietic progenitors, and cultured in the presence of interleukin‐4 and granulocyte macrophage‐colony stimulating factor. In vivo vaccines and in vitro proliferation assays were used to assess ability of the DCs to present tumour antigen. Results The presence of DCs was confirmed in the cultures by fluorescent‐activated cell sorting analysis. In vivo, tumour‐bearing animals receiving tumour extract‐pulsed DCs as a vaccine showed a two to threefold reduction in tumour growth at day 12 and day 16 but no significant difference at day 28. In vitro, tumour extract‐pulsed DCs stimulated significant proliferation of splenocytes from naive animals but not tumour‐bearing animals. In addition, splenocytes from tumour‐bearing animals had an attenuated immune response in vitro. Conclusion These results show that it is possible to use the DC vaccine to modulate the immune response to achieve an antitumour effect, but further manipulation of the DC vaccine may be needed to overcome the tumour‐induced immune suppression.
Effects of l‐arginine on the kidney levels of malondialdehyde in rats submitted to renal ischaemia‐reperfusion
Authors: Rhoden E.L. , Lucas M.L. , Pereira‐Lima L. , Rhoden C.R. , Souto C.A.V. 
Published: March 2003

Objective To evaluate the effects of l‐arginine, a nitric oxide donor, on kidney levels of malondialdehyde (MDA, a product of cellular lipid peroxidation), serum creatinine levels, and urinary volume in rats undergoing unilateral renal ischaemia‐reperfusion. Materials and methods Wistar rats (117) were randomly distributed into three experimental groups (of four subgroups each) in which were assessed renal cell‐lipid peroxidation (kidney levels of MDA), serum creatinine levels and urinary volume. The rats underwent unilateral nephrectomy followed by contralateral renal ischaemia‐reperfusion with or with no pretreatment with l‐arginine (200 mg/kg) given intraperitoneally. Results Pretreatment with l‐arginine caused significantly higher kidney levels of MDA than in the untreated group (P < 0.05). Furthermore, l‐arginine given before surgery attenuated the increase in serum creatinine and significantly increased urinary volume in rats subjected to renal ischaemia‐reperfusion (P < 0.05). Conclusion
l‐arginine tended to be of benefit for renal function during renal ischaemia‐reperfusion in rats. Pretreatment with l‐arginine (200 mg/kg intraperitoneally) seems to increase the renal damage by increasing kidney levels of MDA.
Discordant performance of assays for free and total prostate‐specific antigen in relation to the early detection of prostate cancer
Authors: Blijenberg B.G. , Yurdakul G. , Van Zelst B.D. , Bangma C.H. , Wildhagen M.F. , Schröder F.H. 
Published: March 2003

Objective To assess the value of applying rigid threshold values in interpreting prostate specific antigen (PSA) results, by selecting and comparing five current methods for measuring free and total PSA. Materials and methods Samples taken from an ongoing screening study for prostate cancer (total PSA by Tandem‐E assay, 17 334 participants; biopsy criterion a PSA of 3.0 µg/L, 4 464 men) from men with a total PSA of 1.0–6.0 µg/L were measured for free and total PSA using the Access, Immulite, Elecsys and Prostatus analysis kits, in two patient groups, i.e. with prostate cancer or no evidence of disease. Results Both patient groups had equal means for total PSA but not for free PSA. In all, 360 samples from men with cancer and 96 from men with no evidence of disease were analysed. All methods applied to both groups deviated statistically significantly from the Tandem‐E result for total PSA, except for the Access kit. There was a close correlation among all the methods (correlation coefficients of 0.89–0.97). There were very discordant results for the combination of the Tandem‐E vs Prostatus (8% difference), representing 315 participants at a threshold of 3.0 µg/L. For free PSA (free/total PSA) the situation was worse, with extreme differences of 32% and 36% for both patient groups (Elecsys vs Access). Conclusions Depending on the threshold value applied as an indication for biopsy, when using the total PSA alone or combined with the free/total PSA, care is needed in interpreting patient groups because of the discordance among PSA assays.
Sacral distribution of prostatic lymph nodes visualized on spiral computed tomography with three‐dimensional reconstruction
Authors: Brössner C. , Ringhofer H. , Schatzl G. , Madersbacher S. , Powischer G. , Kuber W. 
Published: March 2003

Objective To evaluate the involvement of sacral lymph nodes in prostatic lymphatic drainage, using contemporary radiological imaging techniques. Patients and methods The study included six patients (mean age 61.8 years, range 51–75) with suspected prostate cancer. First, an oil‐based contrast medium was injected into the prostate under transrectal ultrasonographic and fluoroscopic guidance, after which a standard ultrasound‐guided sextant biopsy was taken. Before injecting the contrast medium, and 20 min and 24 h thereafter, the patients underwent spiral computed tomography of the pelvic region with three‐dimensional reconstruction. Results In all patients the prostate drained via the sacral lymphatic region. Compared with the iliac lymphatic drainage system, there were fewer and narrower sacral lymph nodes. Prostatic sacral lymph nodes were located at S2 to S5, with an emphasis on S3–4. Lymph nodes were detected as presacral and in the sacral foramen, suggesting a direct lymphatic connection to the bony pelvis. Conclusion These results suggest that sacral prostatic lymphatics are a potential route of spread of prostate cancer cells.
Renal cell carcinoma may adapt to and overcome anti‐angiogenic intervention with thalidomide
Authors: Douglas M.L. , Reid J.L. , Hii S.I. , Jonsson J.R. , Nicol D.L. 
Published: March 2003

Objective To report on the failure of thalidomide to inhibit tumour growth in an animal model of human renal cell carcinoma (RCC). Materials and methods An orthotopic xenograft model of human RCC was used in which tumour cells were implanted in the left kidney of male ‘severe combined immunodeficient’ mice. Thalidomide was administered by intraperitoneal injection and after 34 days the mice were killed. The extent of tumour growth was compared in treated and untreated mice. Total RNA was extracted from both tumour‐affected and contralateral kidneys, and analysed by reverse transcription‐polymerase chain reaction for various genes implicated in angiogenesis and metastasis in RCC. Results Thalidomide failed to inhibit the growth of xenograft tumours. The expression of angiogenic genes, e.g. vascular endothelial growth factor and fibroblast growth factor type 2 (FGF‐2) within normal and tumour‐affected kidney tissue was not reduced by thalidomide. Intratumoral transcription of β3‐integrin, a critical component of angiogenesis, was significantly increased in response to thalidomide treatment (P < 0.01). There was also a trend to increased expression of FGF‐2 and tumour necrosis factor‐α in thalidomide‐treated tumours. Conclusions These findings suggest that RCC is capable of adapting to the inhibitory effects of thalidomide. The current uncertainty surrounding the action of thalidomide in vivo warrants caution about its use in humans. Further studies of thalidomide should be carried out in animal models, particularly to establish its safety and effectiveness as part of a combined therapeutic strategy.
Comparison of the bladder tumour antigen test with photodynamic diagnosis in patients with pathologically confirmed recurrent superficial urinary bladder tumours
Authors: Lipinski M. , Jeromin L. 
Published: March 2003

Objective To verify the sensitivity of the bladder tumour antigen (BTAstat, Bard Urological, Covington, GA test against the sensitive procedure of photodynamic diagnosis (PDD), in which 5‐aminolaevulinic acid (5‐ALA, a precursor of fluorescent porphyrins) is absorbed by the tumour and detected by ultraviolet cystoscopy, in the early diagnosis of urinary bladder tumours. Patients and methods Forty‐three patients (31 men and 12 women, age range 21–87 years) were assessed after transurethral resection of their bladder tumour using the BTAstat test and PDD. Sixty‐nine biopsies from suspect areas of bladder mucosa were taken during cystoscopy under ultraviolet light and all suspect lesions electrocoagulated. Results Thirty‐five patients (81%) had a positive BTAstat test; in these patients PDD detected malignant lesions (17 Ta1G1–2, two T1G2, two T1G3 and 14 Tis). In eight patients (19%) the BTAstat was negative but PDD detected three malignant lesions (two Tis and one TaG1). Conclusions PDD is valuable for detecting bladder malignancy and can identify small lesions not detected by the BTAstat test.