bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new operative method to treat high teat stenoses in dairy cows
Authors: John  , HÄssig  , Gobet  , Sicher  , Jaeger  
Published: March 2003

Objective To evaluate in a pilot study an alternative technique using theloscopic surgery in the management of proximal teat stenoses of dairy cows.Materials and methods The study included three lactating dairy cows (mean age 3.5 years) with a stenotic fibrous lesion in the proximal region of a teat. The lesions were suspected to be of traumatic origin and the diagnoses were confirmed by ultrasonography. For surgery, the cows were sedated and the base of the teat anaesthetized. The resectoscope was introduced through an incision in the teat cistern. The surgical area was continuously irrigated with saline solution and the stenotic lesions electroresected. Haemorrhage was controlled whenever possible by electrocoagulation.Results In two cows, the procedure was successful and resulted in normal milk flow. One of the two cows was slaughtered soon after the operation for reasons unrelated to udder health. The other cow could be milked normally at a follow‐up examination 4 months later and on ultrasonography, there was no recurrence of the stenotic lesions. In both cows, there was no evidence of concurrent intramammary infection. In the third cow, the procedure had to be discontinued because of severe intraoperative haemorrhage.Conclusions Video‐assisted theloscopic electroresection of fibrotic teats is a promising, novel and minimally invasive technique for the surgical correction of the glandular part of the cistern. It should be considered as an alternative to conventional surgical methods in valuable dairy cows.
Manual derotation of the twisted spermatic cord
Authors: Cornel  , Karthaus  
Published: March 2003

ObjectiveTo re‐emphasize the safety and efficacy of manual derotation in the management of the twisted spermatic cord.Patients and methodsSeventeen patients (mean age 15 years, range 13–28) with acute unilateral torsion of the spermatic cord, initially treated by manual detorsion, were reviewed; all 17 patients were seen by one consulting urologist (H.F.M.K.).ResultsIn 14 of the 17 patients the attempt resulted in successful manual derotation, i.e. the immediate relief of all symptoms and normal findings at physical examination. No testicular atrophy was detected during the follow‐up (mean 22 months, range 9–72).ConclusionsThese results reinforce the efficacy and safety of manual derotation with subsequent elective bilateral orchidopexy as the primary treatment for the twisted spermatic cord.
Genetic instability in incidentally discovered and advanced prostate cancer
Authors: Crundwell  , Morton  , Arkell  , Phillips  
Published: March 2003

ObjectiveTo investigate the frequency of microsatellite instability, a marker for genetic instability, in incidental and advanced prostate cancers, and to determine the role and prognostic importance of genetic instability in prostate carcinogenesis.Patients and methodsMicrosatellite analysis was performed on 72 prostate cancers, of which 26 were incidentally discovered at transurethral prostatectomy (TURP) for benign disease. They were staged and graded 1–3 according to glandular differentiation. Fresh prostatic tissue was obtained at TURP performed for bladder outlet obstruction, from 43 patients (median age 73 years, range 55–88), with tissue from the remaining 29 (median age 75, range 53–83) patients obtained from pathology archives, having been originally collected at TURP between 1969 and 1986.ResultsInstability was detected in 14 (19%) cancers overall, in eight (31%) of 26 incidental tumours and in six (13%) of 46 clinically apparent tumours. These differences were not statistically different (2P=0.1). The time to progression and survival were similar between men with tumours showing instability and those with no instability.ConclusionThese data suggest that genetic instability is an early event in prostate carcinogenesis, but does not appear to influence prognosis.
The conservative management of Corynebacterium group D2 encrusted pyelitis
Authors: Meria  , Desgrippes  , Fournier  , Arfi  , Antoine  , Martinat  , Teillac  , Le Duc  
Published: March 2003

ObjectiveTo evaluate the conservative management of encrusted pyelitis (EP), an infectious disease caused by urea‐splitting micro‐organisms (Corynebacterium group D2 being the most common), and characterized by stone encrustation of the collecting system.Patients and methodsFour patients (aged 17–62 years) with EP caused by Corynebacterium group D2 were treated conservatively with intravenous vancomycin and percutaneous acidification of the renal collecting system. Percutaneous nephrostomy tubes were placed to allow irrigation with Thomas’ acid solution, the outflow being ensured by ureteric catheters. Patients were monitored and the results of and tolerance to treatment evaluated clinically, by biological assays, and by imaging techniques (ultrasonography, computed tomography and pyelography).ResultsNo kidneys were lost and in all patients with initial renal failure, creatinine levels recovered to previous values. The adverse effects were moderate, consisting of flank pain or discomfort, and low‐grade fever. Three patients developed asymptomatic fungal urinary tract infections requiring antifungal agents. The encrustations were treated effectively and almost disappeared in two patients, while the other two had no residual calcification. One transplanted‐kidney recipient developed a ureteric stricture requiring surgical repair. Within a mean follow‐up of 16 months, there was no recurrence of EP and the residual encrustation remained small.ConclusionThe conservative treatment of EP can avoid surgery in many cases, although there are some adverse effects of irrigation. The long‐term follow‐up and prevention of recurrent EP are nevertheless required.
Ischaemic preconditioning protects the rat kidney from reperfusion injury
Authors: Toosy  , McMorris  , Grace  , Mathie  
Published: March 2003

ObjectiveTo examine the possible role of ischaemic preconditioning (IPC), an adaptive pathophysiological phenomenon that increases tolerance to ischaemia‐reperfusion (I‐R) injury, in renal protection when rats are presented with an I‐R challenge.Materials and methodsFemale Wistar rats (n=36) were divided randomly into four groups: (A) sham‐operated controls; (B) IPC only; (C) renal ischaemia (RI) only; and (D) IPC+RI. The left kidney in groups B and D was preconditioned with four cycles of renal artery occlusion lasting 4 min, each occlusion separated by 11 min of reperfusion. The ischaemic insult, applied in groups C and D, comprised 40 min of sustained left renal artery occlusion. In Group D, the IPC cycle was completed 5 min before the start of the ischaemic insult. Differential left renal function was calculated by 99mTc‐labelled dimercaptosuccinic acid scintigraphy at 0, 2 and 9 days after treatment, and expressed as a percentage of the total renal uptake.ResultsThe mean (sem) maximum decrease in left renal function, to 14.5 (4.3)% of the total, occurred on day 2 in Group C. The equivalent value in Group D showed relative preservation of function, at 36.0 (3.5)% (P=0.001 compared with Group C). The mean left renal function improved by day 9, to 39.6 (6.7)% (Group C) and 48.6 (1.5)% (Group D). The mean left renal function in Group B (50.5–53.9%) did not differ from that in controls (49.4–51.4%).ConclusionAn IPC regimen applied 5 min before RI in the rat significantly protects it from the functional impairment associated with ischaemia and reperfusion.
Up‐regulation of endothelin‐B (ETB) receptors and ETB receptor‐mediated rabbit detrusor contraction in partial bladder outlet obstruction
Authors: Khan  , Dashwood  , Thompson  , Mumtaz  , Mikhailidis  , Morgan  
Published: March 2003

Objective To investigate, in a rabbit model of bladder outlet obstruction (BOO), whether ETB receptors initiate any contractile activity, and to assess the density of these receptors.Materials and methodsPartial BOO was produced in male New Zealand White rabbits, with age‐matched sham‐operated rabbits acting as controls. One and 3 weeks later, the detrusor and bladder neck strips were incubated in organ baths with either BQ788 (an ETB antagonist), BQ123 (an ETA antagonist) or vehicle. Concentration‐response curves were constructed using IRL‐1620 (a selective ETB agonist). Low‐resolution autoradiography was performed on serial detrusor and bladder neck sections from control and partial BOO (3‐week) rabbits using radioligands for ETA and ETB.ResultsIn strips from controls and after 1 week of partial BOO, IRL‐1620 induced no contractions, but after 3 weeks of BOO, IRL‐1620 induced significant concentration‐dependent detrusor contractions (producing 12%, 25% and 70% of the KCl response at 10−8 , 10−7 and 10−6 mol/L, respectively). The ETA antagonist had no effect on IRL‐1620‐mediated contractions. In contrast, the ETB antagonist completely abolished these contractions. Autoradiography showed the presence of ETA and ETB receptors in the detrusor and bladder neck of normal and obstructed animals, and a significant up‐regulation of ETA and ETB receptors only in the obstructed detrusor smooth muscle.ConclusionsIn BOO, ETB receptors initiate detrusor contractile activity. This is a time‐dependent process that may depend on the up‐regulation of ETB receptors in the detrusor. Therefore, ETB receptors may play a role in the pathophysiology of partial BOO.
Steinstrasse: a comparison of incidence with and without J stenting and the effect of J stenting on subsequent management
Authors: Al‐Awadi  , Abdul Halim  , Kehinde  , Al‐Tawheed  
Published: March 2003

Objective To analyse the effect of ureteric stenting on the incidence of steinstrasse and its effects on the subsequent management of steinstrasse.Patients and methods Four hundred adult patients with a unilateral stone burden (mean diameter 1.5–3.5 cm) were randomly allocated into two groups; in group 1, patients had a J stent inserted before extracorporeal shock wave lithotripsy (ESWL) and group 2 did not. Before randomization, the patients had normal renal function and no evidence of ureteric obstruction on intravenous urography. All patients underwent ESWL, with the shock waves delivered first to the most dependent part of the calculi. Patients who developed steinstrasse were identified and the effect of the size of the calculi and the presence of a J stent on the incidence and level of the steinstrasse, on the time of diagnosis, the size of the major stone fragment, associated presenting symptoms and effect on subsequent management were compared between the groups.Results Patients developed steinstrasse in both groups, with 12 (6%) and 26 (13%) in groups 1 and 2, respectively (significantly different, P<0.05). The incidence of steinstrasse depended on the size of the calculus, regardless of whether a J stent was present, being 2.6% and 56% for a burden of 1.5–2.0 cm and 3.1–3.5 cm, respectively (P<0.001). There was no difference in the presenting symptoms in the two groups. The steinstrasse was in the lower third of the ureter in eight of 12 patients in group 1 and in 16 of 26 (62%) in group 2. The steinstrasse resolved spontaneously in seven patients in group 1 and in 12 (46%) in group 2 (P<0.11). Similarly, J stenting had no effect on the subsequent treatment modalities to resolve steinstrasse.Conclusion The use of J stenting before lithotripsy significantly lowers the incidence of steinstrasse in patients with a stone burden of 1.5–3.5 cm. The incidence of steinstrasse increases with the size of the calculi, whether or not a J stent is present; J stenting has no apparent effect on the mode of presentation or the subsequent management of steinstrasse.
Semen cryopreservation after orchidectomy in men with testicular cancer
Authors: Sibert  , Rives  , Rey  , Mace  , Grise  
Published: March 2003

OjectiveTo assess the feasibility of semen cryopreservation after orchidectomy in patients with testicular tumour.Patients and methodsThe quality of semen samples was investigated in 36 men with testicular tumour (mean age 31.7 years, range 20–49) who were referred to our infertility centre for semen cryopreservation. For each patient, the number of straws, semen volume, number of spermatozoa, and sperm motility before and after freezing were evaluated.ResultsFifteen patients (42%) banked sperm before and 21 (58%) after orchidectomy; the delay was >7 days in 19 patients (53%). The mean age, histological diagnosis and tumour stage did not differ significantly whatever the time of cryopreservation. Semen quality did not differ significantly in patients who cryopreserved sperm before or after orchidectomy and there were no significant differences in sperm values whatever the delay before preservation. Semen quality was the same in patients with seminoma or nonseminoma tumour.ConclusionThese findings indicate that spermatogenesis of the contralateral testis is sufficient for successful semen cryopreservation after orchidectomy. Urologists should be encouraged to increase the awareness among oncology teams and patients about the new developments in preserving fertility for patients with cancer.
Asymptomatic inflammation and/or infection in benign prostatic hyperplasia
Authors: Nickel  , Downey  , Young  , Boag  
Published: March 2003

ObjectiveTo determine the extent, pattern and clinical significance of asymptomatic histological inflammation and latent infection (National Institute of Health Category IV prostatitis) in benign prostatic hyperplasia (BPH).Patients and methodsThe study included 80 patients (from a cohort of 100 consecutive potentially eligible subjects) with a diagnosis of BPH, but no history or symptoms of prostatitis. Histological sections were obtained from specimens collected prospectively at transurethral resection of the prostate (TURP), immunostained for leukocyte common antigen and scanned using a computerized image‐analysis system. Foci of inflammation were categorized as glandular, periglandular, stromal or peri‐urethral, and the inflammatory cell density graded from 1 to 3. Relationships and correlations were calculated between the volume, degree and type of inflammation, presence and type of bacteria (culture of deep prostatic biopsies), the use of catheters and prostate specific antigen (PSA) levels.ResultsInflammation was identified in all patients but the mean tissue surface area involved was only 1.1% of the total specimen, with periglandular inflammation being the predominant pattern (0.5%). Of the prostate specimens, 44% showed bacterial growth (in 67% of the catheterized patients and 28% of those uncatheterized; 42% of patients were catheterized before TURP). There was no significant difference between any combination of inflammation pattern, volume or grade of inflammation in those catheterized or not (P=0.15) or culture‐positive (pathogenic or not) and culture‐negative cases (P=0.06). Neither total PSA or PSA density was significantly correlated (P>0.05) with the amount, degree or distribution of inflammation.ConclusionProstatic inflammation is an extremely common histological finding in patients with symptoms of BPH who have no symptoms of prostatitis. There was no correlation between the degree and pattern of inflammation, catheterization, presence of bacteria, serum PSA or PSA density. The clinical significance of asymptomatic Category IV chronic prostatitis associated with BPH has yet to be determined.
Assessing the risk of unsuspected prostate cancer in patients with benign prostatic hypertrophy: a 13‐year retrospective study of the incidence and natural history of T1a‐T1b prostate cancers
Authors: Tombal  , De Visccher  , Cosyns  , Lorge  , Opsomer  , Wese  , Van Cangh  
Published: March 2003

ObjectiveTo determine the incidence and natural history of stage T1a‐T1b prostate cancer in patients undergoing surgery for benign prostatic hypertrophy (BPH), and thus evaluate the effect that recent medical and ‘minimally invasive’ treatments (which provide no prostate sample for pathological examination) might have on the percentage of patients with unsuspected prostate cancer.Patients and methodsA series of 1648 patients undergoing surgery for BPH over a 13‐year period were reviewed retrospectively; the period overlapped the introduction of serum prostate specific antigen (PSA) as a detection method.ResultsStage T1 prostate cancer was found in 182 patients (11%), comprising 126 (11%) of 1199 transurethral resections and 56 (12%) of 449 open enucleations. The introduction of systematic PSA assays gradually reduced the mean incidence of T1 cancer from 23% to 7%, with a greater effect on T1b (from 15% to 2%), while the incidence of T1a remained nearly constant (±5%). The pathological features of surgical specimens from 43 radical prostatectomies undertaken for T1 tumours were reviewed. Locally advanced disease (stage ≥pT3) was apparent in 13% of T1a and 28% of T1b tumours. Amongst the patients electing for surveillance, only 8% of those with T1a progressed within 30–97 months of follow‐up (mean progression time 73 months), whereas 29% of those with stage T1b progressed within 36 months of follow‐up (mean progression time 17 months).ConclusionThese results show that the use of the PSA assay has decreased but not suppressed the incidence of pT1 prostate cancer, with a greater effect on those tumours at higher risk of progression (T1b). This suggests that the detection of prostate cancer based on PSA and transrectal ultrasonography is appropriate for screening patients and is sufficiently accurate that treatments for BPH that provide no pathological materials can be applied safely.
The incidence of detrusor instability before and after colposuspension: a study using conventional and ambulatory urodynamic monitoring
Authors: Brown  , Hilton  
Published: March 2003

ObjectiveTo determine the incidence of detrusor instability (DI) detected by conventional and ambulatory bladder pressure monitoring, any link between urodynamic findings before and after colposuspension, and between patients’ symptoms and the urodynamic findings.Patients and methodsSixty‐five patients, scheduled to undergo colposuspension on the basis of pure genuine stress incontinence on conventional cystometrography (CMG), also underwent ambulatory monitoring (AM) before surgery. All were requested to return 3 months afterward for repeat CMG and AM in random order. In all, 56 patients completed all assessments before and after surgery. In addition to the urodynamic assessment, the patients’ symptoms before and after surgery were compared using a detailed questionnaire.ResultsOn AM before surgery, half the patients showed some DI; afterward, the incidence on AM was 70% and on CMG was 27%. However, on AM, 25% of patients who had DI before surgery showed no evidence of it afterward. Of the 19 women who complained of urgency preoperatively, 16 showed DI on preoperative AM. However, of the 37 women denying urgency preoperatively, 12 (32%) also showed evidence of DI on preoperative AM.ConclusionsThere is a significant incidence of DI detected by CMG after colposuspension in patients who are stable before surgery. The incidence of DI on AM was significantly higher than on CMG both before and after surgery. However, the preoperative urodynamic finding of increased DI on AM does not exclusively predict its presence postoperatively on AM or CMG. In addition, a patient history of urgency does not correlate well with the urodynamic findings before or after surgery. Therefore, from this study it appears that the postoperative symptomatic or urodynamic state cannot be predicted reliably from those before surgery.
Angiotensin II, type 2 receptor in the development of vesico‐ureteric reflux
Authors: Hohenfellner  , Hunley  , Yerkes  , Habermehl  , Hohenfellner  , Kon  
Published: March 2003

ObjectiveTo investigate if mutation of the angiotensin II (Ang II) receptors AT2 is involved in primary vesico‐ureteric reflux (VUR) in humans.Patients and methodsGenetic polymorphisms in the AT1 and AT2 receptors was evaluated in 23 patients having the most common congenital urological abnormality, namely primary congenital VUR. The occurrence of the A1166C transition in the AT1 receptor gene and the A‐1332G transition in the AT2 receptor gene were evaluated and compared with the incidence in normal controls with no urological abnormalities.ResultThe distribution of the AT1 receptor genotypes was no different between patients with VUR and healthy controls. Furthermore, 10 of 23 (44%) patients with VUR and seven of 19 (42%) controls carried the AT2 receptor gene variation. These results contrast with our previous finding of an association between the A‐1332G transition in the AT2 receptor gene and primary obstructive megaureter, and pelvi‐ureteric junction obstruction.ConclusionsWe propose that while the AT2 receptor is crucial for the normal development of the ureter, it does not contribute to the processes which culminate in VUR, which is primarily an abnormality in the bladder trigone.
A prospective randomized controlled trial of hybrid laser treatment or transurethral resection of the prostate, with a 1‐year follow‐up
Authors: Carter  , Sells  , Speakman  , Ewings  , MacDonagh  , O'Boyle  
Published: March 2003

ObjectiveTo compare the clinical outcome after hybrid laser treatment of the prostate, combining potassium titanyl phosphate (KTP) and Nd:YAG lasers, with transurethral resection of the prostate (TURP).Patients and methodsA prospective randomized trial was conducted to compare laser treatment and TURP. The hybrid laser treatment technique involved performing initial 30 W KTP vaporizing bladder neck incisions and prostatotomies followed by a ‘free‐paint’ application of 60 W Nd:YAG coagulation energy. Patients were re‐assessed after 6 weeks, 6 months and 1 year, using the International Prostate Symptom Score (IPSS) and uroflowmetry. TURP was conducted using conventional methods.ResultsIn all, 204 patients were randomized into the study; at 6 weeks there were significant differences between the groups for the IPSS (12.4 vs 9.1, P=0.001) and maximum urinary flow rates (16.1 vs 20.8 mL/S, P<0.001) in favour of the TURP group. At 6 months and one year this difference had disappeared. Similar numbers of patients in each group complained of bothersome postoperative urinary symptoms (23% vs 19%). Blood transfusions (5% vs none) and urethral strictures (9% vs 2%) were more common after TURP, whereas more early infective complications occurred after hybrid laser treatment (24% vs 5%). Only one patient in each group required re‐operation because of poor resolution of symptoms.ConclusionsAt one year, hybrid KTP/Nd:YAG laser treatment of the prostate was equivalent to TURP in the improvements in IPSS, maximum urinary flow rate and post‐void residual urine.