bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis of bladder carcinoma using protoporphyrin IX fluorescence induced by 5‐aminolaevulinic acid
Authors: Koenig F. , McGovern F.J. , Larne R. , Enquist H. , Schomacker K.T. , Deutsch T.F. 
Published: March 2003

ObjectiveTo report the results of a clinical study investigating the diagnosis of malignant and dysplastic bladder lesions by protoporphyrin IX (PPIX) fluorescence and to compare them with those from earlier studies.Patients and methodsThe study included 55 patients with suspected bladder carcinoma (at initial diagnosis or at tumour follow‐up visits); 130 bladder biopsies from 49 patients were classified by pathological analysis. All patients received an intravesical instillation of 50 mL of a 3% 5‐aminolaevulinic acid (ALA) solution a mean of 135 min before cystoscopy, which was then performed under white and blue light. Malignant/dysplastic lesions showing red fluorescence under blue‐light excitation were noted and the increase in detection rate calculated.ResultsThere were 63 benign and 67 malignant/dysplastic areas biopsied; 10 malignant/dysplastic lesions (four transitional cell carcinoma, two carcinoma in situ, four dysplasia) were not detected during routine white‐light cystoscopy but were identified under blue light. Fluorescence cystoscopy improved the overall diagnosis of malignant/dysplastic bladder lesions by 18% over standard white‐light cystoscopy. The improvement was greater for dysplastic lesions and carcinoma in situ (50%). However, the improvement over standard cystoscopy was less than that found by other groups.ConclusionThe ALA‐based fluorescence detection system significantly enhanced the diagnosis of malignant/dysplastic bladder lesions. However, determining the optimum drug exposure time requires further investigation using well‐characterized instrumentation and study protocols, which would then allow comparison of the results from different groups.
An evaluation of the no‐scalpel vasectomy technique
Authors: Kumar  , Kaza  , Singh  , Singhal  , Kumaran  
Published: March 2003

ObjectiveTo evaluate the magnitude and range of complications encountered during no‐scalpel vasectomy (NSV) and to identify any limiting factor or contraindication to NSV.Subjects and methodsA total of 4255 men visiting a family welfare clinic of a city hospital in Delhi, India, or outpatients of the surgery department, opted for NSV; 4253 procedures were performed from September 1989 to December 1997, with two not performed because of technical difficulties. The success and complication rates were recorded.ResultsThe complication rates with NSV were surprisingly low; seven complications were encountered, comprising two small haematomas (0.047%), three painful nodules (0.07%), three wound infections (0.07%) and two vasal fistulae, a complication not previously described. A meticulous procedure should avoid this last complication. The mean duration of NSV was 9.5 min.ConclusionNSV is a refined and rapid technique of vasectomy with an extremely low complication rate. Being a minimally invasive procedure, it allays the fear of incision commonly encountered in men choosing vasectomy.
Microvessel density in prostatic hyperplasia
Authors: Foley S.J. , Bailey D.M. 
Published: March 2003

Objectives To examine the prostates from patients with haematuria associated with benign prostatic hyperplasia (BPH) to determine their microvascular anatomy and thus assess histopathological differences in patients with significant haematuria. Patients and methods Prospectively, 11 patients with BPH and haematuria (mean age 70 years) and 19 control patients with BPH alone (mean age 72 years) were identified. Neither group had received hormone manipulation or had been catheterized. The sub‐urothelial compartment of the prostatic urethra in subsequent specimens from transurethral resection was examined using factor VIII/CD‐34 immuno‐histochemistry. The microvessel density (MVD) was calculated by counting vascular cross‐sectional profiles within a 0.81‐mm2 grid. The pathologist studying the specimens was unaware of the patients’ symptoms. Results The median (range) MVD in the haematuria group was 64 (28–137) and in the controls was 27 (14–39) (P < 0.001). Conclusion The MVD was significantly greater in the patients with haematuria, suggesting that suburo‐thelial microvessel proliferation may play an important role in mediating haematuria associated with BPH. This is the first time that a difference has been shown at the cellular level in patients with haematuria and could form an important foundation for subsequent research.
Genetic alterations of the p16 gene in urothelial carcinoma in Taiwanese patients
Authors: Wu W.‐J. , Kakehi Y. , Chang S.‐F. , Huang C.‐H. , Chang L.‐L. 
Published: March 2003

Objective To measure changes in the p16 gene (MTS1, a negative regulator of cell‐cycle progression at the G1 checkpoint, and a tumour suppressor gene) in urothelial carcinomas (including upper tract urothelial and bladder tumours), and to correlate these measurements with the clinical status of such patients in Taiwan, where renal pelvic tumours comprise 47% of all kidney tumours and are more common than the average worldwide. Materials and methods Thirty‐five upper tract urothelial and 61 bladder tumours were examined for changes in p16. Deletion of the gene was assessed by Southern blot analysis and mutation analysed using polymerase chain reaction‐single strand conformation polymorphism, followed by direct sequencing. Results Of the 61 bladder carcinomas, homozygous deletion of p16 was detected in 12 (20%). However, a homozygous deletion was detected in 11 of 35 (31%) upper tract urothelial carcinomas, a higher frequency than that reported for transitional cell bladder carcinomas. Deletion was detected as frequently in stage I tumours as in late‐stage tumours, suggesting that p16 deletion is a relatively early event in urothelial tumorigenesis. No point mutations were noted for p16 in any of the primary urothelial tumours. Most multiple and recurrent tumours and metastatic nodules in individual patients contained identical p16 genetic lesions, confirming that the tumours were probably monoclonal. In addition, there was a high gene dose of p16 in bladder carcinomas from patients with lymph node metastasis. Conclusion Deletion of p16 appears to be a common event in urothelial carcinomas, especially in upper tract urothelial tumours. High levels of p16 were detected in tumours with lymph node metastasis. It seems likely that a high p16 level is associated with carcinomas of advanced stage and grade, and with poor prognosis in patients with such cancers.
Increased intra‐abdominal pressure alters the contractile properties of rabbit bladder
Authors: Bingöl‐kolog¯lu M. , Sara Y. , Ertunç M. , Onur R. , Büyükpamukçu N. , Tanyel F.C. 
Published: March 2003

Objective To evaluate the effects of increased intra‐abdominal pressure (IAP) on the contractility of the rabbit bladder, as the dynamics of the bladder may be impaired in conditions associated with a high IAP, e.g. constipation and pregnancy. Material and methods The study comprised 22 adult male New Zealand rabbits; six served as the control group, eight had an IAP of 7 cmH2O imposed for 10 days by instilling air into the abdominal cavity and this IAP was maintained for 60 days in a further eight rabbits. After treatment, the rabbits were killed, and the bladders removed and cut into 3 × 12 mm strips. The contractile activity of the muscle strips was then recorded isometrically. Electrical field stimulation (EFS) was applied using a pair of platinum ring electrodes in trains of 3 s duration every 100 s (1 ms, 100 V, 2–100 Hz). Contractile responses to carbachol and isotonic KCl were also evaluated. Results EFS induced a frequency‐dependent increase in contractile activity in all bladder strips. Ten days of high IAP resulted in an increased responsiveness to EFS, but high IAP for 60 days reduced the EFS‐induced responses to the control levels. Carbachol (10−9–10−3 mol/L) elicited concentration‐dependent contractions in all groups. From the concentration‐response curves of carbachol, the log EC50 values (the concentration producing half the maximum effect) of the control and 60‐day treated animals were comparable, at −6.24 (0.05) and −6.25 (0.04), respectively. However, the log EC50 of the 10 day‐treated group was −4.97 (0.08) and significantly (P < 0.01) lower than that of both groups. Isotonic KCl produced contractions in all preparations; these contractions in the control and 60‐day treated animals were similar, while the 10 day‐treated group had significantly (P < 0.05) higher contraction amplitudes. Conclusion Increased IAP alters the contractile properties of the bladder and its responsiveness to carbachol and KCl. As the intravesical pressure closely reflects the IAP, both should be increased in the present experimental design.
Evidence for the autoregulation of vesical circulation by intravesical potassium chloride and distension in the normal human bladder
Authors: Hohlbrugger G. , Frauscher F. , Strasser H. , Stenzl A. , Bartsch G. 
Published: March 2003

Objectives To determine the influence of distension and intravesical KCl on vesical blood flow in the normal human bladder.Subjects and methods Nine normal volunteers underwent comparative cystometry (NaCl vs 0.2 mol/L KCl; filling rate 50 mL/min). Peak systolic blood flow velocity (PSBFV) and end‐diastolic blood flow velocity (EDBFV) were measured in several intramural arteries at a filling volume of 50 mL and at maximum cystometric capacity (Cmax). For these measurements a colour Doppler unit fitted with an endorectal probe was used. The resistance index (RI) was defined as (PSBFV − EDBFV)/PSBFV.Results In the presence of NaCl, the mean PSBFV increased significantly from 9 cm/s at 50 mL to 17 cm/s at Cmax (512 mL). Compared with NaCl, KCl induced a significantly higher mean PSBFV at 50 mL (15 cm/s). With increasing distension the rise in PSBFV with KCl filling (Cmax 478 mL) was nearly parallel to that obtained on NaCl filling (mean 22 cm/s); the RI did not change.Conclusions Bladder distension and intravesical KCl significantly increased the PSBFV. The unchanged RI indicated a concomitant increase in perfusion rates. Hence, the composition of urine (high potassium concentrations and hyperosmolarity) and its storage govern the autoregulation (independent of cardiac output) of vesical circulation, probably by reflexive pathways. These findings provide further evidence for prevesical arteriovenous shunts.
Oxybutynin for detrusor instability with adjuvant salivary stimulant pastilles to improve compliance: results of a multicentre, randomized controlled trial
Authors: Tincello D.G. , Adams E.J. , Sutherst J.R. , Richmond D.H. 
Published: March 2003

Objective To test the hypothesis that compliance with oxybutynin would be improved if the severity of dry mouth could be reduced, thus leading to improved urinary symptom response and improved outcome, in a randomized, controlled trial of oxybutynin with or without salivary stimulant pastilles in patients with detrusor instability.Patients and methods Sixty‐seven women with detrusor instability were randomized to a variable dose regimen of oxybutynin with (37) or without (30) salivary stimulant pastilles for 8 weeks. Patients were asked to complete a baseline voiding diary. In weeks 1 and 2, patients were encouraged to adjust the dose of oxybutynin themselves to achieve optimum symptomatic control. A second diary was completed in the sixth week and patients were reviewed at 8 weeks. The outcome measures were the compliance rate, follow‐up attendance rate, maximum dose of medication, changes in voiding and incontinence episodes, and changes in severity of urgency and of dry mouth symptoms between the first and sixth week.Results Of the 67 women, 32 (47%) completed the study; the proportion completing was the same in both groups. Four patients had stopped the medication and there was no difference in the distribution of maximum dosage achieved between the groups. Both groups reported a reduced severity of urgency symptoms and increased severity of dry mouth. There were no differences in reported symptom change between the groups during the study.Conclusions The combination of oxybutynin and salivary stimulant pastilles does not improve compliance or symptom relief compared with oxybutynin alone; it does not allow a greater dose of oxybutynin to be tolerated.
Affinity of trazodone for human penile α1‐ andα2‐adrenoceptors
Authors: Krege S. , Goepel M. , Sperling H. , Michel M.C. 
Published: March 2003

Objective To determine the affinities of human penile α‐adrenoceptors and cloned human α‐adrenoceptor subtypes for trazodone, an antidepressant with reported beneficial effects in erectile dysfunction. Materials and methods Competition radioligand binding studies were performed with trazodone in human penile tissue and in cell lines stably expressing all cloned human α‐adrenoceptor subtypes. Results Trazodone had higher affinity for human α1‐adrenoceptors (10–130 nmol/L) than for α2‐adrenoceptors (300–700 nmol/L), but did not discriminate between subtypes of human α1‐ or α2‐adrenoceptors. Conclusion Trazodone has high and moderate affinity for human α1‐ and α2‐adrenoceptors, respectively; this might contribute to its reported beneficial effects in erectile dysfunction.
Gene transfer to urethral strictures in rabbits: a preliminary report
Authors: Meria P. , Anidjar M. , Brouland J.P. , Teillac P. , Berthon P. , Cussenot O. 
Published: March 2003

Objective To assess the rationale for virus‐mediated gene transfer into the urethra in vivo and in vitro, using a rabbit model, as this is an attractive approach to prevent recurrence after the endoscopic management of urethral strictures.Materials and methods Primary cultures of rabbit urethral stromal cells were infected with adenoviral and retroviral solutions carrying a nucleus‐targeted β‐galactosidase (β‐Gal) reporter gene (respectively 109 and 107 plaque‐forming units/mL). In addition, to mimic the human clinical situation, a model was developed of thermally induced stricture in rabbit urethra which produced fibrotic stenosis within 15 days. Using a prototype channelled balloon catheter, these strictures were endoscopically dilated and then instilled with the β‐Gal adenoviral or retroviral constructs.Results The application of recombinant adenovirus and retrovirus harbouring a nucleus‐targeted β‐Gal reporter gene to cultured rabbit urethral stromal cells resulted in a high transduction efficiency of up to 90% and 96%, respectively. Five days after infection, histochemical and immunohistochemical staining of the strictured urethrae showed a 3% rate of transfection targeted to stromal cells within the fibrosis, confirmed by polymerase chain reaction (PCR) analysis. Adjacent and distal spread of the virus was excluded by histochemistry, immunohistochemistry and PCR.Conclusion These results represent the first report of endoscopic adenovirus and retrovirus‐mediated gene transfer to the urethra. Although at a low rate, transduction reached stromal cells transmurally within the induced strictures and was site‐specific.
Paediatric anatrophic nephrolithotomy; stone clearance — at what price?
Authors: Gough D.C.S. , Baillie C.T. 
Published: March 2003

Objective To evaluate the functional outcome of anatrophic nephrolithotomy in children. Patients and methods All children undergoing anatrophic nephrolithotomy for complex branching and multiple renal calculi over an 11‐year period were studied prospectively. Demographic data, treatment details and outcome, as assessed by X‐ray, ultrasonography and isotope studies, were recorded. Anatrophic nephrolithotomy was carried out with surface cooling of the kidney followed by nephrostomy drainage for 5–7 days. Results Nine children (median age 4 years, range 7 months to 9 years) underwent anatrophic nephrolithotomy. Predisposing factors included urinary tract infection (by Proteus mirabilis) in all and hyper‐calciuria in two children. The median (range) total ischaemic time at operation was 25 (15–40) min and the operative duration 150 (120–200) min. Three children required a blood transfusion. Stone clearance was incomplete in one child. There was no recurrent stone formation after a long‐term follow‐up (median 32 months, range 14–107) in the other patients. Isotope studies showed impaired split renal function (<40%) in six children before surgery; there was a significant decline (>5%) in divided function in five children (range 6–16%) after surgery. Conclusion Anatrophic nephrolithotomy is an effective means of rendering children with branching calculi stone‐free, but this study suggests that it leads to some further parenchymal damage.
Possible biphasic changes of free radicals in ethylene glycol‐induced nephrolithiasis in rats
Authors: Huang H.S. , Chen C.F. , Chien C.T. , Chen J. 
Published: March 2003

Objective To evaluate the possible role of free radicals in nephrolithiasis in rats induced by ethylene glycol, and to examine the correlation between the urinary enzymes N‐acetyl‐β‐glucosaminidase (NAG), β‐galactosidase (GAL) and neutral endopeptidase (NEP), and free radical production.Materials and methods Hyperoxaluria was produced in male Wistar rats by adding ethylene glycol to their drinking water. After 7, 21 and 42 days of treatment, urinary oxalate, creatinine clearance and urinary enzymes (NAG, GAL and NEP) were measured. The nitroblue tetrazolium perfusion method was used to locate the sites of free‐radical production. Ultrasensitive chemiluminescence was used to directly measure the production of reactive oxygen species (ROS) in vivo. Vitamin E and potassium citrate were fed to rats, in addition to ethylene glycol, to assess their effects on free radical production.Results Urinary oxalate increased significantly and was associated with an increase in NAG and GAL at all sample times. However, urinary NEP activity was unchanged on day 7, although there was four times as much NEP on days 21 and 42 than in the control groups. Formazan particles in the renal cortex were scored as 3+ to 4+ in rats treated for 7 days with ethylene glycol. Blood ROS levels were also higher in this group than in the controls (P < 0.01). After vitamin E and potassium citrate treatment, blood ROS levels were lower than in rats treated with ethylene glycol alone.Conclusion Free radicals may be produced in the early stages of nephrolithiasis in rats fed with ethylene glycol. Free radicals occurred mainly in blood and might be associated with NEP inactivation.
Bacteriological safety and cost‐effectiveness of a nonrefluxing valve in the irrigation system during outpatient flexible cystoscopy
Authors: Thompson A. , Pearce I. , Robinson E. , Ladds T.J. , Payne S.R. 
Published: March 2003

Objective To critically evaluate the infection rate associated with the use of a nonrefluxing irrigation system for outpatient flexible cystoscopy, by comparing it with conventional irrigation systems, and to determine the costs and benefits of this system of irrigation delivery.Patients and methods All patients undergoing flexible cystoscopy on scheduled outpatient lists were considered for inclusion in the study; 143 patients of 220 undergoing cystoscopy fulfilled the study criteria. The study group of patients underwent cystoscopy with a new single‐use nonrefluxing valve inserted into the same irrigation delivery system that was used for the whole endoscopy session, and the control group had the complete irrigation system changed after each endoscopic examination. Midstream urine samples were taken for analysis before cystoscopy and again 3–4 days later. Infection was defined as a pure growth of  105 organisms/mL, with associated pyuria defined as  10 pus cells per high power microscopic field.Results Complete data were available on 133 patients, with a further nine being excluded from the statistical analysis because they had a pre‐existing urinary tract infection, leaving 64 patients in the study and 69 in the control groups. The overall infection rate for flexible cystoscopy was 3.2%, with no significant difference between the study and control groups. Cost savings of > 35% can be expected using the nonrefluxing valve method of irrigation delivery.Conclusion The nonrefluxing valve caused no detectable increase in patient morbidity from bacterial infection when compared with conventional irrigation systems for flexible cystoscopy, and can save considerable costs.
Attenuation of reperfusion injury by renal ischaemic preconditioning: the role of nitric oxide
Authors: Jefayri M.K. , Grace P.A. , Mathie R.T. 
Published: March 2003

Objective To determine the effect on nitric oxide (NO) release and renal NO synthase (endothelial, eNOS and inducible, iNOS) activity of renal ischaemia‐reperfusion (I/R) in vivo in an animal model, and to examine the possible involvement of NO in ischaemic preconditioning (IP) of the kidney.Materials and methods In a right‐nephrectomized rat model, 42 animals were randomized in four groups: controls; IP‐only (4 min of ischaemia followed by 11 min of reperfusion, total of four cycles); renal warm ischaemia (45 min) and 6 h reperfusion; ischaemia (45 min) preceded by IP pretreatment. Serum NO metabolites were assayed 2 and 6 h after ischaemia or the control equivalent. NOS expression in the kidney was detected immuno‐histochemically, and damage assessed morphologically in sections stained with haematoxylin and eosin. Kidney function was assessed by the levels of serum creatinine, urea and electrolytes.Results Compared with before ischaemia, the concentration of serum NO metabolites at 6 h was increased in the IP‐only animals (P = 0.016) and in the IP + I/R group (P = 0.002). There was greater eNOS expression in the IP‐only group (P = 0.009) and in the IP + I/R group than in controls (P = 0.050). iNOS expression was greater in the IP‐only animals than in the control group (P = 0.050). Histological assessment showed less evidence of cellular damage in IP + I/R animals than in the I/R‐alone group (P = 0.020). Serum creatinine level was not significantly different between the IP‐only group and the control. There were no differences after 2 h of reperfusion.Conclusion Ischaemic preconditioning has a protective effect on renal structure and function, which may be produced by increased NO release arising from increased NOS expression by 6 h after reperfusion.
Simultaneous recording of mechanical and intracellular electrical activity in human urinary bladder smooth muscle
Authors: Visser A.J. , Van Mastrigt R. 
Published: March 2003

Objective To elucidate the role of the membrane potential in human detrusor smooth muscle contraction, by simultaneously recording mechanical and intracellular electrical activity in muscle strips. Materials and methods The agonists acetylcholine and carbachol were applied to induce a contraction on muscarinic receptor stimulation; to block the response, atropine was added to the bath. The Ca2+ necessary for activating the contractile machinery can be recruited via two pathways: release from intracellular stores or influx from the extracellular matrix. High potassium was applied to induce Ca2+ influx through voltage‐sensitive Ca2+ channels. Results There were significant changes in the force when agonist, antagonist and high potassium was administered. However, there were significant changes in membrane potential only when KCl was applied to the bath and not with muscarinic agonist or antagonist application. Activity in the form of spike potentials did not change significantly on applying any of the test substances. Conclusion The present results indicate that the Ca2+ mobilized on M3 receptor stimulation originates primarily from intracellular stores, with no systematic changes in membrane potential. Atropine only caused a relaxation in muscle previously contracted by M3‐receptor agonist stimulation; it had no effect on relaxed muscle strips.