bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ambitions of adolescents born with exstrophy: a structured survey
Authors: Wilson Christine , Christie Deborah , Woodhouse Christopher R.J. 
Published: August 2004

A survey is reported by authors in the UK to determine factors that control the quality of life of adolescent patients with exstrophy; as expected, affected adolescents were resilient characters, and they stressed the importance of patients’ views after surgery to correct this condition.OBJECTIVETo determine the factors that control quality of life as perceived by adolescent patients with bladder exstrophy, and to compare their views using standard instruments.PATIENTS AND METHODSSixteen patients (mean age 19 years, range 16–21, 11 male and five female) were recruited from the departmental database; they represented 46% of those available for the study. After giving informed consent, each had a semi‐structured interview, augmented by completing a self‐reported scale, with the principal investigator. They then completed the Culture‐Free Self‐Esteem Inventory‐2 (CFSEI‐2) and the Brief Symptom Inventory (BSI). The interviews were recorded on audiocassette, transcribed verbatim and evaluated using interpretative phenomenological analysis.RESULTSIn the interviews there was a remarkable consistency in the domains identified as important to the patients. There was a wish to be normal and to be treated as such. This was defined (amongst other items) as being able to void with an appropriate noise, being treated as peers at school and at home, and having an umbilicus. All patients reported some bullying (all but one in the past), but only severely in three. Concerns about self‐image centred on scars and genital appearance. Very similar and effective coping strategies had been created, including practical (e.g. suitable clothes) and emotional (e.g. joking, control of revealed information) aspects. Special arrangements made to help (care by a special assistant or use of a disabled lavatory at school) served only to emphasize their abnormality and were resented. No overt psychiatric or psychological morbidity was detected. There was no difference in scores with the CFSEI‐2 or BSI from established age‐related norms.CONCLUSIONThis study confirms the anecdotally reported strong resilience and personality of adolescents with exstrophy. The domains that patients considered important were not those that their carers might have expected or that are used in standard quality‐of‐life instruments. No morbidity was identified by the two instruments used. In exstrophy, and perhaps in other uncommon conditions, the patients' views of relevant domains should be considered in assessing quality of life.
Outcome of valve ablation in late‐presenting posterior urethral valves
Authors: Schober Justine M. , Dulabon Lori M. , Woodhouse Christopher R. 
Published: August 2004

OBJECTIVETo explore the symptoms, radiological findings and outcome after valve ablation in patients who present late with posterior urethral valves (PUV) and who typically have mild forms of the disease with often minimal upper tract changes; these patients frequently escape detection by ultrasonography in utero and the diagnosis may be delayed to as late as adolescence.PATIENTS AND METHODSThe charts of 70 boys (mean age 7.46 years, range 2–14) diagnosed late with PUV and treated with value ablation were retrospectively reviewed. Before ablation, history of voiding habits, voiding frequency, presence of enuresis, dysuria and the incidence of gross haematuria was recorded. Findings of a physical examination, laboratory testing (urine analysis and serum creatinine levels), ultrasonography and voiding cysto‐urethrography (VCUG) were noted. After valve ablation, a review included a detailed voiding history and re‐examination of abnormal variables including an assessment of enuresis, voiding frequency and ultrasonography. The mean (range) follow‐up was 25 (1–78) months. One patient was lost after his first follow‐up visit, but data were included to that time.RESULTSThe most common presenting symptom was voiding dysfunction; 47 (67%) presented with nocturnal enuresis, 42 (60%) with urinary frequency and 12 (17%) with a history of urinary tract infection. On physical examination 12 (17%) had mild age‐corrected hypertension. Microhaematuria was present in 21 (30%) but all patients had normal serum creatinine levels. Ultrasonography showed hydronephrosis in 33 (47%) and a postvoid residual volume in 57 (81%). On VCUG, 52 (79%) patients had clear evidence of PUV, 22 (31%) bladder trabeculation, 11 (16%) vesico‐ureteric reflux and eight (11%) diverticula. On cystoscopy, 67 (96%) patients presented with the classic sail‐shaped PUV and three a ring‐shaped valve. After surgical ablation of the valve most patients dramatically improved; 31 of 42 (74%) had resolution of urinary frequency, 24 of 33 (73%) of diurnal enuresis and 17 of 47 (38%) nocturnal enuresis. Of 57 patients, 39 (68%) established good bladder emptying. Of 33 affected, 20 (60%) had some reduction of hydronephrosis but 63% continued to have some symptoms of voiding dysfunction.CONCLUSIONPUV should be considered in boys presenting with voiding dysfunction. After valve ablation most patients improve dramatically. Despite surgery, enuresis, urinary frequency and poor bladder emptying persisted in some and required further treatment. The continued bladder dysfunction suggested that irreversible urinary tract damage may have occurred. Even in this apparently mildly affected group, long‐term follow‐up is essential.
The concentration of elastic fibres in the male urethra during human fetal development
Authors: Bastos Ana L. , Silva Eloisio A. , Silva Costa Waldemar , Sampaio Francisco J.B. 
Published: August 2004

OBJECTIVETo describe the distribution of elastic fibres in the developing male urethra and to provide stereological data of the concentration of elastic fibres in the human urethra.MATERIALS AND METHODSUrethras were obtained from 10 fresh normal human fetuses at 15–36 weeks of gestation. A place‐matched spongy urethra of a 27‐year‐old normal adult man was also analysed. Samples were fixed in Bouin's solution, embedded in paraffin and histologically processed. The elastic system fibres were evaluated by light microscopy using Weigert's resorcin‐fuchsin technique after oxidation. Morphometric values were assessed by the point‐counting method. The volumetric density (Vv) of elastic fibres was correlated with fetal age.RESULTSAt 15 weeks the elastic fibres were sparse and homogeneously distributed. The size and thickness of elastic fibres increased with age, mainly in the third trimester of gestation. Elastic fibres formed a randomly orientated network in the trabeculae of the corpus spongiosum. The mean (sem) Vv of elastic fibres in the spongy urethra was 5.2 (0.4)% in the fetus at 15 weeks and 14.8 (1.0)% at 36 weeks. In the urethra of the place‐ matched young man the Vv was 19.0 (1.3)%. The concentration of elastic fibres in the spongy urethra increased significantly with age.CONCLUSIONThe high concentration of elastic fibres in the spongy urethra may partly explain its high extensibility. The progressive increase in elastic fibres during development implies functional adaptation of the fetal male urethra.
The physical characteristics of young males with varicocele
Authors: Delaney Daniel P. , Carr Michael C. , Kolon Thomas F. , Snyder Howard M. , Zderic Stephen A. 
Published: August 2004

OBJECTIVETo determine if there is an association with habitus in young males with varicocele, as adolescent boys with varicoceles appear to be mostly taller and leaner than age‐matched controls.PATIENTS AND METHODSRetrospectively reviewing our records we obtained the height and weight of 43 consecutive males (mean age 14.3 years, range 11–19) under long‐term follow‐up for varicocele. The body mass index (BMI), heights and weights were compared with values from the respective growth charts for boys aged 2–20 years (Center for Disease Control and Prevention), and the statistical significance of differences determined using the chi‐square test.RESULTSThe height and weight distributions of patients with varicocele indicated a significant deviation from normal in the 25–95th percentiles for stature and in the 25–75th for weight (P < 0.05). Deviations in BMI were insignificantly different from normal at each percentile.CONCLUSIONThese results indicate that patients with varicocele are significantly taller and heavier than age‐matched controls. Future studies to address the key areas identified in this study will help to further assess the distribution of the incidence of varicocele in closely defined subsets of adolescent growth and development, which may provide some insight into the cause of varicoceles.
Effect of circumcision on urinary tract infection after successful antireflux surgery
Authors: Kwak Cheol , Oh Seung‐June , Lee Ahnkie , Choi Hwang 
Published: August 2004

OBJECTIVETo evaluate whether circumcision during antireflux surgery can reduce the incidence of urinary tract infection (UTI) after successful ureteric reimplantation in patients with primary vesico‐ureteric reflux (VUR).PATIENTS AND METHODSChildren who had undergone antireflux surgery for primary VUR were divided into group 1 (27, circumcised at the time of antireflux surgery at the parents’ request) and group 2 (50, those not circumcised). All antireflux operations were by the Cohen method. Regular urine samples were cultured to detect UTI, which was defined as a single species with >105 colony‐forming units/mL in a midstream voided specimen. Numbers of UTI episodes before and after surgery were compared between the groups, with 99mTc‐dimercaptosuccinic acid (DMSA) renal scans also taken in all patients. Each scan was blindly reviewed in terms of the size, number and zonal location of cortical defects, based on morphology. Interval changes were categorised as improved, no change, progressed, and new scar formation, and compared between the groups. Prophylactic antibiotics were maintained until the follow‐up studies at 4–6 months after surgery.RESULTSThere was no significant difference between the groups in age at the time of operation (mean 42.4 vs 47.4 months), the age at the first documented UTI (mean 26.5 vs 29.3 months), reflux grade, or number of UTI episodes and renal parenchymal scarring on DMSA before surgery. There was no significant difference between the groups in the number of UTI episodes at a mean (range) follow‐up of 151.3 (114–207) months after antireflux surgery. Also there was no significant morphological change on follow‐up renal scans and no difference between the groups.CONCLUSIONThese findings suggest that circumcision during antireflux surgery has no effect on the incidence of postoperative UTI.
Comparison of cryotherapy and nephrectomy in treating implanted VX‐2 carcinoma in rabbit kidneys
Authors: Nakada Stephen Y. , Jerde Travis J. , Warner Thomas , Lee Fred T. 
Published: August 2004

OBJECTIVETo compare the efficacy of cryoablation and radical nephrectomy for treating implanted VX‐2 carcinoma in rabbit kidneys.MATERIALS AND METHODSA pilot study was conducted using 27 New Zealand white rabbits to assess the natural history of VX‐2 carcinoma in the kidney. VX‐2 tumour segments (1 mm3) were excised from subcutaneous tumours in carrier rabbits and implanted in the left kidney of study rabbits. The tumours were allowed to grow for 6, 7, 8, 9, 10, 14, 18, 21 and 28 days after implantation. Tumour progression was analysed in the kidney and surrounding serosa, and metastatic tumour presence in the lung, liver, spleen and bladder determined. After this, 80 rabbits were implanted with VX‐2 in the lower pole and randomized into one of three groups: group 1, 35 rabbits treated 7 days after VX‐2 implantation with cryoablation using a 15‐min double‐freeze technique and a 5‐mm tumour margin target temperature of − 20 °C; group 2, 35 rabbits treated with open radical nephrectomy; or group 3, 10 untreated controls. Rabbits were maintained for 22 days and then killed; the kidneys, lungs, liver, spleen, urinary bladder and ureter were removed, and examined grossly and histologically for tumour presence.RESULTSIn the pilot study there was a consistent 50–100 mm3 tumour after 7 days of growth, with no evidence of metastatic disease. By day 10 the mean kidney tumour was 230 mm3 and two of three rabbits had metastases in the lung. By day 18 the mean primary tumour was 5504 mm3 and all rabbits had metastatic disease. In the comparison study, cryotherapy cured 66% of implanted rabbits while nephrectomy cured 64%. All untreated controls had significant local and metastatic tumours. Findings in animals killed at 15 days after treatment showed significant differences between both treatment groups and untreated controls (P < 0.002). There was no difference in disease‐free survival between the cryotherapy and open nephrectomy groups (P = 0.78)CONCLUSIONBoth cryoablation and radical nephrectomy were effective in treating implanted VX‐2 renal tumours compared with untreated controls. There was no statistically significant difference between cryoablation and nephrectomy.
Microarray analysis of changes in renal phenotype in the ethylene glycol rat model of urolithiasis: potential and pitfalls
Authors: Chen Daniel H.‐C. , Kaung Hue‐Lee C. , Miller Casey M. , Resnick Martin I. , Marengo Susan R. 
Published: August 2004

OBJECTIVESTo investigate, in an initial study, the use of microarray analysis (MA) to develop an information base for urolithiasis. MA enables the screening of thousands of genes simultaneously making it the technique of choice for situations where the results are known, but the underlying mechanisms are not. Little is known about the pathological changes occurring in the kidney during urolithiasis and this has severely hampered efforts to develop effective therapeutics.MATERIALS AND METHODSMale rats were treated with 0.75% ethylene glycol for 2, 4 or 8 weeks; after death the kidneys were processed for RNA isolation and MA, conducted using a rat‐based chip (one kidney/chip) and the results confirmed by reverse transcription‐polymerase chain reaction (RT‐PCR, 21 probe sets; control, four rats; treated, five rats). Targets were defined as different by the software if the fold change (FC) was ≥ 2, and sorted into functional categories using a data‐mining tool. The repeatability of MA was investigated by subjecting the 4‐week samples to MA in two independent runs.RESULTSThe results for targets with a FC of ≥ 2 were plotted (y = 1.01x − 0.75; r2 0.84). Comparing the results obtained by RT‐PCR and MA showed a good qualitative correlation for those targets having a FC of ≥ 5 as determined by MA. Changes in the expression of genes associated with tubule function and regulation, oxidative damage, and inflammation were the most common in the functional categories. Changes in the expression of tubule‐specific markers indicated that there was damage to the proximal (γ‐adducin, organic anion and cation transporters, sodium‐hydrogen exchange protein‐isoform 3) and distal tubules (γ‐adducin, kallikrein) at 2 and 4 weeks. Increased expression of mitochondrial uncoupling protein indicated that there were changes to the mitochondria and oxidative stress at 2 and 4 weeks.CONCLUSIONThis study shows the power of MA as an exploratory technique, and changes in the expression of several physiologically important genes whose expression has not previously been reported to be affected by hyperoxaluria or calcium oxalate crystalluria.
Mechanisms of neurokinin A‐ and substance P‐induced contractions in rat detrusor smooth muscle in vitro
Authors: Quinn Teresa , Collins Colm , Baird Alan W. 
Published: August 2004

OBJECTIVETo investigate the mechanisms of neurokinin A‐ and substance P‐induced contractions of rat urinary bladder smooth muscle, and to compare them with those of the muscarinic agonist carbachol.MATERIALS AND METHODSRat urinary bladder strips were suspended under 1 g of tension in a physiological buffer at 37 °C, gassed with 95% O2/5% CO2. Mechanical activity was recorded isometrically during exposure to neurokinin A and substance P.RESULTSBoth agents produced concentration‐dependent contractions of smooth muscle strips which were unaffected by tetrodotoxin (1 µmol/L), peptidase inhibitors (captopril, thiorphan and bestatin; 1 µmol/L each) or piroxicam (10 µmol/L). The rank order of potency of agonists was neurokinin A > substance P > carbachol. Contractile responses to neurokinin A and substance P, like the contractile responses to carbachol, were abolished in a nominally Ca2+‐free medium and significantly reduced by nifedipine (1 µmol/L). SKF‐96365 (60 µmol/L), an inhibitor of receptor‐mediated Ca2+ entry, abolished the nifedipine‐resistant response to substance P and carbachol, and significantly attenuated the response to neurokinin A. Depleting intracellular Ca2+ stores with thapsigargin (1 µmol/L) significantly attenuated neurokinin A‐induced contractions but had no effect on substance P‐ or carbachol‐ induced contractions. The Rho‐kinase inhibitor, Y‐27632 (10 µmol/L), significantly reduced both phasic and tonic components of the contractile responses to neurokinin A, substance P and carbachol.CONCLUSIONThe contractile responses induced by tachykinins in rat urinary bladder smooth muscle strips involve a direct action on smooth muscle and are not modulated by peptidases or prostanoids. Neurokinin A and substance P, like carbachol‐induced contractions, depend on extracellular Ca2+ influx largely through voltage‐operated and partly through receptor‐operated Ca2+ channels. Intracellular Ca2+ release contributes to the contractile response to neurokinin A but appears to have no involvement in substance P‐ and carbachol‐induced contractions. Rho‐kinase activation contributes to contractions induced by substance P, neurokinin A and carbachol.
Autoaugmentation gastrocystoplasty: further studies of the sheep model
Authors: Close Clare E. , Anderson Paul D. , Edwards Glenn A. , Mitchell Michael E. , Dewan Paddy A. 
Published: August 2004

OBJECTIVETo report our experience with autoaugmentation gastrocystoplasty (AAGC, reported to result in an inconsistent augmentation effect in children) in a sheep model, specifically addressing issues of surgical techniques and postoperative bladder drainage that may affect the augmentation result, as many factors have been implicated in the poor outcome.MATERIALS AND METHODSTen 6‐month‐old male lambs had a suprapubic catheter placed by an open laparotomy. Intraoperative urodynamics were evaluated before and after detrusorotomy for autoaugmentation and after completing AAGC. The bladder was drained with no distension for 1 week after surgery and the urodynamic evaluation repeated on control and experimental animals 6 months after surgery. The animals were then killed and the bladders evaluated for gastric flap survival and histological changes in the native bladder and augmentation segments. The results were analysed using a one‐sided Student's t‐test.RESULTSThe median (range) native bladder volume at leak‐point pressure was 110 (40–490) mL. Intraoperative bladder volumes after completing AAGC confirmed adequate augmentation segments in all animals. The urodynamic evaluation at 6 months after AAGC showed increases in bladder volumes in nine of 10 animals (0–1336 mL), significantly greater than the increase in volume in the control sheep (median 337.5 vs 115.3 mL; P < 0.05). The bladder compliance (volume/pressure at leak capacity) 6 months after AAGC was slightly better but not significantly higher than in controls (median 17.3 vs 10.8 mL/cmH2O; P > 0.05). The median (range) ratio of surviving gastric flap to native bladder circumferences was 34.5 (31–53)%. Histology showed scarring of the submucosal layer in one of 10 augmentation segments and normal urothelium in all bladders.CONCLUSIONAAGC produces reliable bladder augmentation and excellent bladder compliance in a sheep model of a non‐neurogenic bladder. The gastric flap survived well and there was no bladder wall separation with simple postoperative catheter drainage.
Hellenic women managers in the telecommunications sector: living in transition
Authors: Kotsilieri Felia , Marshall Judi 
Published: August 2004

This paper reports a research study into the career experiences and perspectives of a sample of women managers in the telecommunications industry in Greece. The study was conducted from a social constructionist perspective, seeking to explore how social and cultural factors affect the managers’ perceptions. Tensions are explored between the research participants’ relative satisfaction with their career progress and their limited representation at the senior management levels. The strength of cultural expectations on Hellenic women to marry is noted.(The authors are the primary researcher and her research supervisor, respectively.)
Acute renal failure associated with raisin or grape ingestion in 4 dogs
Authors: Mazzaferro E. M. , Eubig P. A. , Hackett T. B. , Legare M. , Miller C. , Wingfield W.E. , Wise L. 
Published: August 2004

AbstractObjective: Description of a case series of 4 dogs with acute renal failure after ingestion of raisins or grapes.Case summary: Four dogs were presented with acute oliguric or anuric renal failure after a known ingestion of varying quantities of raisins or grapes. Prior to the onset of vomiting, all dogs were healthy, had no previous history of renal insufficiency, and had no exposure to other potentially nephrotoxic agents. This case series describes the clinical course and various treatment modalities used in the 4 dogs.New or unique information provided: This is the first report of clinical signs, treatment, and clinical outcome in dogs that developed renal failure after ingestion of raisins or grapes. The pathogenesis of nephrotoxicity associated with raisins and grapes remains unknown. Outcome was favorable in 2 out of the 4 cases of acute renal failure associated with raisin or grape ingestion in these dogs.
Relative adrenal insufficiency in critical illness
Authors: Martin Linda G. , Groman Reid P. 
Published: August 2004

AbstractObjective: To review the effects of critical illness on hypothalamic–pituitary–adrenal (HPA) function in human and veterinary medicine.Data sources: Data from human and veterinary literature was reviewed.Human data synthesis: Relative adrenal insufficiency (RAI) appears to be common in critically ill human patients with sepsis or septic shock. Hypotension that is refractory to fluid therapy and requires vasopressors is the most common presentation of RAI in the human intensive care unit (ICU). Many investigators now advocate the use of a low‐dose adrenocorticotropin hormone stimulation test to diagnose RAI. It is important to evaluate for the presence of adrenal dysfunction, because current data suggest that treatment with ‘stress’ or low doses of glucocorticoids (200–300 mg hydrocortisone daily) may improve patient outcome in humans.Veterinary data synthesis: There is a paucity of controlled studies in the veterinary literature regarding the effects of critical illness on HPA function. The results of these studies are varied. However, research models of sepsis and hemorrhagic shock suggest the existence of RAI in animals. Prospective clinical studies are needed to further examine pituitary–adrenal response to severe illness in veterinary patients, and to determine if there are therapeutic options, including glucocorticoid administration, which will improve patient outcome in animals.Conclusions: RAI is well documented in critically ill human patients, yet little is known about adrenal dysfunction in veterinary critically ill patients. A small number of studies suggest that RAI may exist in certain subpopulations of veterinary patients. The syndrome of RAI could be considered as a differential diagnosis in seriously ill veterinary patients that fail to respond to appropriate therapy, especially when hypotension refractory to fluid and vasopressor therapy is encountered. This disorder may represent a previously unidentified syndrome in critically ill veterinary patients with important therapeutic implications.