bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial awareness in urologists: are they different?
Authors: Gallagher H.J. , Allan J.D. , Tolley D.A. 
Published: March 2003

Objective To compare innate spatial awareness skills, using the MIST‐VR system (Ethicon Ltd, Edinburgh, a computer‐based virtual reality system that objectively tests spatial awareness) among three groups of people (consultant urologists, urological trainees and controls who were not surgeons), because urological surgeons require spatial awareness for endoscopic and laparoscopic surgery, but trainees are selected by academic prowess rather than surgical aptitude. Subjects and methods The MIST‐VR system was used to test 122 volunteers in three groups, i.e. 39 consultant urologists, 46 urological trainees and 37 controls (not surgeons). The demographic data recorded for each group included age, sex, eyesight, handedness, and endoscopic and laparoscopic experience. Volunteers performed a repetitive series of three tasks using the system. Their performance was measured in terms of time, errors and economy of movement, as well as the duration and accuracy of diathermy in Task 3. Results The consultants were significantly older than the trainees and controls (both P < 0.001) and had more endoscopic experience (P = 0.005). In Task 1, the trainees made significantly fewer errors (P = 0.045) and had a greater economy of movement (P = 0.03) than the controls. In Task 2 the trainees performed the task more rapidly than the consultants (P = 0.04) and controls (P = 0.02). Trainees were more economical in movement than were consultants (P = 0.031) and controls (P = 0.046). In the more complex Task 3, trainees outperformed consultants in terms of errors (P = 0.03), economy of movement (P = 0.046), total diathermy time (P = 0.005) and diathermy error (P = 0.03). Controls performed similarly to the consultants. Although there was a trend towards better performance by trainees over controls, this was only significant for time (P = 0.04) and total diathermy time (P = 0.011). A few participants had results that were >2sd above the mean and several people could not complete Task 3. Conclusions Urologists do not differ from the general population in terms of innate spatial ability in this setting. There are several people who may have a defect in spatial awareness but the incidence was the same in each group. Urological trainees outperformed consultants in these tasks; the reasons for this are unclear. The MIST‐VR system is of no help in aptitude testing for urological trainees, although it may have a role in teaching laparoscopic surgery. Testing other psychometric components may be more important for acquiring surgical skills than innate spatial‐awareness skills. Further studies are required to investigate this possibility.
The effectiveness of desmopressin in the treatment of childhood nocturnal enuresis: predicting response using pretreatment variables
Authors: Butler R. , Holland P. , Devitt H. , Hiley E. , Roberts G. , Redfern E. 
Published: March 2003

ObjectiveTo determine the factors that predict the effectiveness of desmopressin in the treatment of childhood nocturnal enuresis.Patients and methodSixty‐six children with monosymptomatic nocturnal enuresis were treated with intranasal or oral desmopressin for a 4‐week period, starting with a standard dose of 20 μg (0.2 mg oral) and increasing after 2 weeks where no progress was apparent to 40 μg (0.4 mg oral). Before treatment a range of variables (demographic, situational, enuretic history, physiological, parental attitude and child) were recorded. Three parameters of success acted as dependent variables, with stepwise linear regression models used to determine pretreatment predictors of success with desmopressin.ResultEach outcome variable produced a very similar model of predictors. Success, as assessed by the most dry nights over a 14‐night period, was associated with less severe enuresis before treatment, a parental belief that the child’s enuresis was unstable and higher birthweight.ConclusionFrom the analysis, a model of arginine vasopressin release is proposed and the clinical implications of the findings addressed.
A follow‐up of enuresis from childhood to adolescence
Authors: Moilanen I. , Tirkkonen T. , Järvelin M.R. , Linna S.L. , Almqvist F. , Piha J. , Räsänen E. , Tamminen T. 
Published: March 2003

ObjectiveTo determine the prevalence and treatment of enuresis in a national population‐based follow‐up study of children aged 8–14 years, to evaluate possible factors that enhance or hamper the attainment of continence and to examine the relationships between enuresis and psychiatric disturbance.Subjects and methodsAn initial study was carried out in 1989 as part of the Finnish Child Psychiatric National Epidemiological Study. Three types of questionnaires were used; the Rutter Scale A for completion by parents, including a question about enuresis, the Rutter scale B for completion by teachers and the Children’s Depression Inventory (CDI), completed by the children. Parents were also asked about demographic and family issues, teachers about school achievements and children about additional psychosomatic symptoms. In a follow‐up in 1995, the target population comprised all previous enuretics and their controls, matched by age, gender, class and school, in the first phase of the study. Replies were received from 315 enuretic boys and 186 girls, with the corresponding values for controls being 310 and 183. The parents were asked about the adolescents’ present enuresis and for permission for a treatment trial, if needed. The adolescents completed the CDI, and a questionnaire about enuresis, previous treatments and possible willingness for a treatment trial. They also reported basic somatic data, their life events and living habits.ResultsIn the initial study, the enuretic children had higher total and subscores as reported by parents, teachers and themselves, except for emotional items reported by the teachers. Additionally, a significantly greater proportion of these children soiled, had sleep‐ ing difficulties and difficulties in falling asleep. Enuretic boys had more frequent nightly arousal and early morning waking, while the enuretic girls had more nightmares than non‐enuretic girls. At 14 years old, the parents reported that 13 adolescents were enuretic; from the children’s replies, nine boys and seven girls were enuretic.ConclusionsThe prevalence of enuresis in those previously enuretic was surprisingly low, probably because of the efficient treatment methods, conditioning and medication. There were evident connections between childhood enuresis and mental well‐being.
Bladder autoaugmentation in myelodysplastic children
Authors: Skobejko‐Wlodarska L. , Strulak K. , Nachulewicz P. , Szymkiewicz C. 
Published: March 2003

ObjectiveTo present the long‐term results of bladder autoaugmentation in myelodysplastic children with low compliance neurogenic bladders who failed attempts at medical management, including clean intermittent catheterization (CIC) and pharmacological bladder relaxation.Patients and methodsTwenty‐one patients with a neurogenic bladder after myelomeningocele operations (mean age 9.5 years, range 3–16) underwent autoaugmentation; 12 children were paraplegic and hydrocephalic, and were treated by insertion of a ventriculoperitoneal valve. All patients had low‐compliance neurogenic bladders confirmed urodynamically. Ten patients had vesico‐ureteric reflux (VUR) and eight had dilated upper urinary tracts with no reflux. All patients had been treated pre‐operatively using CIC and anticholinergic agents, with no success.ResultsOf 21 children treated surgically, 17 were assessed urodynamically and examined to determine the condition of the upper and lower urinary tract. The follow‐up ranged from 3 months to 8 years (mean 6 years). In 13 patients the bladder capacity increased by ≈60 mL and in 14 the intravesical pressure decreased by ≈65 cmH2O. Fourteen children were continent using CIC (from 3‐ to 4‐hourly); in the six patients with VUR the reflux resolved in two, decreased in two and remained unchanged in two. Of eight patients with dilated upper tracts but no reflux, seven improved. There was no improvement in bladder capacity in four patients and no reduction in intravesical pressure in three. Two patients underwent enterocystoplasty (one ileocystoplasty and one colocystoplasty) with good results. Two children needed anticholinergic agents after autoaugmentation.ConclusionsAutoaugmentation effectively reduces high intravesical pressure and provides a sufficient increase in bladder capacity with a concomitant improvement in urodynamic values. The present method allows the extent of the surgical procedure to be limited to the extraperitoneal space and thus maintains all of other options. Bladder autoaugmentation is a reasonable alternative to enterocystoplasty in selected patients.
Using multimedia for patient information — a program about nocturnal enuresis
Authors: Evans J.H.C. , Collier J. , Crook I. , Garrud P. , Harris P. , Mackinlay D.R.E. , Redsell S.A. 
Published: March 2003

ObjectivesTo identify the information needs of children with nocturnal enuresis, and to design, produce and evaluate an interactive computer program to provide this information.Subjects and methodsThe program was developed over an 18‐month period using information provided by children, parents and professionals, and was evaluated in a hospital‐based enuresis clinic in 65 children. Usability and knowledge gained were also evaluated in 43 healthy children aged 8–10 years attending a local inner‐city primary school.ResultsAn interactive program about nocturnal enuresis was developed, which runs on a personal computer and uses sound, voice, cartoon drawings and animation in a modular design. Knowledge scores increased in clinic attendees and in schoolchildren after using the program (Wilcoxon matched pairs test, P<0.001). This improvement was maintained when the program was re‐tested 6–10 months later.ConclusionThis interactive computer program holds children’s attention and increases their understanding of enuresis. Interactive multimedia may be useful to complement the information provided by health professionals. This method of communication may be particularly useful for children with a low level of literacy.
Incidence of apoptosis and metallothionein expression in renal cell carcinoma
Authors: Zhang  , Takenaka  
Published: March 2003

Objective To investigate the frequency of apoptosis and expression of metallothionein (MT) protein and to clarify their roles in renal cell carcinoma (RCC).Materials and methods Apoptosis was detected by using the terminal deoxynucleotidyl transferase (TdT)‐mediated dUTP‐biotin nick‐end labelling (TUNEL) technique in 70 formalin‐fixed and paraffin‐embedded RCC specimens. The expression of MT was determined immunohistochemically.Results The incidence of apoptosis was significantly higher in grade 2 and 3 RCC than in grade 1. There were no significant differences amongst the other categories of RCC when grouped by tumour stage, cell type and growth pattern. The expression of MT was detected in 23 of 70 (33%) RCCs. Subcellularly, MT was localized in the cytoplasm, nucleus and cell membrane of RCC. Statistical analysis showed a close association of MT expression with the higher grades and invasive growth pattern of RCC. In addition, the incidence of apoptosis increased with increasing immunoreactivity of MT staining. There was a significant difference in the incidence of apoptosis between the diffuse staining and negative staining of MT.Conclusions There were close associations of higher grade RCC with both the incidence of apoptosis and the expression of MT, as well as a close relationship between MT expression and the invasive growth pattern of RCC. This suggests that the involvement of apoptotic cell death and MT expression should be considered an important factor in the process of the renal carcinogenesis and tumour progression.
Complications relating to the urinary tract associated with bladder‐drained pancreatic transplantation
Authors: Baktavatsalam  , Little  , Connolly  , Farrell  , Hickey  
Published: March 2003

Objective To evaluate the incidence and management of the urological complications after bladder‐drained pancreatic transplantation.Patients and methods A retrospective study was carried out on 24 consecutive bladder‐drained pancreatic transplants in 24 patients with type I insulin‐dependent diabetes mellitus, 22 with simultaneous kidney transplants and two of pancreas alone, over a period of 53 months.Results All 24 patients were alive within a mean follow‐up of 26.7 months; 22 patients have functioning pancreatic grafts and are insulin‐independent. The overall incidence of urological complications was 83% (20 of 24 patients) and 14 patients had more than one complication. The major non‐infective complication was haematuria (eleven), which was treated conservatively, with only two patients requiring enteric conversion. One patient developed a duodenovesical fistula and lost the functioning pancreatic graft as a consequence. Other non‐infective complications were urethritis (one) and urethral stricture (one), which were managed with catheter drainage and internal urethrotomy, respectively, and vulval ulcers (one) and reflux pancreatitis (one) treated conservatively. The main infective complications were recurrent lower urinary tract infection (nine), asymptomatic persistent bacteriuria (nine), prostatitis and epididymitis (one), and pyelonephritis (one), all managed with appropriate antibiotics. Three patients developed septicaemia from urosepsis and were treated successfully with antibiotics. Two patients developed genital warts and were treated with laser vaporization.Conclusion Although bladder drainage has significantly contributed to the increasing success of pancreatic transplantation, urological complications are frequent and can be serious and life‐threatening. As more of these procedures are performed urologists need to be able to recognize and treat these problems.
Inhibition of penile erection in rats by a long‐acting somatostatin analogue, octreotide (SMS 201–995)
Authors: Kapİc·oglu  , Mollamehmetoglu  , Kutlu  , Can  , Ozgur  
Published: March 2003

Objective To assess the effect of a new somatostatin analogue (SMS 201–995, octreotide) on erectile function in rats.Materials and methods Animals were fasted and anaesthetized intraperitoneally with pentobarbital. A cannula was placed in the trachea and the femoral vein cannulated for intravenous infusion. The hypogastric and pelvic nerve, major pelvic ganglion, and the nerve fibres to the lower genitourinary tract were identified. In 20 animals, these nerves were stimulated unilaterally using bipolar silver‐wire electrodes; the stimulation was repeated every 15 min for 1 h. Twenty animals were divided into two equal groups; after measuring penile erection to obtain basal values, the animals received either saline or 50 μg SMS 201–995 over 1 h and 30 min later, the stimulation was repeated.Results After administering SMS 201–995 or saline, the levels of penile erection reduced linearly in both groups, but SMS 201–995 caused a greater decrease than in the control group (P<0.05) and from baseline (P<0.01) at all times.Conclusion SMS 201–995 inhibits penile erection in rats and the systems may serve as an in vivo animal model for further investigation.
The role of the plain X‐ray in the assessment of prostatic symptoms
Authors: Porter  , Stoddart  , Hinchliffe  
Published: March 2003

Objective To assess the contribution of a plain X‐ray of the kidney, ureters and bladder (KUB) to the assessment of patients presenting with symptoms of bladder outlet obstruction.Patients and methods All patients presenting to the ‘Prostate’ clinic at Weston General Hospital during the 12 months from 1 May 1993 to 30 April 1994 were assessed clinically by a history, examination and routine investigations that included a KUB examined and reported by a radiologist. Patients were followed and treatment instituted as deemed appropriate. The contribution made to the management of the patient by the KUB was assessed.Results Of the 292 patients, 234 had no relevant abnormality detected; four patients had evidence of a bladder calculus, whilst in four osteosclerotic areas were noted on the pelvis and lumbar spine. Of the remainder, 14 (5%) had upper urinary tract calcification. In no patients did the KUB influence their immediate management. Those with asymptomatic upper tract stones were offered a yearly follow‐up.Conclusions The routine use of the KUB as a means of investigating lower urinary tract symptoms in the male may no longer be necessary.
Evaluation of histological structure and its effect on the distribution of α1‐adrenoceptors in human benign prostatic hyperplasia
Authors: Kurimoto  , Moriyama  , Hamada  , Kawabe  
Published: March 2003

Objective To evaluate the histological structure of benign prostatic hyperplasia (BPH) and its relationship with the density of α1‐adrenoceptors in smooth muscle.Materials and methods Specimens from hyperplastic tissues obtained from 14 patients with BPH were evaluated for the density of α1‐adrenoceptors in smooth muscle using autoradiography, Mallory‐Azan staining and computer‐assisted image analyses. The binding of [3H] tamsulosin (a selective α1‐blocker) and the ratio of smooth muscle area was calculated, and the density of α1‐adrenoceptors per area of smooth muscle determined by dividing the degree of binding by the ratio of smooth muscle to total area.Results There was a significant difference between the ratio of smooth muscle area in the hyperplastic acinar nodule and the surrounding stroma (P<0.01). The density of α1‐adrenoceptor per smooth muscle area was significantly higher in the hyperplastic acinar nodule than in the surrounding stroma (P<0.05). There was no correlation between prostatic weight and the ratio of smooth muscle area or the density of α1‐adrenoceptors in each region.Conclusion The distribution of α1‐adrenoceptors on smooth muscle differed with histological structure; both the histological conformation and the difference in the distribution of α1‐adrenoceptors could affect urethral obstruction in BPH.
Lower moiety heminephroureterectomy in the duplex refluxing kidney: the accuracy of isotopic scintigraphy in functional assessment
Authors: Carter  , Malone  , Lewington  
Published: March 2003

Objective To determine the accuracy of dimercaptosuccinic acid (DMSA) scintigraphy in assessing the differential function between upper and lower moieties of a refluxing duplex system.Patients and methods Between 1990 and 1996, 20 patients underwent lower moiety heminephroureterectomy. All patients had their differential renal function assessed by DMSA scintigraphy before and after surgery, the results being assessed by comparing the predicted and actual loss of renal function.Results The mean (SD, range) function attributed to the scarred lower moiety (predicted loss of function) was 4.3 (4.9, 0–14)%, which compared with an actual mean loss of function of 6.8 (5.1, +4 to −16)%. Thus the mean (SD, range) difference between the predicted and actual loss of renal function was −2.1 (3.2, +4 to −8)%.Conclusion DMSA scintigraphy provides an accurate assessment of the differential renal function between upper and lower moieties in a duplex system. The decision to proceed to lower moiety heminephroureterectomy can be logically based on the information gained from DMSA scintigraphy.
Is the timing of post‐vasectomy seminal analysis important?
Authors: Smith  , Crooks  , Singh  , Scott  , Lloyd  
Published: March 2003

Objective To review the practice in two hospitals with differing protocols in the timing of seminal analysis after vasectomy.Patients and methods The results from 245 vasectomies carried out at Hospital A, where semen was assessed 3 months after vasectomy, were reviewed and compared with those from 100 consecutive vasectomies at Hospital B, where semen was assessed 6 months after vasectomy. The results of seminal analysis at Hospital A were also audited after changing to the 6‐month protocol. The patients’ preferences for the timing of seminal analysis were also obtained.Results Of the 245 patients at Hospital A, 58 (24%) failed to provide samples, leaving 187 (76%) for evaluation; 528 samples were examined (mean 2.8 per patient, range 1–13). The first sample was positive in 36 (19.3%) and the second positive in 10 (5.3%), the first being negative. Four (2%) patients had persistent spermatozoa at 6 months, one subsequently undergoing exploration. Thirty‐one (17%) patients provided further samples despite providing two consecutive clear ones. At Hospital B, 24 (24%) patients failed to provide samples; 10 (13%) patients had persistent spermatozoa at 6 months and live spermatozoa were detected in one patient’s samples. All eventually produced clear samples, with none requiring exploration. After changing the protocol, 87 vasectomies were performed, with 18 (21%) patients failing to provide samples; seven (10%) of the samples collected showed occasional nonmotile spermatozoa at 6 months in either the first, second or both samples, with all samples clear by 8 months after vasectomy.Conclusions The complete disappearance of spermatozoa after vasectomy takes longer than is generally believed and we therefore suggest that given adequate counselling, seminal analysis 6 months after vasectomy is cost‐effective and in the patient’s interest.
The percentage of free prostate specific antigen is an age‐independent tumour marker for prostate cancer: establishment of reference ranges in a large population
Authors: Lein  , Koenig  , Jung  , Mcgovern  , Skates  , Schnorr  , Loening  
Published: March 2003

Objective To define the reference range for the ratio of free to total prostate‐specific antigen (fPSA%) in a population of healthy men with no clinically evident prostate cancer and to assess the influence of age on this tumour marker, thus determining the utility of fPSA% in enhancing the discriminatory power of PSA to differentiate healthy men and patients with benign prostatic hyperplasia from those with prostate cancer.Subjects and methods In a prospective cohort study between May and August 1996, 1160 white men aged 20–89 years (957 were 40–69 years old, 82% of all subjects) from nine European and eight non‐European countries were assessed. None of the participants who had a history of prostate cancer had undergone prostatectomy. A standard clinical examination including a digital rectal examination was performed to exclude the presence of prostate cancer. Transrectal ultrasonography was not an inclusion criterion, as it was not available in every case. Total PSA (tPSA) and free PSA (fPSA) were determined in 61 laboratories using the appropriate Enzymun‐Test® for tPSA and fPSA (Boehringer Mannheim Diagnostics, Mannheim, Germany). Serum tPSA, fPSA and fPSA% were then assessed as a function of the subjects’ age.Results The serum tPSA and fPSA were significantly different among age decades 2–8 (P<0.001), with increasing median values, indicating that both variables depend on age. The recommended upper reference limit (95th percentile) for tPSA is 1.78 ng/mL for men aged 30–39 years, 1.75 ng/mL for 40–49 years, 2.27 ng/mL for 50–59 years, 3.48 ng/mL for 60–69 years and 4.26 ng/mL for 70–79 years. The fPSA% was not significantly different between decades 3–8 (P=0.06). Those aged 20–29 years had a slightly higher median value (P=0.03) than the other age groups. The recommended lower reference limit (fifth percentile) for fPSA% is 12.6%.Conclusion The fPSA% for clinically relevant age groups in healthy men was independent of age, which simplifies the use and interpretation of this relatively new tumour marker.