bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic delay and risk of relapse in patients with stage I nonseminomatous germ cell tumour followed on active surveillance
Authors: Napier M.P. , Rustin G.J.S. 
Published: March 2003

Objective To determine whether delayed diagnosis affects the outcome of patients with stage I nonseminomatous germ cell tumour (NSGCT) followed by a policy of ‘active surveillance’. Patients and methods A series of 185 consecutive patients with either low‐risk (no vascular invasion) or unknown risk stage I NSGCT referred to Mount Vernon Hospital between 1983 and 1998 were analysed retrospectively for the type and duration of symptoms before orchidectomy, time to relapse, and for site and stage of relapse. Results Twenty‐six patients (14%) relapsed within a medium follow‐up of 98 months. The median (range) time to relapse was 4 (1–14) months. All patients were effectively salvaged with chemotherapy and in some by surgery. The median duration of symptoms before orchidectomy for those patients relapsing was 2 months, and not significantly different from those who did not relapse. Conclusions In patients with stage I NSGCT the duration of symptoms before diagnosis did not influence the probability of relapse.
Does intraprostatic vasopressin prevent the transurethral resection syndrome?
Authors: Sharma D.P. , Harvey A.B. 
Published: March 2003

Objective To determine whether intraprostatic vasopressin (IPVP) prevents the transurethral resection (TUR) syndrome during prostatectomy. Patients and methods The study comprised 36 consecutive patients (mean age 68 years) with prostates clinically assessed as ≥ 20 g who underwent standard transurethral prostatectomy (TURP). Ten units of vasopressin in 0.5 mL were diluted with 9.5 mL isotonic saline and injected into the prostate transrectally before TURP. Blood samples were taken before and immediately after TURP to measure serum sodium concentration and free haemoglobin levels. The TURP irrigant used was cooled, boiled water maintained at 70–80 cmH2O pressure during resection. Twenty patients had alcohol added to the irrigant and their breath alcohol assessed at 10‐min intervals during TURP. All patients had their pulse rate, blood pressure and sensorium monitored continuously. Extreme care was taken to avoid and/or identify capsular damage during resection. Results The mean weight of tissue resected was 36 g and the mean resection time 24 min. There was no significant change in clinical variables during TURP. In 19 patients the breath alcohol changes were insignificant. Changes in free haemoglobin were not significant, but the levels decreased after TURP in four patients, caused by the dilution consequent on the infusion of 800–1000 mL isotonic saline during surgery. Serum sodium concentrations showed only insignificant decreases, except in one patient whose breath alcohol suggested the absorption of 500 mL of irrigant. This patient's serum sodium concentration decreased by 9 mmol/L; 1 L of 5% dextrose was infused during the procedure and capsular damage was recognized early during TURP. Conclusion Insignificant volumes of irrigant entered the circulation of the patients during TURP with water irrigation and IPVP. The greatest risk factor for fluid entry during TURP is capsular damage. IPVP decreases bleeding and therefore improves visibility, so allowing the early identification of capsular damage. IPVP seems therefore to be of help during TURP by decreasing bleeding and allowing insignificant volumes of irrigant to enter the vasoconstricted vessels; it appears to prevent the TUR syndrome.
Epidemiology of prostatitis in Finnish men: a population‐based cross‐sectional study
Authors: Mehik A. , Hellström P. , Lukkarinen O. , Sarpola A. , Järvelin M.‐R. 
Published: March 2003

Objective To study the lifetime occurrence of prostatitis in Finnish men and their exposure to the disease. Subjects and methods A population‐based cross‐sectional survey was conducted in the two most northerly provinces of Finland (Oulu and Lapland). Altogether, 2500 male residents aged 20–59 years were chosen at random to complete a questionnaire on prostatitis. The data were collected between June 1996 and October 1997. Replies were received from 1832 men, giving a response rate of 75%. Results The overall lifetime prevalence of prostatitis was 14.2%. The risk of having or having had prostatitis increased with age, being 1.7 times greater in men aged 40–49 years than in those aged 20–39 years, and 3.1 times greater in those aged 50–59 years. The overall incidence was 37.8/10 000 person years. More than a quarter of the 261 men who had or had had prostatitis symptoms (27%) suffered from them at least once a year, while 16% suffered from persistent symptoms; 63% of the men with prostatitis had their worst symptoms during the winter (November‐March). Neither education nor profession had much influence on the occurrence of prostatitis, but divorced and single men had a lower risk than married men. Most patients felt they had not received enough information about the disease at their first visit to a general practitioner. Conclusions The results of this survey showed that the occurrence of prostatitis symptoms in men living in northern Finland is higher than that reported in other parts of the world. This could be partly caused by the cold climate.
Allogeneic whole‐tumour cell vaccination in the rat model of prostate cancer
Authors: Hrouda D. , Todryk S.M. , Perry M.J.A. , Souberbielle B.E. , Kayaga J. , Kirby R.S. , Dalgleish A.G. 
Published: March 2003

Objective To investigate cancer immunotherapy using whole allogeneic (differing tissue‐type) tumour cells as vaccines in the rat prostate cancer model. Materials and methods Two rat models of prostate cancer were used; MAT‐LyLu tumours which grow in Copenhagen rats and PAIII tumours which grow in Lobund–Wistar rats, with crossover of the cell lines to test allogeneic vaccination. The cell lines were immunologically characterized by flow cytometry. Irradiated tumour cells were administered as subcutaneous vaccines either before tumour challenge or after tumour establishment (both subcutaneous). A preparation of heat‐killed Mycobacterium vaccae bacilli (SRL172) was used as an adjuvant to increase vaccine efficiency. Results Flow cytometry analysis of the cell lines showed that the PAIII cells had higher levels of major histocompatibility complex (MHC) class I and intercellular adhesion molecule (ICAM‐1) expression than the MAT‐LyLu cells. However, both tumour cell lines were rejected in their allogeneic hosts. Prophylactic vaccination with allogeneic MAT‐LyLu cells protected against PAIII tumour challenge in Lobund–Wistar rats, with 80% of animals surviving for > 5 months, compared with 40% for animals receiving autologous cells. The immunity was prolonged, as rats were protected when rechallenged 5 months later. In Copenhagen rats allogeneic PAIII cells protected against the more aggressive MAT‐LyLu tumour challenge only when the cells were combined with SRL172. Initial therapy experiments showed that vaccination with the cell lines mediated only limited tumour regression in the Lobund‐Wistar rats. Conclusion The allogeneic tumour cell vaccination model described is valuable for assessing the principle and efficacy of allogeneic prostate cancer cell vaccines for clinical use.
Ultrasonography of urinary tract lesions caused by bilharziasis in Yemeni patients
Authors: Salah M.A. 
Published: March 2003

Objective To evaluate abnormalities detected by ultrasonography in Yemeni patients with active Schistosoma haematobium infection. Patients and methods As part of a co‐operation between a private hospital and the Schistosomiasis Control Project in Yemen, laboratory and ultrasonographic examinations were undertaken in 158 patients (eight female, 150 male, mean age 17 years) with active S. haematobium infection. Upper urinary tract dilatation, lower ureteric changes and bladder wall abnormalities (thickness, hyper‐echogenicity and polypoid lesions) were recorded. Laboratory findings and ultrasonographic changes were evaluated and categorized according to the age of the patients. Results Twenty‐eight patients (18%) showed no morphological lesion on ultrasonography. Bladder abnormalities (thickness, hyper‐echogenicity and polypoid lesions) were found in 130 patients (82%) and upper tract lesions in 86 (54%). There were no upper tract lesions seen without an associated bladder abnormality. There were polyps within the lower ureteric lumen in four patients; in these patients there was a higher incidence of severe infection. One patient had a urinary bladder tumour. Conclusion Urinary bilharziasis has typical ultrasonographic features, but may occur with no morphological lesion detectable on ultrasonography. Upper tract lesions seem to develop only with lower tract abnormalities.
A model of superficial bladder cancer using fluorescent tumour cells in an organ‐culture system
Authors: Crook T.J. , Hall I.S. , Solomon L.Z. , Birch B.R. , Cooper A.J. 
Published: March 2003

Objective To develop a reproducible in vitro simulation of superficial bladder cancer for testing cytotoxic agents at clinically relevant concentrations. Materials and methods Square explants (5 mm) of rat bladder were cultured in Petri dishes in minimal volumes of Waymouth's MB 752/1 medium supplemented with 10% fetal calf serum, antibiotics and glutamine. Parental and resistant MGH‐U1 urothelial cancer cells were transfected with a green fluorescent protein (GFP) vector. Transfectants were purified by flow cytometry. Cells were seeded onto the prepared organ cultures and images obtained using confocal microscopy. The tumour colonies were confirmed using scanning electron microscopy. Conventional intravesical cytotoxic agents including epirubicin, mitomycin‐C and estramustine were tested in the system. Results Colonies of GFP‐MGH‐U1 cells became established on the explants and were identified by confocal microscopy; the development of the colonies was then followed over several days. Staining the explant for viability allowed imaging of normal urothelium on the explant surface or surrounding skirt of urothelial cells. The conventional cytotoxic agents epirubicin, mitomycin C and estramustine showed the expected differential responses to parental and resistant cell types. The colonies were able to survive high concentrations of the drug, equivalent to those in clinical use. The colonies were imaged serially over a period of several days. Conclusion This system provides a more realistic model for testing cytotoxic agents for use in intravesical therapy, by allowing clinically relevant concentrations of drugs to be tested. The differential properties of the parental and resistant cells are maintained. The model also enables the same tumour colony to be imaged over several days in culture. The model may also be adapted for use in testing the effects of drugs on normal urothelium and the study of the effects of growth factors.
Vaginoplasty in male transsexuals using penile skin and a urethral flap
Authors: Perovic S.V. , Stanojevic D.S. , Djordjevic M.L.J. 
Published: March 2003

Objectives To describe and present the results of a one‐stage vaginoplasty in male‐to‐female sex reassignment surgery. Patients and methods The present technique is based on penile disassembly and the use of all penile components for vaginoplasty (except the corpora cavernosa). The neovagina consists of two parts; a long vascularized urethral flap and a pedicled island tube skin flap created from the penile skin. The urethral flap is embedded into the skin tube. The tube, consisting of skin and the urethral flap, is inverted, thus forming the neovagina. The new vagina is inserted into the previously prepared perineal cavity between the urethra, bladder and rectum. The neovagina is then fixed to the sacrospinous ligament. The labia minora and majora are formed from remaining penile and scrotal skin. The new method was used in 89 patients (mean age 28 years, range 18–56) with a mean (range) follow‐up of 4.6 (0.25–6) years. Results Good cosmetic and functional results were obtained in 77 of the 89 patients (87%). Importantly, the neovagina produced in most patients was of satisfactory depth and width. There was only one major complication, a rectovaginal fistula caused by intraoperative injury to the rectum. Conclusions The technique produces a vagina with more normal anatomical and physiological characteristics than those produced by other methods, as all the penile components are used (except for the corpora cavernosa) to form almost normal external female genitalia. Vaginoplasty using pedicled penile skin with a urethral flap is a good alternative to other methods of vaginoplasty in male‐to‐female sex reassignment surgery.
Permeability of intestinal mucosa from urinary reservoirs in man and rat
Authors: Nejdfors P. , Könyves J. , Davidsson T. , Ekelund M. , Månsson W. , Weström B.R. 
Published: March 2003

Objective To evaluate the barrier properties of intestinal mucosa chronically exposed to urine and to evaluate possible differences between ileal and colonic segments used in the reconstruction of the urinary tract. Materials and methods Mucosal specimens from patients with continent reservoirs with an abdominal stoma, or orthotopic neobladders constructed from colonic segments, were obtained at revisional surgery. Control segments were obtained during right‐sided hemicolectomy. In addition, ileal and colonic segments from enterocystoplasties in rats were assessed. The mucosa‐to‐serosa passage of marker molecules, i.e. 14C‐mannitol, 3H‐glucose, fluorescein isothiocyanate‐dextran 4400 and ovalbumin, was measured using modified Ussing diffusion chambers. Results In man, there were no permeability differences between segments exposed to urine and control segments for any of the marker molecules. In rats, there was less passage of markers in ileal and colonic transplanted segments than in intestinal segments from sham‐operated animals. Conclusions Intestinal mucosa that has been in chronic contact with urine maintains its barrier function; in the rat model the permeability was even decreased. In addition, there were no detectable differences between ileal and colonic segments in this model.
Bacterial adherence to ofloxacin‐blended polylactone‐coated self‐reinforced l‐lactic acid polymer urological stents
Authors: Multanen M. , Talja M. , Hallanvuo S. , Siitonen A. , Välimaa T. , Tammela T.L.J. , Seppälä J. , Törmälä P. 
Published: March 2003

Objective To determine whether ofloxacin coating has any effect on bacterial adherence to bioresorbable self‐reinforced
l‐lactic acid polymer (SR‐PLLA) urological stents. Materials and methods SR‐PLLA stents were coated with ε‐caprolactone/l‐lactide copolymer blended with ofloxacin at three different concentrations of ofloxacin (0.5, 2 and 5% w/w). The adherence of five bacterial strains (Pseudomonas aeruginosa, Enterococcus faecalis, Proteus mirabilis and two strains of Escherichia coli) to the coated SR‐PLLA stents was analysed. Uncoated stent pieces were used as controls. The effect of ofloxacin coating on bacterial growth in the microenvironment of the stent pieces was also analysed. Results Ofloxacin coating prevented bacterial adherence to SR‐PLLA stent material; this effect correlated significantly with the ofloxacin concentration of the caprolactone coating. Ofloxacin coating reduced the amount of bacteria in the microenvironment of the stent, but because of natural resistance, ofloxacin coating had little effect on E. faecalis. Conclusion Except for E. faecalis, ofloxacin coating may reduce stent‐associated infections. However, further studies are needed to confirm its biocompatibility and efficacy in clinical use.
Magnetic resonance urography enhanced by gadolinium and diuretics: a comparison with conventional urography in diagnosing the cause of ureteric obstruction
Authors: Jung P. , Brauers A. , Nolte‐Ernsting C.A. , Jakse G. , Günther R.W. 
Published: March 2003

Objective To compare the ability of magnetic resonance urography (MRU), enhanced using gadolinium and frusemide diuresis, and conventional intravenous urography (IVU) to diagnose the cause of ureteric obstruction. Patients and methods The study included 82 patients in whom IVU showed or suggested obstruction and who also underwent MRU. The images from both methods were interpreted by various investigators independently; two evaluated the IVU and two others the MRU, the latter being unaware of the diagnosis after IVU. If the diagnosis remained unclear, further investigations (e.g. computed tomography, retrograde pyelography or ureteroscopy) were conducted. Results The diagnoses were ureteric calculi in 72 patients, ureteric tumours in eight and extra‐ureteric tumours in two. In those with urolithiasis, the diagnosis was correct with IVU in 49 patients and with MRU in 64. The diagnosis in this group was incorrect with MRU in only two patients. The main reason for the failure of IVU was absent contrast medium excretion. Three of eight patients with ureteric tumours were correctly diagnosed by IVU but in three patients the diagnosis was incorrect. MRU correctly diagnosed seven of the eight patients in this group, with no false diagnosis. Conclusion IVU is currently likely to remain the standard procedure for imaging the upper urinary tract, but this study shows the potential of MRU when enhanced with gadolinium and frusemide. MRU may be helpful if there is a dilated system with no excretory function, in pregnant women, in children and in those with contrast medium allergy.
The excisional, plication and internal drainage techniques: a comparison of the results for idiopathic hydrocele
Authors: Ku J.H. , Kim M.E. , Lee N.K. , Park Y.H. 
Published: March 2003

Objective To assess the results of the excision, plication and internal drainage techniques for hydrocele repair. Patients and methods Between January 1990 and June 1998, 132 patients (mean age 54.36 years, range 16–83) underwent repair for idiopathic hydrocele using one of three techniques (excision, eversion/plication or internal drainage); the complication and recurrence rates of each technique were evaluated. Results The excisional technique resulted in the highest complication rate (81%) and the internal drainage technique the lowest (7%). Postoperative scrotal oedema occurred in 74% of patients after plication and this was the highest rate among the techniques (P < 0.001). Differences in the rates of wound infection and haematoma among the three techniques were not statistically significant. The internal drainage technique had the highest recurrence rate (85%) and the excisional technique the lowest (1.3%; P < 0.001). Conclusions Although useful, the internal drainage technique has a high recurrence rate and we suggest abandoning its use for hydrocele repair. The present results suggest that plication is better than excision, causing fewer complications, and better than internal drainage, as the results are more favourable.
An assessment of the clinical efficacy of intranasal desmopressin spray in the treatment of renal colic
Authors: Lopes T. , Dias J.S. , Marcelino J. , Varela J. , Ribeiro S. , Dias J. 
Published: March 2003

Objectives To assess the efficacy of desmopressin nasal spray compared with diclofenac given intramuscularly in patients with acute renal colic caused by urolithiasis. Patients and methods The study included 61 patients randomized into three different groups; group A received desmopressin (40 µg, nasal spray), group B diclofenac (75 mg) intramuscularly and group C, both desmopressin and diclofenac. Pain was assessed using a visual analogue scale (a 10‐cm horizontal scale ranging from ‘no pain’ to ‘unbearable pain’) at baseline, 10, 20 and 30 min after administering the treatments. Results On admission, the pain level was the same in all three groups. At 10 min the pain decreased in all groups to a level that was not significantly different. At 20 min groups B and C had similar mean pain levels (3.7), whereas in group A it was 5.0. At 30 min, groups B and C scored 2–3, and group A 5.6. All three treatments were equally effective at 10 and 20 min but at 30 min there was a stabilization/slight increase in pain level in group A. Conclusions Desmopressin has several advantages, e.g. ease of administration, simplicity of delivery and apparent lack of side‐effects, which makes it suitable for ambulatory use. Desmopressin acts rapidly and seems to be effective in both single and combined therapy with diclofenac; it decreases the need for a second treatment and increases the analgesic effect of diclofenac. Some patients responded well to desmopressin, with rapid and complete pain relief. These results indicate that desmopressin may be used to treat renal colic either alone or combined, increasing the analgesic effect of other drugs. More studies are needed to validate and confirm the results; it would also be useful to determine factors that may identify the subgroup of patients who respond quickly and with almost complete pain relief.
The renal‐resistive index from the last 3 months of pregnancy to 6 months old
Authors: Andriani G. , Persico A. , Tursini S. , Ballone E. , Cirotti D. , LellI Chiesa P. 
Published: March 2003

Objective To measure the renal resistive index (RI, an estimate of renal vascular resistance, used to assess upper tract obstructive uropathy) from the last trimester of pregnancy to the sixth month of life in a large series of healthy subjects, and thus to identify normal values that can be used routinely. During the first semester of life significant haemodynamic changes during the physiological development of the kidney cause considerable variability in RI, which is thus considered less reliable in this period.Subjects and methods From September 1998 to October 1999, 93 subjects (186 renal units, RU) were enrolled; 32 were fetuses in the last trimester of pregnancy (group 1, 64 RU) and 61 were children (122 RU), 30 aged 0–1 month (group 2, 60 RU), 20 aged 1–3 months (group 3, 40 RU) and 11 aged 3–6 months (group 4, 22 RU). All subjects underwent colour Doppler ultrasonography and the RI of the renal artery was measured for each kidney.Results The RI was very high in group 1 but decreased noticeably during the first 6 months of life, reaching values similar to those in adults after the third month. The variability in RI continuously declined with age, becoming less important. The normal ranges for groups 1–4 were 0.67–0.88, 0.57–0.90, 0.60–0.84 and 0.65–0.75, respectively. There were no statistically significant differences between the left and right kidneys.Conclusion In the first semester of life there is more than one landmark value of RI depending on the month of age of the infant. This should be considered when assessing upper tract obstructive uropathies after birth and the RI should be compared with the normal ranges reported herein.