bluuebunny/crossref_metadata_2025_split huggingface dataset:
The predictive value of diagnostic imaging for histological lesions of the upper poles in duplex systems with ureteroceles
Authors: Bolduc S. , Upadhyay J. , Restrepo R. , Sherman C. , Farhat W. , Bägli D.J. , McLorie G.A. , Khoury A.E. , El Ghoneimi A. 
Published: December 2004

OBJECTIVETo compare the diagnostic imaging findings with the histological lesions in upper pole nephrectomy (UPN) specimens of duplex system ureteroceles, using renal ultrasonography (US) and nuclear renal scintigraphy.PATIENTS AND METHODSBetween 1992 and 2000, 86 patients with a ureterocele in a duplex system underwent surgery. The results from US were reviewed in 84 patients by a radiologist, for echogenicity, parenchymal thinning and hydronephrosis; 77 nuclear renal scans describing the differential function of the upper poles were also reviewed. Fifty‐five patients underwent UPN (25 antenatal, 30 postnatal; 18 intravesical, 37 extravesical) and the specimens were available for independent review by a pathologist, describing five histological categories, i.e. chronic interstitial inflammation, fibrosis, tubular atrophy, glomerulosclerosis and dysplasia. Histological lesions were categorized as severe (> 25%) or minimal (≤ 25%). Radiological features and the histology of UPN were then analysed, and correlated using Fisher's exact test and multivariate analysis.RESULTSSevere histological lesions were reported in 38 specimens (69%) and minimal lesions in 17 UPN specimens (31%). Severe parenchymal thinning was associated with a severe pathological lesion (P < 0.02). There was no correlation with the echogenicity or degree of hydronephrosis. Dysplasia, found in 64% of specimens, did not correlate with increased echogenicity. Minimally functioning upper poles on nuclear renal scan (≤ 4% overall function) were significantly associated with severe histological lesions (P = 0.01). There was no correlation between diagnostic imaging features and the mode of presentation or type of ureterocele.CONCLUSIONSMultivariate analysis, severe parenchymal thinning on renal US and minimal function on nuclear renal scan can be used to predict the severity of histological lesions of the upper pole. These results may be helpful in the making therapeutic decisions for patients with ureteroceles in duplex systems.
Analysis of the long‐term outcome of surgically corrected vesico‐ureteric reflux
Authors: Mor Y. , Leibovitch I. , Zalts R. , Lotan D. , Jonas P. , Ramon J. 
Published: December 2004

Authors from Tel‐Aviv reviewed a group of patients who had VUR corrected in childhood, assessing their long‐term outcome. Even when patients were successfully treated during childhood they were still prone to recurrent UTI, renal scarring, hypertension and complications during pregnancy. They suggested that a protocol for long‐term follow‐up was required. PUJ obstruction is evaluated in two studies. The first of these, from Athens, presents the characteristic clinical and imaging findings in patients with obstruction by crossing renal vessels. In the second, the authors from Toronto describe their experience with the technique of dismembered laparoscopic pyeloplasty via a retroperitoneal approach. They gave a very balanced view about their early experience with this procedure, which will be helpful to the reader. They end by suggesting that modifications in the method used for the anastomosis were required. OBJECTIVETo review patients who had vesico‐ureteric reflux corrected surgically by ureteric reimplantation during childhood, and thus assess their long‐term outcome.PATIENTS AND METHODSBetween 1970 and 1979, 322 children underwent ureteric reimplantation; 100 (79 women and 21 men) were re‐assessed and the long‐term results evaluated using a questionnaire, a review of the patients’ current medical records and an appointment in the outpatient clinic. The evaluation focused on the frequency of late urinary tract infections (UTIs), current renal function tests, related complications during pregnancy and the incidence of hypertension at least 20 years after surgery.RESULTSOf the study group, 51% (66% of men and 47% of women) had no long‐term urological complications. The incidence of UTIs was 43% in women and 24% in men, and of pyelonephritis 27% and 9.5%, respectively. Hypertension was detected in 6% of the patients during assessment. There were new renal scars, despite surgery, in 20% of the patients. Forty‐seven women had been pregnant, 28% reporting UTIs during pregnancy. In 7% of 94 pregnancies the women also had pre‐eclampsia and two women had transient gestational ureteric obstruction which required drainage. Renal functional tests were worse in one man and one woman who developed end‐stage renal disease and had a renal transplant.CONCLUSIONSThis series shows that even patients who were treated successfully by ureteric reimplantation during childhood are prone to recurrent UTIs, progressive renal scarring, hypertension and complications during pregnancy. There is a need to establish a protocol for the long‐term follow‐up of such patients.
Laparoscopic dismembered pyeloplasty by a retroperitoneal approach in children
Authors: El‐Ghoneimi A. , Farhat W. , Bolduc S. , Bagli D. , McLorie G. , Aigrain Y. , Khoury A. 
Published: December 2004

OBJECTIVESTo report our experience with dismembered laparoscopic pyeloplasty by a retroperitoneal approach in children with pelvi‐ureteric junction (PUJ) obstruction.PATIENTS AND METHODSBetween 1999 and 2002, retroperitoneal laparoscopic dismembered pyeloplasty was attempted in 21 children (one bilateral; mean age 8 years, range 1.7–17). In a flank position with four ports (one of 5 or 10 mm and three of 3 mm), the PUJ was resected and the anastomosis made using 6/0 absorbable sutures. Any redundant renal pelvis was reduced when needed. A JJ stent was inserted in all patients.RESULTSThe procedure could not be completed by laparoscopy in four patients, the main reason being difficulty in completing the anastomosis; in the other 18 patients the procedure was successful. An aberrant crossing vessel was found in nine patients and dismembered pyeloplasty enabled ureteric transposition in all, with no conversion. The mean (range) operative duration was 228 (170–300) min and the mean hospital stay 2.5 (2–4) days. In three patients the JJ stents were not in the bladder at the time of removal by cystoscopy, and ureteroscopy was used to retrieve them. All children returned to full activities within 7 days of surgery. The mean (range) follow‐up was 12.7 (2–36) months, with six children followed for> 2 years; all were asymptomatic, with imaging confirming improved hydronephrosis.CONCLUSIONSThese mid‐term results confirm that retroperitoneal laparoscopic dismembered pyeloplasty is a safe and feasible approach in children. Although the technique is very demanding it has the advantage of duplicating the principles of the open approach. The long operative duration and high conversion rate might be reduced with experience. Before expanding this approach to younger children, refinements in the anastomotic technique are needed.
Diagnostic accuracy of flow rate testing in urology
Authors: Patel H.R.H. , Garcia‐Montes F. , Christopher N. , Reeves B.C. , Emberton M. 
Published: December 2004

OBJECTIVETo highlight the importance of methodological standards in diagnostic testing in urology, by reviewing the extent of compliance with these standards in reports of published evaluations.METHODSSixteen papers evaluating the diagnostic accuracy of urinary flow‐rate testing were independently assessed by two reviewers for compliance with the following methodological standards: specification of study population, analysis of pertinent subgroups, avoidance of evaluation (verification) bias, avoidance of review bias, reporting of precision of estimates of test accuracy, indeterminate test results, and test reproducibility. Compliance with each standard was expressed as a percentage with a 95% confidence interval.RESULTSCompliance ranged from just 12.5 (1.5–38)% for reporting of test reproducibility to 87.5 (62–98)% for specification of the study population. Only nine of the 16 evaluations complied with four or more of the methodological standards; one paper did not comply with any.CONCLUSIONSThis evaluation of urological flow‐rate testing show poor compliance with accepted methodological standards. The study design, reporting and evaluation of new diagnostic tests can be improved by adhering to these standards. Policy‐makers, purchasers and providers would be less likely to adopt new diagnostic tests inappropriately if they were to appraise published evaluations against the standards. A reduction in the inappropriate use of tests would in turn lead to more cost‐effective use of healthcare resources.
The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women
Authors: Dallosso H.M. , McGrother C.W. , Matthews R.J. , Donaldson M.M.K. ,   the Leicestershire MRC Incontinence Study Group
Published: December 2004

OBJECTIVESTo investigate the role of diet and other lifestyle factors in the incidence of overactive bladder and stress incontinence in women. Studies have suggested relationships between different aspects of lifestyle and symptoms of urinary incontinence, but there is a lack of firm evidence about their role in its cause.SUBJECTS AND METHODSA random sample of women aged ≥ 40 years living at home took part in a prospective cohort study. Baseline data on urinary symptoms, diet and lifestyle were collected from 7046 women using a postal survey and food‐frequency questionnaire. Follow‐up data on urinary symptoms were collected from 6424 of the women in a postal survey 1 year later. Logistic regression was used to investigate the association of food and drink consumption and other lifestyle factors with the incidence of overactive bladder and stress incontinence.RESULTSIn the multivariate model for the onset of an overactive bladder, there were significantly increased risks associated with obesity, smoking and consumption of carbonated drinks, and reduced risks with higher consumption of vegetables, bread and chicken. Obesity and carbonated drinks were also significant risk factors for the onset of stress incontinence, while consumption of bread was associated with a reduced risk.CONCLUSIONSCausal associations with obesity, smoking and carbonated drinks are confirmed for bladder disorders associated with incontinence, and additional associations with diet are suggested. Behavioural modification of lifestyle may be important for preventing and treating these disorders.
Association between leptin receptor gene polymorphisms and early‐onset prostate cancer
Authors: Kote‐Jarai Z. , Singh R. , Durocher F. , Easton D. , Edwards S.M. , Ardern‐Jones A. , Dearnaley D.P. , Houlston R. , Kirby R. , Eeles R. 
Published: December 2004

Significant tissue loss is a consistent feature of ureteric obstruction with, most studies showing increased programmed cell death or apoptosis of kidney epithelial cells. The study by Chuang et al. showed that there is also muscular damage during obstruction, specifically of the ureteric myocytes. More importantly they show for the first time that this induction of cell death is associated with the increased expression of cytochrome c and the caspases, key proteins that drive the induction of apoptosis. Admittedly they do not show whether cytochrome c is released from the mitochondria or that the caspases are truly activated, important events in the cell death pathway, but an increase in their expression does indicate their role in this process. Understanding the pathways leading to tissue loss during ureteric obstruction has important implications in the development of novel treatments for this condition. OBJECTIVETo report a case‐control study examining the relationship between polymorphisms in the leptin receptor (OBR) gene and the development of young‐onset prostate cancer, because epidemiological studies report that prostate cancer risk is associated with animal fat intake, and thus we investigated if this association occurs via this genetic mechanism.PATIENTS, SUBJECTS AND METHODSThe Lys109Arg (OBR1) and Gln223Arg (OBR2) polymorphisms in the coding region of OBR were studied in blood DNA from 271 patients with prostate cancer aged < 56 years at diagnosis and 277 geographically matched control subjects. Cases were collected through the Cancer Research UK/British Prostate Group Familial Prostate Cancer Study. Blood DNA was genotyped using the polymerase chain reaction and a restriction enzyme digest.RESULTSThere was no statistically significant association between the OBR genotype and prostate cancer risk; men homozygous for 109Arg genotype had a slightly increased risk for prostate cancer, with a relative risk (95% confidence interval) of 1.36 (0.65–2.85), and those homozygous for the 223Arg allele had some reduction in prostate cancer risk, at 0.82 (0.58–1.26), but neither was statistically significant.CONCLUSIONThis case‐control study showed no significant association between leptin receptor gene polymorphisms and the risk of young‐onset prostate cancer, suggesting that genetic variations in OBR are unlikely to have a major role in the development of early‐onset prostate cancer in the UK.
Stage I seminoma of the testis: a bi‐institutional retrospective analysis of patients treated with radiation therapy only
Authors: Santoni R. , Barbera F. , Bertoni F. , De Stefani A. , Livi L. , Paiar F. , Scoccianti S. , Magrini S.M. 
Published: December 2004

OBJECTIVETo analyse relapse patterns, toxicity and second malignancy in patients with stage I pure germ cell testicular tumours, treated in 1970–1999.PATIENTS AND METHODSIn all, 487 patients received irradiation after surgery to the infra‐ (407, 83.5%) or infra‐ and supra‐diaphragmatic volumes (80, 16.5%). Treatment‐related toxicity was classified according to previous criteria and fertility investigated in 246 men. Second malignancies were identified by retrospective analysis of clinical records or telephone interviews in men who no longer needed a long‐term follow‐up.RESULTSThe 10‐year overall survival was 97% (98% and 96%, respectively, for the aortic nodes only, or aortic and iliac nodes, i.e. the ‘dog leg’ field) and disease‐free survival was 94%. Twenty‐one patients relapsed (five with a true ‘in‐field’ recurrence, nine progressed to the mediastinum, and seven had disseminated disease). Acute toxicity was mainly gastrointestinal, with 7.6% classified as grade II. In all, 73 men achieved paternity after irradiation; nine did not but had normal sperm. Second malignancies were diagnosed in 16 (3.3%) men.CONCLUSIONPara‐aortic irradiation may be used safely in patients with stage I seminoma and undisturbed testicular drainage, with equivalent results to the ‘dog‐leg’ group; these unrandomized data confirm the lower toxicity and equivalent survival rates of this treatment.
Colour Doppler ultrasonography for detecting perineural invasion (PNI) and the value of PNI in predicting final pathological stage: a prospective study of men with clinically localized prostate cancer
Authors: Kravchick S. , Cytron S. , Peled R. , Ben‐Dor D. , Kravchenko Y. 
Published: December 2004

OBJECTIVESTo assess the ability of colour Doppler transrectal ultrasonography (CD‐TRUS) to improve the accuracy of detecting perineural invasion (PNI, reported to be an independent predictor of extraprostatic extension) and in predicting the pathological stage of the cancer, comparing it with the results of grey‐scale TRUS‐guided biopsies.PATIENTS AND METHODSThis prospective study included 47 men with clinically localized disease; all underwent 10‐core TRUS‐guided biopsy and two bilateral CD‐TRUS‐guided biopsies, targeted on the area adjacent to the neurovascular bundle. The rates and accuracy of PNI detection on 10‐core and CD‐TRUS‐targeted biopsies were compared with the pathological outcome. Various patient, clinical and pathological factors were compared, and multivariate analysis used to assess the value of the technique in predicting PNI and pathological outcome.RESULTSCD‐TRUS‐guided biopsies predicted the presence of PNI in the radical prostatectomy specimens with a sensitivity of 89%, and specificity and positive predictive values of 100%. Seven of 24 (29%) patients with PNI on the needle biopsies had pT3 disease. Conversely, the absence of PNI on guided biopsy accurately predicted pathologically localized disease in 96% (negative predictive value) of patients. However, the results of multivariate analysis showed that serum prostate‐specific antigen was the only strong predictor of pT3.CONCLUSIONCD‐TRUS is a useful tool for detecting PNI and predicting pathological localized cancer; it can be used in candidates for nerve‐sparing radical prostatectomy.
Effects of intravenous and infravesical administration of suramin, terazosin and BMY 7378 on bladder instability in conscious rats with bladder outlet obstruction
Authors: Velasco C. , Guarneri L. , Leonardi A. , Testa R. 
Published: December 2004

OBJECTIVETo evaluate the effect of the nonselective purinergic antagonist suramin and the α1‐adrenergic antagonists, terazosin and BMY 7378, given intravenously or infused directly into the bladder during cystometry in conscious rats with bladder outlet obstruction induced by urethral ligation.MATERIALS AND METHODSCystometry was performed in conscious female rats recording bladder volume capacity (BVC), evaluated as the amount of saline infused between two voiding cycles, and micturition volume (MV). Changes in frequency and amplitude of spontaneous non‐voiding bladder contractions (NVC) were also recorded. The effects of the intravenous administration of suramin (100 mg/kg), BMY 7378 (1 mg/kg), and terazosin (0.3 mg/kg) on NVC, BVC and MV were evaluated in obstructed rats with bladder infusion of saline. The effects of infravesical infusion of suramin (3–10 µmol/L), terazosin (1 µmol/L) and BMY 7378 (10 µmol/L) were also evaluated and compared with values observed in control rats during saline infusion into the bladder.RESULTSIntravenous injection with suramin had no effects on NVC, BVC and MV, but suramin infused into the bladder induced a consistent reduction in the amplitude of NVC (significantly different from matched control animals) with a tendency to reduce their frequency. BVC and MV were slightly but significantly decreased by infravesical infusion of suramin. In contrast, BMY 7378 and terazosin, given intravenously, were extremely potent at inhibiting the frequency and amplitude of the NVC, butwere inactive on NVC when infused into bladder.CONCLUSIONSThese findings confirm a role for α1‐adrenergic receptors in bladder instability caused by bladder outlet obstruction. In addition, a purinergic neurotransmitter, presumably ATP, is shown to be involved.
Release of cytochrome c and activation of caspases related to myocyte apoptosis in obstructed ureters in a rat model of obstructive uropathy
Authors: Chuang Y.‐H. , Chuang W.‐L. , Huang S.‐P. , Huang C.‐H. 
Published: December 2004

OBJECTIVETo investigate the roles of cytochrome c and caspases in the pathogenesis of muscular damage in obstructed ureters in a rat model.MATERIALS AND METHODSApoptotic cells were detected using in situ end‐labelling of DNA fragments. The expression of cytochrome c, and caspases‐3, ‐8 and ‐9 was examined in 54 rats, using immunohistochemistry.RESULTSThe severity of ureteric smooth muscle damage increased during obstruction. Apoptotic myocytes, and the expression of cytochrome c and the three caspases in the smooth muscle layer were apparent 14 days after ligation, reaching a peak at 21 days. The numbers of apoptotic cells in the smooth muscle layer correlated significantly with expression of cytochrome c and the three caspases (r = 0.8673, 0.8701, 0.5723 and 0.7910, respectively; all P < 0.01). The expression of cytochrome c in the smooth muscle layer correlated significantly with the expression of the three caspases (r = 0.8234, 0.7558 and 0.7825, respectively; all P < 0.001). The expression of caspase‐3 and ‐8, and ‐3 and ‐9 also correlated significantly (r = 0.6721 and 0.8501, respectively; both P < 0.002).CONCLUSIONSCytochrome c and caspases are involved in ureteric myocyte apoptosis; the release of cytochrome c might be important in ureteric damage during obstructive uropathy.
Prophylaxis of calcium oxalate stones by Herniaria hirsuta on experimentally induced nephrolithiasis in rats
Authors: Atmani F. , Slimani Y. , Mimouni M. , Hacht B. 
Published: December 2004

OBJECTIVETo evaluate the prophylactic potential of a herbal decoction from Herniaria hirsuta, a medicinal plant widely used in Morocco to treat kidney stones, by assessing the effect of oral administration in experimentally induced calcium oxalate (CaOx) nephrolithiasis in rats.MATERIAL AND METHODSTwo groups of six rats each were rendered nephrolithic by treating with ethylene glycol 0.75% and ammonium chloride 1% for 3 days, and then ethylene glycol only for 3 weeks. Maintained on ethylene glycol, one group of rats was also given 1 mL/day of the plant decoction, while the others received 1 mL of water instead for 2 weeks. Urine samples (24 h) were collected individually at 1, 3, 7, and 14 days for physicochemical analysis. On completing the treatment the kidneys were collected and analysed by light microscopy.RESULTSThe water intake and diuresis decreased in the treated rats; there was no significant difference in urinary pH between the groups. Urinary chemistry was apparently unaffected by the plant extract, except for the magnesium content, which was higher in treated rats. Crystalluria was characterized by the excretion of large CaOx monohydrate and dihydrate crystals in untreated, but smaller crystals in treated rats. The histology showed large deposits of CaOx crystals in all parts of the kidney in untreated rats but with almost no deposits in those of treated rats.CONCLUSION H. hirsuta has an impressive prophylactic effect on CaOx stones in nephrolithic rats; the effect did not seem to be mediated by biochemical or diuretic changes.
The sex ratio of pregnancies complicated by hospitalisation for hyperemesis gravidarum
Authors: Schiff Melissa A. , Reed Susan D. , Daling Janet R. 
Published: December 2004

Objective  To evaluate the sex ratio among pregnancies complicated by first trimester hyperemesis gravidarum and extend previous findings to include a measure of severity.Design  Population‐based case control study.Setting  All non‐federal hospitals in Washington State.Population  Two thousand and one hundred and ten pregnant women hospitalised for hyperemesis gravidarum and 9783 pregnant women without hyperemesis gravidarum.Methods  The infant sex ratio for pregnant women admitted to the hospital for hyperemesis gravidarum was evaluated using the Washington State hospital discharge database linked to the birth certificate database for years 1987–1996. Cases were pregnant women hospitalised for hyperemesis gravidarum (International Classification for Diseases—9th edition [ICD‐9] diagnosis code 643) in the first trimester. Controls were women who experienced a singleton live birth and were not hospitalised for hyperemesis in Washington State during the same time period. Regression analysis with general estimating equations was used to calculate an odds ratio (OR) and 95% confidence interval (CI) to assess the association of hyperemesis gravidarum with infant sex ratio.Main outcome measure  Infant sex ratio.Results  Pregnant women hospitalised for hyperemesis gravidarum in the first trimester had a 50% increased odds of having a female infant compared with controls (OR 1.5, 95% CI 1.4, 1.7). Women hospitalised for three or more days had the greatest odds of having a female infant compared with control women (OR 1.8, 95% CI 1.5, 2.0).Conclusion  Hyperemesis gravidarum is associated with an increase in female live births and may be a marker for high oestrogen levels in utero.