bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidermal growth factor receptor expression: predictive value for the outcome after cystectomy for bladder cancer?
Authors: Sriplakich  , Jahnson  , Karlsson  
Published: March 2003

ObjectiveTo determine whether epidermal growth factor receptor (EGFR) immunostaining of tumour cells is associated with cancer‐specific death after cystectomy for locally advanced bladder cancer.Patients and methodsThe hospital records of all patients treated with cystectomy for urothelial cancer of the urinary bladder between 1967 and 1992 were reviewed retrospectively. The paraffin‐embedded specimens obtained before treatment from 173 patients were processed for immunohistochemical staining, using the monoclonal antibody NCL‐EGFR (Novocastra, UK). EGFR immunostaining was considered positive if membrane staining was found in at ≥20% of tumour cells in one or more fields at ≥200 (area 0.59 mm2 ).ResultsMost patients (149) received preoperative irradiation and one had neoadjuvant chemotherapy. The mean observation time was 81.3 months; 63 patients (36%) had tumour recurrence within 1–80 months (mean 18.3). Positive EGFR immunostaining was found in 100 patients (58%). The proportion of T2–4 tumours was higher in those EGFR‐positive than in those EGFR‐negative. Proportional‐hazards analysis revealed that clinical stage was significantly associated with cancer‐specific death, but EGFR expression was not.ConclusionAlthough positive immunostaining for EGFR was more frequent in higher stages of locally advanced bladder cancer, this variable was not an independent predictor of outcome after cystectomy.
Telomerase activity in human renal cell carcinoma
Authors: Sugimura  , Yoshida  , Hisatomi  , Nakatani  , Ikemoto  
Published: March 2003

ObjectiveTo determine if telomerase activity plays an important role in the progression of renal cell carcinoma (RCC).Materials and methodsTelomerase activity was measured in 53 tissue samples of RCC (52 patients), 11 samples of normal renal tissue and six tissue samples from benign renal disease using a fluorescence‐based telomeric repeat amplification protocol. The activity was assessed for associations with clinical and pathological variables of RCC. To examine the influence of telomerase activity on cell immortalization in vitro, primary cultures of RCC cells were produced; the maximum passage number beyond which cell culture could not be continued was compared with the associated telomerase activity.ResultsAmong the tissue samples of benign renal disease, one from a patient with a hydronephrotic nonfunctioning kidney had detectable telomerase activity, whereas none of the normal renal tissues had. In 32 of the 53 RCC tissue samples (60%), telomerase activity was detectable, varying from 1.8 to 100.0 TPG units, but was not associated with any clinical or pathological variable such as clinical stage, tumour size, grade or pathological subtype. Telomerase activity also had no association with the maximum passage number of primary cell cultures.ConclusionsTelomerase activity may not be a prognostic marker for RCC. Alternative mechanism(s) which lengthen telomeres should be considered if maintaining telomere length is considered essential to tumour progression.
Bcl‐2 proto‐oncogene expression in low‐ and high‐grade prostatic intraepithelial neoplasia
Authors: Baltaci S. , Orhan D. , Özer G. , Tolunay Ö. , Gög?üs O. 
Published: March 2003

Objective To determine the incidence of bcl‐2 protein expression in low‐ and high‐grade prostatic intra‐epithelial neoplasia (PIN) lesions, and to explore the role of bcl‐2 in prostatic tumorigenesis. Materials and methods Immunoreactivity for bcl‐2 was examined in 10 samples of benign prostatic hyperplasia (BPH), 13 of primary prostatic adenocarcinoma, 15 of high‐grade PIN and 18 of low‐grade PIN. All immunostaining results were scored for the approximate percentage of positive tumour cells and relative immunostaining intensity (score range 0–12). Results In all BPH samples, bcl‐2 staining was detected consistently in the basal cell layer of the ducts and acini, but no staining was ever apparent in luminal cells. The immunoreactivity for bcl‐2 was heterogeneous in the prostatic carcinomas and bcl‐2 protein expression was present in six samples. In these six bcl‐2‐positive tumours, the mean (range) staining score was 1.15 (1–6). There was detectable expression of bcl‐2 in low‐ and high‐grade PIN in all cell layers; immunoreactivity was present in 10 of 15 high‐grade PIN lesions, with a mean (range) score of 1.14 (1–4), and in 12 of 18 samples of low‐grade PIN, with a mean (range) score of 1.77 (1–6). Conclusions The high incidence of bcl‐2 protein expression in low‐ and high‐grade PIN lesions suggests that bcl‐2 protein expression is associated with early prostate tumorigenesis.
PC‐SPES, a dietary supplement for the treatment of hormone‐refractory prostate cancer
Authors: Pfeifer B.L. , Pirani J.F. , Hamann S.R. , Klippel K.F. 
Published: March 2003

Objective To assess the effectiveness of PC‐SPES, a dietary supplement containing eight herbal extracts, which is a popular alternative therapy among patients with hormone‐refractory prostate cancer; anecdotal reports claim that this agent provides relief of metastatic pain, improvements in quality of life and reduction of prostatic specific antigen (PSA) level.Patients and methods Sixteen men treated for advanced metastatic prostate cancer (stage D3) with either orchidectomy or a luteinizing‐hormone releasing hormone agonist, with or without anti‐androgen, were enrolled into a prospective clinical trial to evaluate the possible toxic and beneficial effects of PC‐SPES. After hormone‐ablative therapy had failed, and with established disease progression, all patients received supplemental treatment with PC‐SPES (2.88 g daily) for 5 months. Hormonal therapy was continued throughout the trial to avoid the known withdrawal effect of anti‐androgen on PSA levels.Results The supplemental intake of PC‐SPES was associated with significant (P < 0.05–0.01) improvements in quality‐of‐life measures, reductions in patient’s pain ratings (P < 0.05–0.01), and a decline in PSA levels (P < 0.01), with no major side‐effects.Conclusions These results support the anecdotal reports of the beneficial effects of PC‐SPES as a comparable alternative to current management regimens in hormone‐refractory prostate cancer. However, no conclusions can be drawn about the long‐term effects of this new herbal therapy.
Comparison of the perimeatal‐based flap (Mathieu) and the tubularized incised‐plate urethroplasty (Snodgrass) in primary distal hypospadias
Authors: Oswald J. , Körner I. , Riccabona M. 
Published: March 2003

Objectives To determine whether the perimeatal‐based flap technique or the tubularized incised‐plate repair is the more appropriate treatment for distal hypospadias in terms of fistula rate, cosmesis of the meatus and operative duration. Patients and methods Between July 1997 and August 1998, 60 children (none of whom had previously undergone a procedure for hypospadias) underwent primary distal hypospadias repair in a prospective randomized trial. Thirty patients were allocated to undergo a Mathieu repair (mean age 24.9 months, range 9–72) and 30 a Snodgrass procedure (mean age 23.1 months, range 7–19). The mean follow‐up was 15.4 months. Results The mean duration of surgery was significantly lower for the Snodgrass procedure than for the Mathieu repair (75 vs 115 min, P < 0.05). Three children undergoing a Mathieu repair had complications (two a urethrocutaneous fistula and one a meatal stenosis), compared with only one in the Snodgrass group (glanular dehiscence). The resultant meatus was slit‐like in all patients undergoing the Snodgrass repair whereas those with a Mathieu repair had a rounded and horizontal meatus. Conclusion The overall complication rate was lower and the surgery significantly quicker with the Snodgrass urethroplasty, which also had a better cosmetic outcome. The Snodgrass technique is recommended as a primary treatment for distal hypospadias.
Anatomical studies of the urethral plate: why preservation of the urethral plate is important in hypospadias repair
Authors: Erol A. , Baskin L.S. , Li Y.W. , Liu W.H. 
Published: March 2003

Objective To describe the detailed anatomy of the urethral plate in relation to its controversial role in hypospadias surgery. Materials and methods A newborn penis with proximal penile hypospadias and two fetal penises with distal shaft hypospadias were included in the study; 30 normal fetal penises served as the control. Specimens were embedded in paraffin and serially sectioned (6 µm) after formalin fixation. Every 10th section was stained with haematoxylin and eosin. Immunohistochemical staining for nerves (S100), smooth muscles (α‐actin), blood vessels (factor VIII) and epithelium (cytokeratins 7, 14 and 18) were used on selected sections, with particular attention to the urethral plate. Masson’s trichrome and Sirius Red stains were used to localize collagen. Results There were extensive blood vessels, glands and smooth muscle under the urethral plate in the hypospadias specimens. These relatively well organized tissues corresponded to an abnormally formed corpus spongiosum. The glands underneath the urethral plate and adjacent to the normal urethra showed positive staining for cytokeratins 7 and 18, respectively (markers of endodermal origin) but were negative for cytokeratin 14 (a marker of ectodermal origin). Penile skin and urethral plate epithelium stained positively for cytokeratin 14 but not for cytokeratin 7 and 18. The urethral plate has a rich nerve supply, as determined by S100 staining. Collagen intensity under the urethral plate was no different from that in normal areas. Tunica albuginea stained intensely for type I and III collagen. Conclusion These results show that the urethral plate is well vascularized, has a rich nerve supply and an extensive muscular and connective tissue backing. These features may explain the lower complication rate with onlay flaps than with tube flaps. Therefore, from these anatomical findings, we continue to advocate preservation of the urethral plate and the onlay island flap for hypospadias reconstruction.
Acellular bladder matrix allografts in the regeneration of functional bladders: evaluation of large‐segment (> 24 cm2) substitution in a porcine model
Authors: Merguerian P.A. , Reddy P.P. , Barrieras D.J. , Wilson G.J. , Woodhouse K. , Bagli D.J. , Mclorie G.A. , Khoury A.E. 
Published: March 2003

Objectives To evaluate the use of a large‐segment (> 24 cm2) bladder substitution with porcine bladder acellular matrix allograft (BAMA) in a large animal model. Materials and methods Bladders were harvested from pigs at the time of necropsy and subjected to detergent and enzymatic extractions to render them acellular. The BAMA produced had the surgical handling and suture‐retaining properties of normal bladder tissue. Six pigs had BAMA segments implanted under general anaesthesia, through a low midline abdominal incision and after partial cystectomy. The defect was repaired with a BAMA patch (mean size 43.88 cm2, range 12–72), with no urinary diversion. Two animals each were then killed at 9, 16 and 30 days and the bladders explanted. The native bladder and BAMA patch were analysed morphometrically to evaluate cellular re‐population and matrix re‐organization. Results All animals survived surgery; there were no urinary leaks and no stones detected in any of the bladders. At 9 days there was a diffuse infiltration with acute inflammatory cells, but no areas of necrosis. There were isolated areas of smooth muscle cell (SMC) infiltration of the BAMA. At 16 days the luminal surface was lined with a single layer of urothelium, there was stromal infiltration with disorganized SMC and angiogenesis, with mature vessels in the BAMA patch. At 30 days the urothelium was multilayered with organizing groups of SMCs and angiogenesis. The highest cell density was at the periphery of the repopulated BAMA patch, decreasing towards the centre. Conclusions The implantation of large patches of BAMA is technically feasible and may prove to be a viable surgical alternative to bladder augmentation with intestinal segments. The advantages of BAMA include the potential for complete and functional regeneration of a bladder substitute. This model provides a tool with which to obtain a better understanding of the cellular and molecular aspects of matrix re‐population.
Reduction of radiation exposure to patients in the follow‐up of shockwave lithotripsy
Authors: Talati J. , Khan S. , Biyabani R. , Khan R.A. , Naz I. , Abbas F. , Buchholz N.‐P. 
Published: March 2003

Objectives To assess, in patients undergoing extracorporeal shock wave lithotripsy (ESWL), if a policy of using unilateral X‐rays of the kidney, ureter and bladder (hemi‐KUB) whenever possible and appropriate during diagnosis and follow‐up, was successful in reducing the radiation exposure associated with ESWL.Patients and methods Two groups of patients of statistically comparable size and demography were assessed retrospectively before and after the implementation of the policy. All had undergone ESWL for radio‐opaque upper urinary tract stones and all were finally rendered stone‐free. The number and type of all radiological procedures from initial diagnosis of the stone to documented stone‐free status were recorded and the dose calculated.Results The appropriate use of hemi‐KUB X‐rays resulted in a significant mean reduction of radiation exposure after treatment of 2.28 mSv per patient (P < 0.05). Furthermore, as expected, the radiation dose was clearly but not closely correlated with stone size (r = 0.419).Conclusions The appropriate use of hemi‐KUB X‐rays during the follow‐up after ESWL is a simple and effective way of significantly reducing the radiation exposure of such patients.
Melatonin administration prevents the nephrotoxicity induced by gentamicin
Authors: Özbek E. , Turkoz Y. , Sahna E. , Ozugurlu F. , Mizrak B. , Ozbek M. 
Published: March 2003

Objective To investigate the effect of melatonin on the antioxidant enzyme activity and renal tubular necrosis induced by gentamicin. Materials and methods Twenty‐four adult male Sprague‐Dawley rats were divided into three equal groups. In group 1, the rats were injected with vehicle (controls), in group 2 they were injected with gentamicin for 5 days and in group 3 injected with gentamicin plus melatonin for 5 days. At 24 h after the last injection, rats were killed and the renal cortex separated from the medulla. Most of the cortex was homogenized but a small sample was fixed in formaldehyde solution for histological examination by light microscopy. Blood samples were also taken to assess the serum levels of urea, creatinine, Na+, K+ and γ‐glutamyl transpeptidase (γ‐GT); before death, urine samples were analysed for protein content. Crude extracts of the cortex were used to determine lipoperoxides, reduced glutathione (GSH‐Px), catalase and superoxide dismutase (SOD). The results were compared using the Mann–Whitney U‐test. Results Compared with the controls rats, gentamicin caused hyperproteinuria, an increase in the level of γ‐GT in serum, a marked increase in lipoperoxides and a significant decrease of GSH‐Px, catalase and SOD activity in the kidney. In the rats in group 3 there was a marked restoration in lipid peroxidation, GSH‐Px, catalase, SOD activity and proteinuria, and in γ‐GT in serum. In rats in group 2 there was widespread tubular necrosis (grade 2–4) but in rats in group 3 there was a marked reduction in the extent of tubular damage. There was no significant difference in serum levels of Na+, K+, blood urea nitrogen and creatinine. Conclusion These results indicate that melatonin prevents the tubular necrosis induced by gentamicin in rats, presumably because it is a potent antioxidant and restores antioxidant enzyme activity in the rat kidney.
Deferred treatment of localized prostate cancer in the elderly: the impact of the age and stage at the time of diagnosis on the treatment decision
Authors: Neulander E.Z. , Duncan R.C. , Tiguert R. , Posey J.T. , Soloway M.S. 
Published: March 2003

Objective To assess the clinical behaviour of clinically localized prostate cancer in elderly patients monitored until progression, and the impact of clinical variables, i.e. clinical stage, Gleason score, the dynamics of prostate specific antigen (PSA) and age, on the natural history of the disease. Patients and methods Between February 1991 and January 1998, 54 patients (mean age 76.4 years, median 77 at the time of diagnosis) with clinically localized prostate cancer who elected for watchful waiting were identified. They were monitored regularly and treatment deferred until progression. Progression was defined as local stage progression (as assessed on a digital rectal examination), biochemical progression or metastasis. All patients who progressed were offered either radiation therapy or hormonal treatment. Each clinical variable was assessed by univariate and multivariate analysis to predict disease progression. The mean follow‐up was 47 months. Results Of the 54 patients, 28 (52%) progressed; 10 had biochemical, 11 local and four biochemical and local progression, and three developed metastasis. All the patients who progressed elected to receive hormonal treatment. The mean time to progression was 35 months. Gleason score ( 6 and > 6), age ( 75 and > 75 years) and serum PSA level ( 10 and > 10 ng/mL) were statistically significant predictors of disease progression (P = 0.04, < 0.001 and 0.02, respectively). The clinical stage at the time of diagnosis had a borderline effect on disease progression (P = 0.06). On multivariate analysis, Gleason score and PSA level were statistically significant predictors of disease progression. Conclusion These results suggest that the treatment of prostate cancer should not be deferred in patients aged > 75 years with a good performance status when the biopsy has a Gleason score  6 and the serum PSA level is  10 ng/mL.
The role of spinal and peripheral α1‐ and α2‐adrenoceptors on bladder activity induced by bladder distension in anaesthetized rat
Authors: Jeong M.S. , Lee J.G. 
Published: March 2003

Objective To elucidate the effects of α1‐ and α2‐adrenoceptor antagonists on the micturition reflex induced by bladder distension in the anaesthetized rat at the peripheral and spinal level. Materials and methods Using continuous cystometry in 80 anaesthetized female Sprague–Dawley rats, changes in basal pressure (BaP), micturition pressure (MP), bladder capacity (BC), micturition volume (MV), interval of bladder contraction (frequency) and residual volume (RV) to the selective intra‐arterial and intrathecal administration of drugs were monitored and analysed. Results The intra‐arterial administration of phentolamine, prazosin, doxazosin and tamsulosin significantly decreased the MP; doxazosin increased MV, BC, RV and frequency. MP was inhibited more by intra‐arterial doxazosin than by prazosin or tamsulosin. Intrathecal phentolamine increased BaP, BC, RV and decreased MP and MV; tamsulosin decreased frequency and increased BC. Clonidine markedly increased BaP and frequency, whereas MV and BC were significantly lower; yohimbine increased MV, BC and decreased RV. Intra‐arterial yohimbine significantly increased MV. Conclusions At the spinal level, the micturition reflex evoked by bladder distension was preferentially suppressed by phentolamine or yohimbine, suggesting the involvement of α2‐adrenoceptors. In the periphery, α1‐adrenoceptor blockers preferentially suppressed the reflex. We suggest that both α1‐ and α2‐adrenoceptors play a role in the distension‐evoked micturition reflex in the rat.
Expression and localization of basic fibroblast growth factor in diabetic rat prostate
Authors: Wang Z.‐J. , Ikeda K. , Wada Y. , Foster H.E. , Weiss R.M. , Latifpour J. 
Published: March 2003

Objective To assess fibroblast growth factor‐2 (FGF2/bFGF), which is important in the development and maintenance of the normal prostate and in the development of human benign prostatic hyperplasia (BPH) and prostatic carcinoma, in an animal model of experimentally induced diabetes. Materials and methods Using Western blotting and immunohistochemical analyses, the expression of FGF2 in prostates from several groups of rats was investigated. Rats had diabetes for 8 or 16 weeks (induced by intravenous injection with 65 mg/kg streptozotocin); rats were also treated with insulin (starting 8 weeks after the induction of diabetes, for 8 weeks), and two further groups acted as age‐matched control rats. Immunohistochemical markers for smooth muscle (α‐actin) and epithelium (cytokeratin) were used to distinguish different cell types in adjacent prostatic sections. Results Diabetic rats had smaller prostates and lower serum testosterone levels than their controls; insulin treatment of diabetic rats increased prostatic size and testosterone levels. As shown by Western blotting, diabetes caused greater FGF2 expression than in controls, whereas reverse‐transcriptase polymerase chain reaction studies showed similar levels of prostatic FGF‐2 mRNA in all groups. Immuno‐histochemical studies showed that FGF‐2 was expressed in both stromal and epithelial components of the rat prostate. Furthermore, although the expression of FGF2 was higher in epithelial than stromal cells in control prostates, it was distributed uniformly in the diabetic prostate. Conclusion The differences in the level of expression and pattern of distribution of FGF2 suggests a potential role for FGF2 in the changes observed in prostatic growth in diabetic rats.
Ejaculatory duct obstruction in infertile men
Authors: Paick J.‐S. , Kim S.H. , Kim S.W. 
Published: March 2003

Objective To analyse our experience of ejaculatory duct obstruction (EDO) in infertile men, evaluating the diagnostic steps and the outcome of management according to the aetiology. Patients and methods Over a 7‐year period, 50 infertile men were diagnosed with EDO as a contributory factor to male infertility. Diagnostic criteria included a history, physical examination, semen analyses, semen fructose measurement, hormonal study, testicular biopsy, transrectal ultrasonography (TRUS) and/or vasography. Thirty‐one patients with EDO were treated by transurethral resection (26) or forced lavage via a vasotomy (five). Results In 45 of the 50 men, semen analyses showed the typical characteristics of complete EDO. Seminal values were variable in five cases of partial EDO; the semen fructose levels were < 1.4 g/L in all five. The main cause of EDO was a midline cyst in 16, Wolffian malformation in four, tuberculosis in 17, previous genitourinary infection in five and idiopathic in eight men. In 17 patients the seminal vesicles appeared to be atrophied on TRUS; 15 of these patients had a history of pulmonary tuberculosis and subsequent vasography in five showed multiple bilateral vasal obstruction. TRUS findings correlated well with vasography except in one case. The overall rate of improved semen values and paternity was 61% and 26%, respectively. Of 16 patients with midline cysts, 14 had improved semen variables and achieved paternity, seven after transurethral resection. Conclusions TRUS should be the first diagnostic procedure used when infertile men are suspected of having EDO, but vasography should still be considered for a more comprehensive diagnosis. In patients with atrophic seminal vesicles on TRUS and with a history of pulmonary tuberculosis, further study is unnecessary and microscopic epididymal sperm aspiration is recommended for in vitro fertilization. The measurement of semen fructose may be helpful in diagnosing partial EDO. Patients with midline cysts who are treated by transurethral resection are expected to have the best outcome.