bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ice‐water test in detrusor hyper‐reflexia and bladder instability
Authors: Petersen T. , Chandiramani V. , Fowler C.J. 
Published: November 2003

Objectives To determine: (i) the outcome of the ice‐water test (IWT) in patients with an overactive detrusor and to define the sensitivity of the test in differentiating bladder instability from detrusor hyper‐reflexia; and (ii) to investigate any differences in sensitivity to the IWT with detrusor hyper‐reflexia caused by suprapontine and spinal pathologies.Patients and methods Of 130 consecutive patients with urinary symptoms who underwent a urodynamic evaluation and IWT, 80 had detrusor overactivity; of these 60 had detrusor hyper‐reflexia and 20 had bladder instability. The patients with detrusor hyper‐reflexia were further subdivided into two groups, suprapontine or spinal, based on the site of the neurological lesion.Results The overall sensitivity of the test in patients with detrusor hyper‐reflexia was 65% and the specificity 85%. In patients with a spinal pathology causing detrusor hyper‐reflexia, the test was positive in 70%, while 46% with suprapontine causes of detrusor hyper‐reflexia had a positive test.Conclusions Although 65% of the patients with detrusor hyper‐reflexia and known neurological disease had a positive IWT, so did 15% of the patients with no neurological disease and bladder instability. Patients with suprapontine pathology had a lower sensitivity than those with infrapontine pathology, but this was not statistically significant. The relatively larger number of false‐negative tests in patients with a suprapontine pathology is one reason why the test is insufficiently sensitive to discriminate between detrusor hyper‐reflexia and bladder instability.
Early experience with high‐intensity focused ultrasound for the treatment of benign prostatic hypertrophy
Authors: Sullivan L.D. , McLoughlin M.G. , Goldenberg L.G. , Gleave M.E. , Marich K.W. 
Published: November 2003

Objective To evaluate the safety and effectiveness of high‐intensity focused ultrasound (HIFU) in patients with benign prostatic hypertrophy (BPH).Patients and methods The study comprised 25 patients (mean age 67 years, range 47–84) with BPH treated using the Sonoblate HIFU device. Patients were evaluated before and after one treatment of HIFU using the American Urological Association (AUA) symptom score, peak urinary flow rate (Qmax) and a quality‐of‐life (QOL) score, and any complications were noted.Results Five patients with large glands were withdrawn because the failure rate was high in these patients. The remaining 20 patients showed a mean improvements in the AUA symptom score (20.25 to 9.56), Qmax (9.2 to 13.7 mL/s) and QOL score (4.75 to 2.50). There were no major complications.Conclusions HIFU is safe, produces minimal side‐effects or complications and relieves the symptoms of prostatism.
The expression of waf‐1, p53 and bcl‐2 in prostatic adenocarcinoma
Authors: Byrne R.L. , Wilson Horne C.H. , Robinson M.C. , Autzen P. , Apakama I. , Bishop R.I. , Neal D.E. , Hamdy F.C. 
Published: November 2003

Objective To determine the associations between the expression of waf‐1 (a cyclin‐dependent kinase inhibitor regulated by p53), p53, bcl‐2 and tumour progression in prostate cancer.Patients and methods Samples of prostatic tissue were obtained by biopsy or at prostatectomy from 40 men (mean age 73 years, range 55–88) with histologically confirmed prostate cancer, examined using immunohistochemical staining for the three gene products, and the expression related to the stage, grade, disease progression and survival of the patients.Results Fifteen of 18 patients whose tumours were positive for waf‐1, 10 of 12 positive for bcl‐2 and 17 of 19 positive for p53 had disease progression. Fifteen of 19 patients positive for p53 had poorly differentiated tumours compared with 11 of 21 negative for p53 (P<0.05). A significant number of patients positive for p53 progressed and had a shorter time to progression compared to those negative for p53 (P<0.05). There was no correlation between either waf‐1 and/or bcl‐2 staining and clinical grade, stage or tumour progression.Conclusions This study confirmed the association of p53 protein accumulation with aggressive behaviour in prostate cancer and identified waf‐1 protein in prostatic tumours. There was no evidence that the upregulation of waf‐1 was associated with a better outcome in patients with prostate cancer.
Spontaneous ascent of the testis
Authors: Gracia J. , Navarro E. , Guirado F. , Pueyo C. , Ferrández A. 
Published: November 2003

Objective  To report confirmed cases of spontaneous testicular ascent in patients with a cryptorchid testis which had been previously placed in the scrotum. Patients and methods  Between 1972 and 1992, 46 cryptorchid testes (36 patients), which were previously verified to be in the scrotum by staff paediatricians or paediatric surgeons, were treated surgically. The clinical, surgical and anatomicopathological records were reviewed to determine testicular position and associated conditions, and biopsies were taken from 35 testes. Results  The mean time between the last ‘normal’ exploration until the testes ascended was 4.5 years. Before ascent, the testes were confirmed to be in the scrotum by up to seven separate recorded examinations. During surgical treatment, an open processus vaginalis was found in 18 testes. The mean (sd) tubular fertility index was 40 (37)%. Conclusion  This study confirms that a previously descended testis can ascend spontaneously. The clinical and anatomicopathological characteristics of these testes were similar to those of the cryptorchid testis.
Neoadjuvant androgen deprivation therapy before radical prostatectomy: who is unlikely to benefit?
Authors: Rabbani F. , Sullivan L.D. , Goldenberg S.L. , Stothers L. 
Published: November 2003

Objective To determine which patients undergoing radical prostatectomy for localized cancer are unlikely to benefit from neoadjuvant androgen withdrawal therapy.Patients and methods Over a 5‐year period, 173 patients underwent radical retropubic prostatectomy; 87 patients received no pre‐operative androgen withdrawal therapy, for whom the clinical stages were T1b (17 patients), T1c (3), T2a (31) and T2b/c (36). Pre‐operative prostate biopsies contained well‐differentiated cancer in 43 and moderately differentiated cancer in 44 patients. Serum prostate‐specific antigen (PSA) ranged from 0.4 ng/mL to 110.1 ng/mL (median 5.0). The presence of extracapsular disease, positive surgical margins and seminal vesicle involvement were correlated with pre‐operative PSA, PSA density (PSAD), the natural logarithm of PSA [ln(PSA)], biopsy grade, clinical stage, and sparing of neurovascular bundles.Results Patients with a PSA ≤4.0 ng/mL had a rate of extracapsular disease and positive margins of 8.3% and none had seminal vesicle invasion; corresponding rates for patients with a PSA >4.0 ng/mL were 57%, 51% and 12%, respectively. Multivariate analysis revealed ln(PSA) to be the best predictor of extracapsular disease (P0.001), margin positivity (P0.001) and seminal vesicle invasion (P=0.0019).Conclusions These results suggest that in patients who have clinically localized, well or moderately differentiated prostate cancer, a PSA ≤4.0 ng/mL is predictive for organ‐confined disease. This group is unlikely to benefit from neoadjuvant androgen deprivation. Ln(PSA) may be able to improve the accuracy of mathematical multivariate models predicting the presence of extracapsular disease or margin positivity, but this will require verification in larger population‐based studies.
Persistent Müllerian duct syndrome with or without transverse testicular ectopia and testis tumours
Authors: Berkmen F. 
Published: November 2003

Objective  To report three patients with persistent Müllerian duct syndrome (PMDS) associated with a unilateral testicular tumour. Patients and methods  Three adults with PMDS and an associated testicular malignancy were evaluated using physical examination, imaging, measurement of tumour markers, surgical exploration and chromosome analysis. Results  The position of the uterus and fallopian tubes differed in all patients; one was in the scrotal sac, another in the abdomen and the third in the left inguinal canal. Two of the patients were cousins and their pedigree showed that they were probably in a sex‐limited group. Both also had transverse testicular ectopia; fertility was documented in the younger patient. In all cases, the karyotype was proved to be 46, XY. Conclusion  We recommend that the diagnosis of PMDS is made radiologically and that the detection of Müllerian inhibiting factor is mandatory. As malignancy does not occur in the retained Müllerian ducts, hysterectomy should not be performed at abdominal exploration, although orchidectomy should be, because orchidopexy offers only limited protection against future malignancy if performed after 2 years of age. It is not necessary to perform testicular biopsy to detect tumour in the scrotal testis in this syndrome, because an impalpable tumour can be localized by ultrasonography.
Complications of the post‐chemotherapy resection of retroperitoneal residual tumour mass in patients with
Authors: Gels M.E. , Nijboer A.P. , Hoekstra H.J. , Sleijfer D.Th. , Molenaar W.M. , Plukker J.Th. , Droste J.H.J. , Schraffordt Koops H. 
Published: November 2003

Objective To evaluate the resection of the retroperitoneal residual tumour mass (RRTM) for histological examination after chemotherapy in patients with disseminated non‐seminomatous testicular germ cell tumours (NSTGCTs), with particular attention to surgical morbidity.Patients and methods From 1979 to 1995, 112 patients (mean age 28 years, range 16–53) with NSTGCT had residual disease after chemotherapy for which surgical evaluation was indicated; the histology of the residual tumour and the surgical complications were assessed. Possible associations between the occurrence of surgical complications and the age of the patient, size of the residual tumour, operative duration, previous laparotomy and pathological findings were evaluated.Results The median size of the residual tumour was 4 cm (range 0–18); histological examination revealed viable tumour in 9%, mature teratoma in 44% and necrosis/fibrosis in 44% of the patients. In three patients (2.8%) no residual tumour mass was found at laparotomy. There were 26 complications in 20 patients (18%); urinary tract infection was the most common, occurring in nine patients (8%). One patient died during the induction of anaesthesia. There were no significant relationships between the occurrence of complications and age, size of the residual tumour, operative duration, previous laparotomy or pathological findings.Conclusion The resection of RRTM after polychemotherapy treatment for disseminated NSTGCT is a safe surgical procedure, with low treatment morbidity consisting mainly of urinary tract infection. Knowledge of the potential complications may help to prevent morbidity. However, the surgical evaluation of the ultimate effect of polychemotherapy remains the gold standard.
A randomized cross‐over study comparing the use of a catheter valve and a leg‐bag in urethrally catheterized male patients
Authors: German K. , Rowley P. , Stone D. , Kumar U. , Blackford H.N. 
Published: November 2003

Objectives  To evaluate the use of a catheter valve (CV) and a leg‐bag (LB) in men with urethral catheters and to determine the preferred modality. Patients and methods  Eighteen men (mean age 71.4 years, sd 3.4, range 63–76) presenting in acute retention and catheterized urethrally were enrolled in a 6‐week randomized cross‐over study comparing the CV with the LB (3 weeks with each modality). The outcome was assessed using a questionnaire which quantified the incidence of bladder spasms, nocturnal frequency, the extent of any by‐passing episodes and the degree of discomfort. At the end of the study, the patients were asked to express a preference (using a subjective scoring scale) for either the CV or the LB and to give the reasons why. Results
There was no difference in the reported incidence of bladder spasms or discomfort and no difference in positive urine cultures with each modality. However, with the CV, there was a slightly higher incidence in nocturnal frequency and by‐passing episodes. Thirteen patients preferred the CV whilst five preferred the LB. With the subjective scoring scale (range 0–10), the CV scored significantly higher than the LB (7.2, sd 3.1 and 5.2, sd 2.8, P<0.05: paired t‐test). Conclusions  Most patients preferred to use the CV, reporting that it felt more comfortable and discreet, and many patients did not like the sensation of urine ‘sloshing about’ when using the leg‐bag. Some patients using the CV were troubled by nocturnal frequency. In these patients we suggest that a combination of a valve during the day and an overnight bag may be the ideal solution.
Bladder and urethral anaesthesia with electromotive drug administration (EMDA): a technique for invasive endoscopic procedure
Authors: Fontanella U.A. , Rossi C.A. , Stephen R.L. 
Published: November 2003

Objective To assess the efficacy of the electromotive administration of lignocaine and adrenalin as local anaesthesia (EMDA/LA) for invasive lower urinary tract procedures. Patients and methods Electric current generators, catheters and electrodes were designed and fabricated, using defined electrochemical principles, to carry out EMDA/LA of the bladder and prostatic urethra of 91 patients who underwent 27 bladder‐mapping biopsies, 62 transurethral resections (TURs) of bladder tumours, 21 transurethral incisions on the prostate or bladder neck incisions, 12 TURs of the prostate (122 operations in total) and nine miscellaneous interventions, all using rigid instruments. Resections were performed using electrocautery. Most patients, while minimally sedated and fully conscious, completed an assessment of EMDA/LA using a simple pain scale. Results In five of the 122 procedures, the pain was described as intolerable, six were recorded as painful but tolerable and the remaining 111 procedures were recorded as having minimal to no discomfort only. Side‐effects were few, there was no clinical evidence of lignocaine toxicity and serial serum lignocaine levels measured in four patients were innocuous. Conclusions EMDA/LA provides safe, effective anaesthesia for most invasive endoscopic procedures in the lower urinary tract.
The agreement among urological experts on the diagnostic management of patients with common urological problems
Authors: HANSEN M.V. , ZDANOWSKI A. 
Published: November 2003

Objective To assess the level of agreement among randomly selected international urologists on the diagnostic management of patients with prostate cancer, bladder cancer, urinary stones or lower urinary tract symptoms (LUTS) arising from benign prostatic hyperplasia (BPH).Methods A computer program was used to provide an unbiased format of 53 simulated patients, comprising 13 with prostate cancer, 10 with bladder cancer, 10 with stones in the upper urinary tract and 20 with LUTS from BPH. For each case, the history was provided to the user while information from 60 diagnostic tests could be chosen interactively. Thirty‐three university‐based urologists participated in the study. The probability that a certain test was used by them in a certain patient []> P(test)] and the related costs (Swedish 1995 prices) were recorded. The probability that two urologists would agree (relative measure of agreement, RMA) on whether or not to use one particular test in a certain case was RMA(test)=P(test)2+[1–P(test)]2 and the mean of this RMA(test) for a certain patient [RMA(case)] was used as a measure of the inter‐individual agreement among the urologists on the diagnostic management. The significance levels of the generalized kappa statistic, KG , were also calculated. The correlation between the RMA(case) and the diagnostic groups was analysed.Results The KG was statistically significant for all cases; the RMA(case) was significantly correlated with the diagnostic groups (rs=0.86). The agreement in the diagnostic management was the strongest for stones, then for bladder cancer and prostate cancer, and the weakest for BPH. The mean cost for the diagnostic evaluation for one case varied from $455 to $1771 (mean 898) and varied in the diagnostic groups, i.e. $1718 for prostate cancer, $947 for bladder cancer, $400 for stones and $594 for BPH.Conclusion The diagnostic management of urological patients varies greatly among urological experts from the industrial world. As a consequence, the related diagnostic costs might vary by about 400% if prices were similar everywhere. The agreement on the diagnostic management of cases is strongly correlated to the diagnosis. LUTS from BPH seems to be managed with the poorest agreement.
The historiography of French economic growth in the nineteenth century
Authors: Crouzet François 
Published: November 2003

SummaryThere has been a long‐standing debate about French nineteenth‐century economic growth. After 1945 the ‘retardation—stagnation’ thesis dominated. From the 1960s ‘revisionists’ painted a more optimistic view. Recently, ‘anti‐revisionism’ has revived gloomy ideas. New research has been primarily responsible for changes of view. National income estimates, and later cliometric studies, bolstered the revisionist argument. Work on the ‘great depression’ stimulated anti‐revisionism. Scholars have also been influenced by the economic and political state of France at the time they were writing and the debate has been somewhat politicized. The article ends by surveying the ‘moderate revisionism’ which now prevails.
Modulation of L‐type voltage‐gated calcium channels by recombinant prion protein
Authors: Korte Stefan , Vassallo Neville , Kramer Michael L. , Kretzschmar Hans A. , Herms Jochen 
Published: November 2003

AbstractThe prion protein (PrPC) has a primary role in the pathogenesis of transmissible spongiform encephalopathies. Here we analysed in detail the effect of recombinant PrPC and N‐ and C‐terminal fragments of PrPC on the whole‐cell current amplitude through voltage‐gated calcium channels (VGCCs) of cultured wild‐type cerebellar granule cells. With the application of full‐length recombinant PrPC (50–500 nm), a highly significant reduction of the whole‐cell current amplitude was observed in a dose‐dependent manner. Amplitude reduction was abolished when cells were pre‐incubated with nifedipine, a specific blocker of voltage‐gated L‐type calcium channels. N‐terminal PrP fragments also led to a dose‐dependent reduction of the maximal current amplitude, whereas a C‐terminal fragment did not affect the current amplitude. These data demonstrate that nanomolar concentrations of PrPC modulate L‐type VGCCs in mouse cerebellar granule cells, an effect that is dependent upon the copper‐binding amino‐terminal domain of PrPC.
Quality assessment of frying oils and fats from 63 restaurants in Athens, Greece
Authors: Andrikopoulos Nikolaos K. , Boskou George , Dedoussis George V. Z. , Chiou Antonia , Tzamtzis Vassilios A. , Papathanasiou Assimina 
Published: November 2003

AbstractSamples of used frying oils and fats from 63 restaurants and fast‐food outlets, from the inner and outer suburbs of Athens, were randomly collected during a 1‐month period. Sampling was performed after deep‐frying or pan‐frying of several foods, of both vegetable and animal origin, in different frying oils or fats (sunflower oil, cottonseed oil, corn oil, palm oil, palm kernel oil, soybean oil, vegetable shortening oil, vegetable cooking oils and fats). Sunflower oil was the most widely used frying medium and deep‐fried potatoes (French fries) were the most common fried food. Sixteen samples (approximately 25%) were found with polymerized triglycerides (PTG) over the 12% limit of rejection, while 11 of them (approximately 17%) with total polar materials (TPM) over the 25% limit of rejection. From the above ‘over‐limit’ samples, only one was from the pan‐frying process. The higher TPM and PTG mean values were found in low‐unsaturated vegetable frying oils and cooking fats, with the highest values observed when food of animal origin was fried. Vitamin E content of the fried samples examined was lower than that of the respective fresh samples (28% mean loss), but in most cases in relatively high levels.
A longitudinal study of vergence adaptation in incipient presbyopia
Authors: Baker Fiona J. , Gilmartin Bernard 
Published: November 2003

AbstractBackground:  To investigate vergence adaptation during the incipient phase of presbyopia, when the amplitude of accommodation approaches the level where the first reading addition is required. The study aimed to assess the ability of the vergence system to counteract changes in the component contributions to the overall vergence response with the decline in the amplitude of accommodation in presbyopia, although previous reports on the nature of changes in accommodative, tonic and proximal vergence are equivocal.Methods:  Using a ‘flashed’ Maddox rod technique, an assessment of vergence adaptation to 6Δ base‐out and 6Δ base‐in prism was made for 28 subjects (aged 35–45 years at the commencement of the study). The measurements were taken four times over a 2‐year period.Results:  Using a repeated measures analysis of variance, the results show that with the decline in amplitude of accommodation, there is a statistically significant reduction in the magnitude of vergence adaptation to both base‐out (p < 0.05) and base‐in prism (p < 0.01).Conclusions:  This study shows that with ageing, there is a decrease in the ability of the slow vergence mechanism to overcome a change in fusional vergence demand and would suggest that either the fast component of fusional vergence must cope with any change in fusional vergence demand or that the sum of the accommodative, tonic and proximal vergence responses are virtually stable with age.
The assessment of automated measures of hydrogel contact lens refractive index
Authors: Nichols Jason J. , Berntsen David A. 
Published: November 2003

AbstractPurpose:  To investigate within‐ and between‐operator reliability and validity of refractive index measures of hydrogel lenses.Methods:  Twenty‐three lenses of various nominal water contents were examined by two operators on two occasions separated by 1 h. An automated refractometer (CLR 12‐70, Index Instruments, Cambridge, UK) was used for refractive index measures. Lenses were presented in a random order to each operator by a third party, and operators were masked to any potential lens identifiers. Intraclass correlation coefficients (ICC), 95% limits of agreement (LoA), and paired t‐tests were used to characterize the within‐ and between‐operator reliability and validity of lens refractive index measures.Results:  The mean (±S.D.) difference between sessions was 0.0001 ± 0.0011, which did not significantly differ from zero (p = 0.64). Within‐operator reliability was excellent (ICC = 0.9990, 95% LoA = −0.0021 to 0.0024). The mean (±S.D.) difference between‐operators was 0.0002 ± 0.0010, which was not significantly different from zero (p = 0.54). Between‐operator reliability was also excellent (ICC = 0.9984, 95% LoA = −0.0026 to 0.0029). The mean difference between the nominally reported refractive index and our refractive index measures was −0.0009 ± 0.082, which did not differ statistically from zero (p = 0.52); the 95% LoA for this difference was −0.0152 to 0.0169.Conclusion:  There is good reliability within‐ and between‐operators in measuring the refractive index of hydrogel lenses using the CLR 12‐70 automated refractometer.