bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gubernacular development in Müllerian inhibiting substance receptor‐deficient mice
Authors: Bartlett J.E. , Lee S.M.Y. , Mishina Y. , Behringer R.R. , Yang N. , Wolf J. , Temelcos C. , Hutson J.M. 
Published: December 2004

Objective To determine, in mice with disrupted Müllerian inhibiting substance (MIS) receptor genes, whether MIS affects gubernacular development; MIS causes Müllerian duct regression and is proposed to be involved in the first stage of testicular descent, because gubernacular development is abnormal in humans with persistent Müllerian duct syndrome. Materials and methods Ten wild‐type, 11 heterozygotic and 12 homozygotic mice for MIS receptor mutations were killed at 17.5 or 18.5 days after conception or at birth, to provide serial sagittal sections of the pelvis. The amount of cremaster muscle, mitotic bodies in the gubernacular bulb, and gubernacular size were quantified by computer analysis (four mice/group). Results Müllerian ducts were present in the homozygous mutants, partially present in the heterozygotes and absent in the wild‐type controls. All mice had descended testes. The cremaster muscle was significantly less developed in homozygous mutants than in wild‐type controls (P < 0.001) and heterozygotes (P < 0.01) at birth. The mitotic index between the gubernacula of all groups was indistinguishable. There was no statistical difference in gubernacular area amongst the groups. Poor cremaster muscle development in homozygous mutants gave the muscle a loose mesenchymal appearance. Conclusions Although there was an observable effect on cremaster muscle development in these mutant mice, gubernacular development and testicular descent were otherwise normal, and thus there must be other reasons for the observed differences in humans with persistent Müllerian duct syndrome.
Calyx to parenchyma ratio in pelvi‐ureteric junction obstruction
Authors: Imaji R. , Dewan P.A. 
Published: December 2004

Objective To review the ultrasonography of patients who had undergone pyeloplasty for pelvi‐ureteric junction (PUJ) obstruction, and document the changes in calyceal distension and parenchymal thickness after pyeloplasty, to attempt to establish an additional prognostic indicator. Patients and methods Fifty‐eight patients who underwent pyeloplasty for PUJ obstruction were assessed retrospectively. Pre‐ and postoperative ultrasonograms were analysed for both pyelocaliectasis, graded according to the Society for Fetal Urology criteria, and the ratio of the depth of calyces to the thickness of the parenchyma (C/P ratio). Patients underwent nuclear medicine renography before and 3 months after pyeloplasty. The results were analysed using the paired t‐test, Kruskal–Wallis test, Spearman's correlation coefficient by rank test and the Mann‐Whitney U‐test. Results There was no significant difference in hydronephrosis grade before and after surgery (P < 0.05) but there was a significant difference in the C/P ratios (P < 0.01). There was no correlation between C/P ratios and the results of diuresis renography. Conclusion Hydronephrosis as measured by an estimate of pelvic volume is an insensitive marker of improvement after pyeloplasty. Reduced calyceal distension correlates well with other favourable prognostic indicators. Therefore, the C/P ratio may be an additional indicator of the appropriateness of surgical intervention, and should be the subject of further study.
Management of severe hypospadias using Glassberg's modification of the Duckett repair
Authors: MacGillivray D. , Shankar K.R. , Rickwood A.M.K. 
Published: December 2004

Objective  To assess the effectiveness of Glassberg's modification of Duckett's technique in the surgical correction of severe hypospadias. Patients and methods  The case notes of 24 boys who underwent hypospadias repair using this technique were reviewed, noting the severity of the lesion, the method of repair and the clinical outcome. Results  One operation was required in 14 (58%) of patients; complications requiring further surgery occurred in 10 boys (42%). Conclusion  This technique allows a single‐stage procedure when otherwise a two‐stage procedure would be necessary.
A single‐centre long‐term outcome analysis of artificial urinary sphincter placement in children
Authors: Hafez A.T. , McLorie G. , Bägli D. , Khoury A. 
Published: December 2004

Objective To retrospectively evaluate the outcome of artificial urinary sphincter (AUS) placement in 79 children, with a mean follow‐up of 12.5 years. Patients and methods A total of 89 children had an AUS placed between 1977 and 1994; complete data were obtained for 79 (63 boys and 16 girls). The indication for AUS placement was urinary incontinence caused by sphincteric deficiency with a stable bladder. Before and after surgery, all patients underwent ultrasonography, voiding cysto‐urethrography and urodynamics. Logistic regression was used to assess the factors influencing the outcome. Results The mean (range) age at surgery was 11.7 (3–18) years. The cause of incontinence was a neuropathic bladder in 74 patients and bladder exstrophy in five. At a mean (range) follow‐up of 12.5 (5–22) years, 63 of 79 patients (80%) had an intact AUS. The AUS was removed in 16 patients (20%) because of erosion at a mean (range) of 5.6 (1–11) years after insertion; there were 0.035 revisions per patient‐year. Of 63 patients with an AUS in place, 57 (90%) are completely dry and 36 (57%) are using clean intermittent catheterization. Thirteen patients (20%) developed bladder instability during the follow‐up, which was managed by anticholinergics in eight, spinal cord de‐tethering in three and enterocystoplasty in two. Hydronephrosis occurred in 12 of 126 renal units (10%) that improved after enterocystoplasty or anticholinergics. The overall 10‐year survival of the AUS was 79% (78% for early models and 80% for the AMS800); the survival was not affected by age, sex, model, previous bladder neck surgery, augmentation cystoplasty or intermittent catheterization. Bladder exstrophy was associated with lower AUS survival, as four of the five patients affected had the AUS removed secondary to erosion (P = 0.014). Conclusion In children the AUS has a 79% 10‐year survival and gives a 90% continence rate. Bladder instability after AUS placement can be managed with anticholinergics or enterocystoplasty. The AUS is not a justifiable treatment option for patients with bladder exstrophy.
Allogeneic whole‐cell vaccine: a phase I/II study in men with hormone‐refractory prostate cancer
Authors: Eaton J.D. , Perry M.J.A. , Nicholson S. , Guckian M. , Russell N. , Whelan M. , Kirby R.S. 
Published: December 2004

Objective To establish the safety and toxicity of an allogeneic human tumour cell vaccine in patients with hormone‐refractory prostate cancer, and to determine any biochemical, immunological or clinical response to vaccination. Patients and methods Sixty patients with hormone‐refractory prostate cancer were recruited and randomly allocated into four equal groups. Three cell lines (from a bank of four) were administered initially every 2 weeks and then monthly, in conjunction with the immunostimulant Mycobacterium vaccae (SRL‐172), each group receiving a different combination of the four cell lines. The patients' serum prostate‐specific antigen (PSA) levels were monitored regularly, and the immune response to the vaccine measured using nonspecific intracellular cytokines and specific humoral and cell‐mediated assays. Results The vaccine was safe and well tolerated with no major side‐effects. Whilst several patients had a decline in PSA from the entry level, there was no significant decrease that could be attributed solely to the vaccine. However, the immunological data were more encouraging, with several patients from each arm of the trial having an increase in cytokine production, increases in specific antibodies and evidence of T‐cell proliferation in response to the vaccinations. Conclusion The failure of the vaccine to produce a PSA response in the patients in the trial is not surprising considering the stage of the disease. The high PSA levels on entry indicate that the burden of disease was probably high and thus this was an extremely challenging group of patients in which to try and elicit a response through immunotherapy. However, the immunological evidence of a response to the vaccine was encouraging and suggests that further exploration of immunotherapy in less advanced disease may yield more encouraging clinical responses.
Spongioplasty and separation of the corpora cavernosa for hypospadias repair
Authors: Dodat H. , Landry J.‐L. , Szwarc C. , Culem S. , Murat F.‐J. , Dubois R. 
Published: December 2004

ObjectiveTo describe a surgical method (a modified Duplay technique), and its results, for hypospadias repair, developed to avoid the common complication of fistula.Patients and methodsThe urethroplasty was modified so that it no longer comprises a simple approximation of the urethral plate with no dissection. The inferior surface of the corpora cavernosa is exposed as far as the lateral border and to the end of the glans, allowing tension‐ free suturing of urethral tissues, with a lengthening effect of the intermediate plane. This corrects chordee and especially the ‘bucket‐handle’ glans, and protects the reconstructed urethra and proximal urethra. The study included 51 children who had their hypospadias repaired over a 9‐month period (mean age at surgery 20.6 months, range 1–11 years); 14 had coronal, three anterior penile juxta‐coronal, 23 anterior penile, four medium penile, five posterior and two penoscrotal hypospadias.ResultsAll children were followed and no fistula was apparent in any with anterior hypospadias; two fistulae occurred after repair of the posterior form. The risk of fistula is therefore reduced (two in 51).ConclusionThis technical modification can be used to treat all forms of distal hypospadias (glanular, glanulo‐preputial, and anterior penile). It was also used for several cases of more severe hypospadias. These good results must be confirmed in a larger series of patients.
Detection of telomerase status by semiquantitative and in situ assays, and by real‐time reverse transcription‐polymerase chain reaction (telomerase reverse transcriptase) assay in bladder carcinomas
Authors: Longchampt E. , Lebret T. , Molinie V. , Bieche I. , Botto H. , Lidereau R. 
Published: December 2004

ObjectiveTo investigate whether telomerase activity could be used as a diagnostic and/or prognostic marker of bladder carcinoma, by assessing telomerase activity using semiquantitative and in situ methods, and quantifying telomerase reverse transcriptase (hTERT) mRNA expression in a series of bladder carcinomas.Material and methodsTelomerase activity was detected by the telomeric repeat amplification protocol (TRAP) assay using a telomerase polymerase chain reaction (PCR) enzyme‐linked immunosorbent assay (ELISA) kit on a series of 29 bladder carcinomas and on three normal bladder samples. hTERT mRNA levels were quantified using real‐time quantitative reverse transcription (RT)‐PCR. For the in situ detection of telomerase activity, the same telomerase PCR ELISA kit was used and applied to frozen‐tissue sections only for discordant cases between telomerase activity and hTERT mRNA status.ResultsTelomerase activity was positive in 15 of the 29 bladder carcinomas (52%) and negative for the three normal bladder samples. hTERT was detected and quantified in all tumour samples, with major differences in hTERT values. None of the three normal bladder samples had quantifiable hTERT mRNA, giving complete sensitivity and specificity for the method in diagnosing bladder carcinoma. Comparing the results of RT‐PCR and TRAP assay showed a significant association between the enzyme activity and levels of hTERT mRNA expression, with only five discordant cases, most of them being TRAP‐negative and hTERT‐positive. Among these cases the in situ results of telomerase activity were concordant with hTERT mRNA levels by RT‐PCR and not with TRAP assay results, as nuclear fluorescence of malignant epithelial cells. The semiquantitative evaluation of positive cell numbers showed a heterogeneity of telomerase activity within the tumour tissue. There was a significant correlation between RT‐PCR and histopathological variables (grade and stage), and a significant correlation between TRAP assay results and histopathological grade.ConclusionDetecting hTERT mRNA by RT‐PCR seems to be a promising method, with a much better sensitivity than the TRAP assay in diagnosing bladder carcinomas, and a better correlation with histopathological variables. False‐negative cases on the TRAP assay are explained by the heterogeneity of telomerase activity within tumour cells. Thus evaluating hTERT gene expression levels could be used as a marker of malignant progression, useful in the early diagnosis and follow‐up of bladder carcinomas.
Retroperitoneal laparoscopic vs open partial nephroureterectomy in children
Authors: El‐Ghoneimi A. , Farhat W. , Bolduc S. , Bagli D. , McLorie G. , Khoury A. 
Published: December 2004

ObjectivesTo compare the results of retroperitoneal laparoscopic with open partial nephroureterectomy.Patients and methodsLaparoscopic retroperitoneal partial nephroureterectomy was undertaken in 15 children (13 upper and two lower poles; median age at the time of surgery 61 months, range 5–212). A three‐trocar retroperitoneal approach was used. The polar vessels were identified and either coagulated or clipped before transecting the parenchyma using a harmonic scalpel. An additional 13 consecutive children underwent similar procedures (11 upper and two lower poles) by conventional open surgery (median age at surgery 16 months, range 1.5–72).ResultsOne patient in the laparoscopy group required conversion to open surgery because of a peritoneal tear and was excluded from the analysis. The mean (range) operative duration was 146 (50–180) and 152 (75–240) min for the open surgery and laparoscopy groups, respectively. The blood loss was minimal (< 20 mL) in both groups. The mean (range) hospital stay was 1.4 (1–3) and 3.9 (3–5) days for the laparoscopy and open groups, respectively (P < 0.001). Eight patients were discharged on the day after the laparoscopic procedure. In addition, of those patients in the laparoscopy group who had a lower‐pole partial nephrectomy, one had a urinoma after surgery.ConclusionLaparoscopic retroperitoneal partial nephrectomy is a safe and feasible procedure in children. It requires a similar operative duration to that of an open procedure. The main advantage to the laparoscopic approach is that it significantly decreases the hospital stay compared with that after an open procedure.
The use of cell salvage during radical retropubic prostatectomy: does it influence cancer recurrence?
Authors: Davis M. , Sofer M. , Gomez‐Marin O. , Bruck D. , Soloway M.S. 
Published: December 2004

ObjectiveTo assess whether there is a difference in the biochemical recurrence rate in patients who had radical retropubic prostatectomy (RRP) with or without cell salvage transfusion.Patients and methodsThe records of 769 consecutive patients undergoing RRP between 1992 and 1998 were retrospectively reviewed. Patients having adjuvant hormonal treatment, postoperative external beam radiotherapy, or a follow‐up of < 1 year were excluded from the analysis. The remaining 408 patients were categorized into three groups: 87 who received cell‐salvaged blood using a commercial cell saver; 264 receiving only autologous transfusion; and 57 with no transfusion. Disease recurrence was defined as a prostate‐specific antigen (PSA) level of> 0.2 ng/mL. Bivariate and multivariate logistic regression analyses were used to assess and compare the risk of cancer recurrence in the three groups. Covariates used in the multivariate analyses included Gleason score, preoperative PSA level, seminal vesicle involvement and surgical margins.ResultsThe mean (range) follow‐up was 40.2  (12–104) months; there were no significant differences among the groups in initial PSA level and Gleason score. In the multivariate logistic regression analysis, the initial PSA, Gleason score, seminal vesicle involvement and surgical margins, but not transfusion group, were independent predictors of recurrence.ConclusionCell salvage during RRP does not influence the recurrence of prostate cancer. Cell salvage is a safe method of transfusion during RRP.
The correlation between preoperative voiding mechanism and surgical outcome of the tension‐free vaginal tape procedure, with reference to quality of life
Authors: Wang A.C. , Chen M.‐C. 
Published: December 2004

ObjectivesTo determine whether the surgical outcome of the tension‐free vaginal tape (TVT) procedure differs in patients with dysfunctional voiding (DV) or normal voiding.Patients and methodsThe voiding mechanism and surgical efficacy of the TVT procedure were analysed retrospectively by reviewing the charts of 79 consecutive women treated over 2 years. Based on their initial voiding mechanism, the patients were divided into two groups, with or without DV. The King's Health Questionnaire was used to evaluate the women's quality of life both before and 1 year after surgery.ResultsThe change in free maximum urinary flow rate (Qmax) after surgery differed significantly between the groups (P = 0.001). Moreover, both before and after surgery, the free Qmax was significantly lower (P = 0.019 and 0.001, respectively), and the detrusor pressure at Qmax (both P < 0.001) and urethral resistance (P = 0.036 and 0.027, respectively) significantly higher in the group with DV. The subjective outcome measure showed that the cure rates were not significantly different in the two groups (P = 0.173), but the objective outcome measure showed a significant difference (P = 0.025). Analysis of the total scores for all domains showed that significantly more women improved by> 25% in the group without than in those with DV (P = 0.016).ConclusionsThe objective cure rate of the group without DV undergoing the TVT procedure was significantly higher than in those with DV. In addition, subjective measures assessed by the disease‐specific quality‐of‐life questionnaire indicated that the group without DV had a better quality of life than those with DV.
Long‐term results of orthotopic neobladder reconstruction after radical cystectomy
Authors: Kulkarni J.N. , Pramesh C.S. , Rathi S. , Pantvaidya G.H. 
Published: December 2004

ObjectiveTo assess, in a retrospective study, the long‐term results of neobladder reconstruction after radical cystectomy, as this is the standard of care for muscle‐invasive bladder cancer.Patients and methodsData were retrieved for all patients with muscle‐invasive transitional cell carcinoma of the bladder treated by radical cystectomy and orthotopic neobladder substitution between 1988 and 1998. All perioperative and long‐term complications were recorded. The voiding pattern, frequency of micturition and continence were assessed, and a complete urodynamic profile recorded.ResultsIn all, 102 patients underwent radical cystectomy with orthotopic neobladder reconstruction in the study period; their mean (range) follow‐up was 73 (36–144) months. Neobladder substitution was with an ileocaecal segment in 35 patients, sigmoid colon in 34 and ileum in 33. Early complications occurred in 32 patients (31%) although open surgical intervention was required in only nine (9%). The death rate after surgery was 3.9%. Late complications occurred in 31 patients (30%) and were primarily caused by uretero‐enteric and vesico‐urethral strictures (9% each). Most patients had daytime (89%) and night‐time (78%) continence. The mean maximum pouch capacity (mL) and pouch pressure at capacity (cmH2O) were 562.5 and 23 (ileocaecal), 542 and 17.8 (sigmoid) and 504 and 19.1 (ileal), respectively; the mean postvoid residual was 29, 44 and 23 mL, respectively. Nine patients with ileocaecal neobladders, and 20 and seven with sigmoid and ileal neobladders, required clean intermittent catheterization. Twenty‐four patients had recurrence of disease, of whom 20 died.ConclusionsOrthotopic neobladder reconstruction requires complex surgery but has an acceptable early and late complication rate in properly selected patients. It provides satisfactory continence without compromising cure rates.
Combined treatment with vitamin E and colchicine in the early stages of Peyronie's disease
Authors: Prieto Castro R.M. , Leva Vallejo M.E. , Regueiro Lopez J.C. , Anglada Curado F.J. , Alvarez Kindelan J. , Requena Tapia M.J. 
Published: December 2004

ObjectiveTo assess the effectiveness of the combination of colchicine and vitamin E (which has anti‐fibrotic, anti‐mitotic and anti‐inflammatory effects) in modifying the early stages of Peyronie's disease, by evaluating pain relief, correction of deformities and plaque size.Patients and methodsIn all, 45 patients were divided into two groups and treated from January 1998 to November 2001. Their mean (range) age was 53.4 (40–62) years, the time from onset of the disease < 6 months and they had penile deformity of < 30°; no patient had erectile dysfunction. Twenty‐two patients were given ibuprofen 400 mg/day for 6 months, whilst 23 received a combination of vitamin E 600 mg/day plus colchicine 1 mg every 12 h. Pain, plaque size and penile deformity were assessed at 6 months.ResultsThere were no statistically significant differences between the groups at baseline in age, time from onset of the disease until the initial evaluation or plaque size. Although the proportion of patients reporting pain relief was higher amongst those receiving colchicine plus vitamin E (91% vs 68%) this was not significantly different, but differences in plaque size and penile curvature were significant.ConclusionsThe use of colchicine plus vitamin E during the early stages of Peyronie's disease (time from onset < 6 months) in patients with penile curvature of < 30° and no erectile dysfunction is an effective and well‐tolerated way to stabilize the disease. A more extensive study is needed, comparing these results with other oral therapies.
Penile epithelioid sarcoma and the case for a histopathological diagnosis in Peyronie's disease
Authors: Usta M.F. , Adams D.M. , Zhang J.‐W. , Davis R. , Hellstrom W.J.G. 
Published: December 2004

ObjectivesTo devise a set of clinical criteria that would identify which penile abnormality could be malignant and warrant biopsy, between Peyronie's disease (a pathological fibrosis involving the tunica albuginea of the penis) and epithelioid sarcoma (ES) of the penis (a rare malignant condition which can resemble Peyronie's disease in clinical presentation).Patients and methodsThe pathology reports and histological slides of men with Peyronie's disease who underwent penile biopsy were reviewed for ES. The medical charts of suspicious cases were then reviewed by a pathologist, unaware of the origin, for consistencies in signs, symptoms and clinical findings. These consistencies were then to be used to develop criteria for biopsy. Thirty‐two men underwent penile biopsy from 1992 to 2001.ResultsBecause there were no actual cases of ES, a specific set of criteria for ES could not be established. A review of previously published cases was then used for comparison with the present patients.ConclusionsMany of the previously reported cases included signs and symptoms of urethral narrowing or compression, causing lower urinary tract symptoms. In addition, the penile nodule size was reported to progressively enlarge over time. Because of the high prevalence of Peyronie's disease and low prevalence of ES, biopsy of every penile nodule is not judicious. However, signs and symptoms of urethral obstruction, and a progressively growing and persistently painful nodule should suggest a possible malignancy and warrant biopsy.