bluuebunny/crossref_metadata_2025_split huggingface dataset:
Positron emission tomography with 18fluorine‐labelled deoxyglucose: utility in localized and advanced prostate cancer
Authors: Sanz  , Robles  , Giménez  , Arocena  , Sánchez  , Rodriguez‐Rubio  , Rosell  , Richter  , Berián  
Published: March 2003

ObjectiveTo determine the role of the positron emission tomography (PET) with 18F‐labelled deoxyglucose in the identification of prostatic cancer in the iliac and obturator lymphatic nodes before radical prostatectomy, and in the localization of relapse in patients in biochemical progression.Patients and methodsTwenty‐one patients were divided into two groups. Group A consisted of 11 men diagnosed with organ‐confined prostate cancer, where attention was focused on the iliac and obturator lymphatic nodes, the results being compared with the pathological anatomy obtained from surgical procedures. Group B included 10 patients treated by radical prostatectomy, radiotherapy or orchidectomy and who were in biochemical progression, in whom the aim was to identify recurrence of the disease.ResultsIn none of the 11 patients of group A who had undergone radical prostatectomy were deposits of radiotracer identified in the area of the iliac and obturator nodes which would indicate node metastases. However, the histopathological analysis of these nodes showed tumour in three patients. In group B the PET scans showed recurrence of prostate cancer (by deposits of radiotracer) more clearly than did computed tomography (CT) in two patients (both with recurrence in soft tissue). In one patient bone scintigraphy identified a lesion compatible with prostatic disease in the bone; this was clinically confirmed but was not identified by PET.ConclusionPET, using deoxyglucose labelled with 18F, cannot reliably identify prostatic adenocarcinoma in the iliac and obturator lymph nodes before surgery; other tracers may give better results. To locate relapses in patients with biochemical progression, PET seems to have better sensitivity than CT when identifying diseases in soft tissues and is possibly inferior to bone scintigraphy in detecting bony metastases.
Perivesical fat necrosis after adjuvant intravesical chemotherapy
Authors: Doherty  , Trendell‐Smith  , Stirling  , Rogers  , Bellringer  
Published: March 2003

ObjectiveTo document the presence of extensive transmural and perivesical fat necrosis in a series of radical cystectomies, and associate the surgical and pathological findings with the administration of intravesical chemotherapy.Patients and methodsThe study comprised 12 patients with pT2+ transitional cell tumours who were referred to the West Middlesex University Hospital and who proceeded to primary radical cystectomy between November 1996 and April 1998. The association between the presence of widespread transmural and extravesical necrosis and the administration of a single dose of intravesical epirubicin or mitomycin C in the 24 h after the initial transurethral resection of bladder tumour (TURBT) was analysed using the two‐tailed Fisher’s exact test.ResultsThe association between the presence of transmural and extravesical fat necrosis and administration of intravesical chemotherapy was highly significant (P=0.015).ConclusionsThe depth and extent of the mural muscle necrosis and perivesical fac necrosis in patients receiving intravesical chemotherapy within 24 h of TURBT is remarkable and more florid than the usual muscle necrosis seen after TURBT. Clinically, the necrotic tissue makes the cystectomy significantly more difficult technically, and may even mimic extravesical spread of malignant disease. This was not borne out by the histology of the specimens, which showed no extravesical spread of the tumour. Surgeons should be aware of the possibility that such operative findings might be the result of intravesical chemotherapy.
Transcutaneous penile oxygen pressure during bicycling
Authors: Nayal  , Schwarzer  , Klotz  , Heidenreich  , Engelmann  
Published: March 2003

ObjectiveTo evaluate the blood supply to the penis during bicycling and thus determine whether the associated perineal compression might be responsible for some cases of impotence.Subjects and methodsThe transcutaneous penile oxygen partial pressure (pO2 ) at the glans of the penis was measured in 25 healthy athletic men; pO2 is readily measured by noninvasive techniques currently widely used in the management of premature infants, and which have been shown to give pO2 levels that correlate with arterial pO2 levels. The measurements in the healthy subjects were taken in various positions, before, during and after bicycling.ResultsThe mean (sd) pO2 of the glans when standing before cycling was 61.4 (7.2) mmHg; it decreased after 3 min of cycling to 19.4 (4.7) mmHg. After 1 min of cycling in a standing position it increased significantly to 68 (7.6) mmHg; when cycling was continued in a seated position, after 3 min the pO2 fell to 18.4 (4.2) mmHg and there was a full return to normal pO2 values after a 10‐min recovery period.ConclusionThe pO2 seems to correlate with the blood supply to the penis. The present results support the hypothesis that as the penile arteries are compressed against the pubic bone by the saddle during bicycling, the pO2 values decrease. Additionally, shifting from a seated to a standing position while cycling significantly improved the pO2 value of the penis and penile blood oxygenation was then even greater. Therefore, we suggest that cyclists change their body position frequently during cycling. Correcting the handlebars or the height of the saddle, tipping the nose of the saddle to produce a more horizontal, or even downward pointing position, and attention to the design of the saddle may be the only required precautions.
Comparison of marker protein expression in benign prostatic hyperplasia in vivo and in vitro
Authors: Fry P.M. , Hudson D.L. , O’Hare M.J. , Masters J.R.W. 
Published: March 2003

Objective To use multiple immunofluorescence to compare the in vivo and in vitro expression of tissue‐specific proteins in BPH.Materials and methods Pure populations of prostate epithelial and stromal cells were produced using standard methods. Serum‐free media for epithelial cells were compared. Co‐localization of proteins was compared in frozen‐tissue sections and cultured cells by simultaneous multiple immunofluorescence, and recorded using a high‐resolution charge‐coupled device camera.Results In contrast to the other serum‐free media tested, epithelial cells grew without squamous differentiation or vacuolation in prostate epithelial growth medium (PrEGM, Clonetics, BioWhittaker UK Ltd., Berks, UK). These cells were predominantly of a basal phenotype, with some cells showing a luminal phenotype. Most of the stromal cells had features of myofibroblasts, but smooth muscle cells and fibroblasts also were present.Conclusion PrEGM is a commercially available serum‐free medium in which primary cultures of prostate epithelial cells can be propagated reproducibly. This study provides a comprehensive description of tissue‐specific protein expression in BPH in vivo and in vitro. The use of simultaneous multiple immunofluorescence to study co‐localization has resulted in a more precise definition of phenotype than has previously been possible, thereby establishing the relevance of the in vitro model system BPH.
Strong effects of definition and nonresponse bias on prevalence rates of clinical benign prostatic hyperplasia: the Krimpen study of male urogenital tract problems and general health status
Authors: Blanker M.H. , Groeneveld F.P.M.J. , Prins A. , Bernsen R.M.D. , Bohnen A.M. , Bosch J.L.H.R. 
Published: March 2003

Objective To estimate the prevalence of benign prostatic hyperplasia (BPH) in the community, and study the influence of BPH definition, age and response bias on prevalence rates. Subjects and methods A community‐based longitudinal study of 3924 men aged 50–75 years was conducted in a Dutch municipality (Krimpen) near Rotterdam. Data from those responding were collected using self‐administered questionnaires, and during visits to the health centre and outpatient clinic of the urology department. The questionnaires included symptom scores on general well being (Inventory of Subjective Health, ISH) and lower urinary tract symptoms (International Prostate Symptom Score, IPSS). A short version of the questionnaire (including the IPSS and ISH) was sent to a random sample of those not responding. All subjects participating fully underwent a physical examination, uroflowmetry, transrectal ultrasonometry of the prostate and had their prostate specific antigen level measured. Age‐specific prevalence rates of BPH were estimated using different definitions, based on one or more of symptom severity, prostate volume and maximum flow rate. The influence of response bias was estimated using the questionnaires. Results The response rate was 50% (full participants). Of those not responding, 55% completed a short version of the questionnaire (partial participants). Compared with full participants, partial participants had a lower IPSS and slightly lower ISH. The prevalence rates of clinical BPH in the study population was 9–20% (95% confidence interval, 8–11% to 22–27%) depending on the definition used. After adjusting for nonresponse bias, the age‐group specific prevalences for 5‐year age strata were 1.1–1.8 times lower for all BPH definitions used. Conclusions The prevalence rates of clinical BPH depend largely on the definition used and increase strongly with age. The effect of age is stronger when more variables are included in the definition. Adjustment for response bias results in substantially lower prevalence rates.
A comparative study of terazosin and tamsulosin for symptomatic benign prostatic hyperplasia in Japanese patients
Authors: Okada H. , Kamidono S. , Yoshioka T. , Okuyama A. , Ozono S. , Hirao Y. , Okajima E. , Yamamoto K. , Kishimoto T. , Park Y. , Kurita T. 
Published: March 2003

Objective To compare the efficacy and safety of an incremental‐dose regimen of terazosin (1–2 mg daily) and a fixed‐dose regimen of tamsulosin (0.2 mg daily), on Japanese patients with symptomatic benign prostatic hyperplasia (BPH). Patients and methods This multicentre, single‐blind, randomized trial compared terazosin and tamsulosin over 4 weeks, in 61 patients with symptomatic BPH randomly assigned to terazosin (n = 31) or tamsulosin (n = 30). Terazosin 0.5 mg twice daily was administered for 2 weeks, followed by 1 mg twice daily for 2 weeks. Tamsulosin (0.2 mg) was administered once daily for 4 weeks. Symptoms were evaluated using the International Prostate Symptom Score (IPSS), and quality of life (QOL) was assessed subjectively before treatment, and again after 2 and 4 weeks of treatment. Objective measurements taken before and after the treatment period were the maximum (Qmax) and average (Qave) urinary flow rates, and the percentage residual urine volume. Improvement was defined as a 25% decrease from baseline in IPSS, > 1 point increase in QOL score, and > 2.5 mL/s increase in Qmax. Adverse reactions potentially related to the study drugs were recorded throughout the treatment period. Results Both terazosin and tamsulosin produced statistically significant improvements in subjective and objective variables. Neither treatment affected systolic or diastolic blood pressure or pulse rate. Adverse reactions were noted in four patients (three in the terazosin group and one in the tamsulosin group). However, there was no statistically significant difference in the incidence of adverse effects between the groups. Conclusions Despite the limitations of small sample size and relatively short treatment periods, terazosin and tamsulosin were equally effective in the treatment of symptomatic BPH in Japanese patients, using relatively lower doses than those used in Western countries.
Angiogenesis and lymphangiogenesis in stage 1 germ cell tumours of the testis
Authors: Jones A. , Fujiyama C. , Turner K. , Fuggle S. , Cranston D. , Turley H. , Valtola R. , Bicknell R. , Harris A.L. 
Published: March 2003

Objective To determine whether angiogenesis can be used as an additional prognostic indicator in patients with stage 1 germ cell tumours of the testis. Patients and methods Paraffin sections were assessed immunohistochemically from 51 patients with clinical stage 1 germ cell tumours of the testis (28 seminoma, 23 teratoma) treated by orchidectomy and surveillance only. Sections were analysed for microvascular density (MVD), and expression of the angiogenic factors vascular endothelial growth factor (VEGF) and thymidine phosphorylase (TP). In addition, in the seminoma cases the presence of mRNA for the lymphangiogenic factor VEGF‐C was examined by in situ hybridization, and its corresponding receptor VEGFR‐3 by immunohistochemistry. Results Teratoma specimens had a significantly higher mean (range) MVD (85, 26–163; P < 0.01) than both seminoma (37, 16–91) and four normal specimens (26, 18–30). Teratoma specimens also had significantly higher VEGF expression than both seminoma and normal specimens (P < 0.01). Despite these differences between groups, and indeed individual tumours, there was no significant correlation between MVD and VEGF, or between either MVD or VEGF and relapse‐free survival. TP expression was significantly greater in tumours than in normal specimens (P < 0.02) but with very little inter‐tumour variation. VEGF‐C mRNA and VEGFR‐3 protein were detected in a third to a half of cases, with expression mostly around endothelial vessels. Conclusions The marked differences between normal testis and tumours implicate angiogenesis in the biology of germ cell tumours of the testis. In addition, the detection of factors involved in lymphangiogenesis in some seminomas, tumours which initially metastasize primarily to lymph nodes, indicate that although not prognostic in this study, further studies are warranted in both these areas in the search for further prognostic indicators and therapeutic targets.
Induction of apoptosis by mitomycin‐C in an ex vivo model of bladder cancer
Authors: Kelly J.D. , Williamson K.E. , Weir H.P. , McManus D.T. , Hamilton P.W. , Keane P.F. , Johnston S.R. 
Published: March 2003

Objective To examine mitomycin‐C (MMC)‐induced apoptosis in an ex vivo model of superficial TCC, and relate it to the in vivo response to chemotherapy. Materials and methods Dose‐ and time‐response curves were constructed to determine the optimal conditions for the induction of apoptosis by MMC in an ex vivo model of superficial bladder cancer. Subsequently, 41 individual tumours were exposed to MMC in the model and the effects assessed by measuring of apoptosis before and after chemotherapy. The relationships between tumour grade and stage and the intrinsic and induced apoptotic counts were determined. In tandem, in a clinical study, the relationship between in vivo response of a marker tumour to MMC and the ex vivo induction of apoptosis was determined. Results In the ex vivo model, apoptosis was induced at a MMC concentration of 0.5 mg/mL after an incubation time of 8 h. In 41 tumours the intrinsic apoptotic index (AI) was higher with increased grade and stage of tumour (P = 0.048). There was no correlation between the intrinsic AI and the AI after treatment with MMC (induced AI). In 21 tumours (51%) the induced AI did not increase above a predetermined response threshold and these tumours were considered resistant to MMC. Resistance to MMC was related to tumour grade (P = 0.037) with a trend for G3 pT1 tumours to be resistant to the therapy. There was a significant association between ex vivo sensitivity and in vivo marker tumour response (P = 0.02). Conclusions Apoptosis is differentially induced in an ex vivo incubation model of superficial TCC by MMC and evidence suggests that this response matches that seen in vivo. The measurement of apoptosis before therapy does not predict the apoptotic response of a tumour to chemotherapy. The ability to undergo apoptosis correlates with clinical outcome.
Paediatric urinary tract infection and the necessity of complete urological imaging
Authors: Kass E.J. , Kernen K.M. , Carey J.M. 
Published: March 2003

Objective To evaluate voiding cysto‐urethrography (VCUG) in assessing children with urinary tract infection (UTI) when renal/bladder ultrasonography and renal scintigraphy show no abnormality. Patients and methods A total of 468 renal scintigrams taken in children for an indication of UTI between January 1996 and December 1998 were reviewed. The renal and bladder ultrasonograms of those children with a normal renal scan were then reviewed. Children with both normal renal scans and normal ultrasonography were then evaluated for the frequency and grade of vesico‐ureteric reflux (VUR) on VCUG. Results Of the 468 patients, 453 (97%) had complete imaging studies; 152 of the children evaluated had normal renal scans, of whom 101 had a normal renal ultrasonogram. Twenty‐three (23%) children with both a normal renal scan and renal/bladder ultrasonogram showed VUR on VCUG, of whom 14 had bilateral VUR and 13 grade III or higher VUR. Conclusion This study indicates that about 23% of patients may have significant VUR despite both a normal renal scan and ultrasonogram. Therefore, VCUG remains important in evaluating and managing children with UTI.
Long‐term follow‐up of female patients with congenital adrenal hyperplasia from 21‐hydroxylase deficiency, with special emphasis on the results of vaginoplasty
Authors: Krege S. , Walz K.H. , Hauffa B.P. , Körner I. , Rübben H. 
Published: March 2003

Objective To assess, in a long‐term follow‐up, female patients with congenital adrenal hyperplasia (CAH), with special emphasis on vaginal functional outcome and sexual activity after vaginoplasty. Patients and methods Twenty‐seven patients with CAH (aged 14–33 years; six Prader grade II, 14 grade III, six grade IV and one grade V) underwent surgery between 1972 and 1988. Three of the patients underwent clitoridectomy, 24 clitoroplasty and 25 vaginoplasty (24 with a Fortunoff flap and one a ‘pull‐through’ procedure). In 20 patients the vaginoplasty was a one‐stage procedure, undertaken at a mean (range) age of 3.6 (1–9) years, and in five patients a two‐stage operation. The analysis was based on the patients' history and examination; the patients also completed a questionnaire, including a psychological profile. Results Nine of the 25 patients (36%) who underwent vaginoplasty developed intravaginal stenosis; of these nine, six were Prader grade III and three grade IV. All had undergone a single‐stage procedure at a mean (range) age of 4.7 (2–9) years. Of the 16 patients who answered the questionnaire, 14 had problems with their overall body image; patients in whom vaginal stenosis was corrected were particularly anxious about sexual intercourse and had problems with orgasm. Conclusion The main problem during the long‐term follow‐up was intravaginal stenosis; all the affected patients had undergone a single‐stage procedure early in life to correct ambiguous genitalia. This high rate of vaginal stenosis suggests that vaginoplasty should be undertaken at the beginning of puberty, because higher oestrogen levels may prevent stenosis and, if necessary, dilatation can be performed by the patient. These data also underscore the importance of psychological support in the treatment of children with CAH.
Extracorporeal shock wave therapy in the management of Peyronie's disease: initial experience
Authors: Husain J. , Lynn N.N.K. , Jones D.K. , Collins G.N. , O'reilly P.H. 
Published: March 2003

Objective To evaluate prospectively the efficacy of extracorporeal shock wave therapy (ESWT) as a conservative treatment for Peyronie's disease. Patients and methods After obtaining ethical committee approval, 37 patients with Peyronie's disease were treated using ESWT. Before treatment the degree of angulation was assessed by artificially inducing an erection with a vacuum device. The severity of pain on erection was assessed using a visual analogue scale (0–5). Each patient was treated with a minimum of three sessions of ESWT (3000 shock waves at an energy density of 0.11–0.17 mJ/mm2) at 3‐week intervals. The results were analysed using the Wilcoxon signed‐rank test. Results Of the 37 patients, 34 completed the protocol; the mean (range) duration of the disease was 19.43 (4–60) months and the mean follow‐up 7.5 (5–11) months. Almost half (47%) of the patients reported an improvement in angulation, with a mean reduction of 29.3° (10°−60°) (P < 0.001); 12 of the 20 (60%) patients with pain on erection reported immediate relief, the mean reduction being 2.3 (1–4) on the visual analogue scale (P < 0.001). There was only minimal bruising at the site of treatment and no major side‐effects were reported. Conclusion ESWT is an effective and safe treatment for Peyronie's disease; the long‐term follow‐up and results are awaited.
The clinical implications of telomerase activity in upper tract urothelial cancer and washings
Authors: Wu W.‐J. , Liu L.‐T. , Huang C.‐N. , Huang C.‐H. , Chang L.‐L. 
Published: March 2003

Objective To measure telomerase activity in upper tract urothelial carcinomas (as renal pelvic tumours comprise nearly half of all kidney tumours in Taiwan, a much higher percentage than in other countries) and to determine whether telomerase activity could be used as an additional diagnostic marker in exfoliated cancer cells present in upper tract urothelial washing fluids, thus providing earlier diagnosis and treatment. Materials and methods Telomerase activity was assessed using the telomeric repeat amplification protocol assay in tissue samples from 31 upper tract urothelial carcinomas (from 29 patients). The feasibility of identifying cancer using telomerase activity in exfoliated cancer cells in 17 upper tract urothelial washing samples was also investigated. Results Telomerase activity was found in 30 (97%) of the 31 upper tract urothelial cancer tissue samples; telomerase activity was detectable in 95% of superficial cancers and in all 11 invasive tumours. The sensitivity of measuring telomerase activity was 100% for grade 1, 93% for grade 2 and 100% for grade 3 tumours. In contrast, telomerase activity was detected in only two (8%) of 26 normal adjacent tissue samples. When the telomerase activity of urothelial washing fluid was compared with that in the corresponding tumours, there was compatible telomerase activity in 15 of the 17 samples. Telomerase activity was more sensitive than voided urine cytology (15%) and washing fluid cytology (53%). In addition, the telomerase activity was high in metastatic lesions. Conclusion Telomerase activity is present in most upper tract urothelial cancer tissues and may be present at an early stage of carcinogenesis. Telomerase activity can be detected in exfoliated cells in urothelial washing fluids in a high proportion of patients with upper tract urothelial cancer. These results suggest that measuring telomerase activity in the exfoliated cancer cells obtained from urothelial washing could be a potentially useful addition to the conventional diagnostic tools used to identify patients with upper tract urothelial carcinoma.