bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rising incidence of prostate cancer in Scotland: increased risk or increased detection?
Authors: Brewster D.H. , Fraser L.A. , Harris V. , Black R.J. 
Published: March 2003

Objective To assess the extent to which the increasing incidence of prostate cancer in Scotland can be explained by increased detection, particularly through transurethral resection of the prostate (TURP) and use of the prostate‐specific antigen (PSA) test.Subjects and methods This population‐based study was confined to men resident in Scotland and aged 50 years. Temporal trends were examined in age‐specific and age‐standardized incidence, mortality and TURP rates, and PSA testing rates during 1981–1996. Also analysed were the geographical variations in age‐standardized incidence and mortality rates during two distinct periods, 1984–1986 (before PSA testing) and 1994–1996 (after PSA testing). Finally, incidence rates and relative survival at 5 years were calculated by age group and 5‐year periods of diagnosis during 1968–1992.Results The incidence of prostate cancer in men aged 50 years increased from an age‐standardized rate of 142.0 per 100 000 in 1981 to 240.9 in 1996, with the steepest increase occurring between 1992 and 1993. The mortality rate increased similarly until 1993, but was relatively stable thereafter, falling slightly in 1996. In 1981–1988, incidence rates were closely correlated with TURP rates (r = 0.98, P < 0.001). In 1989–1996, incidence was closely correlated with PSA testing rates (r = 0.98, P < 0.001). By 1994–1996, incidence rates varied substantially between Scottish mainland health boards (range 167.7–303.0 per 100 000), with much less variation in mortality rates (90.7–110.0). Relative survival has increased recently in all age groups although, in the era before PSA testing, survival was reasonably stable despite increasing incidence.Conclusion Although there may have been a true increase in risk, much of the observed increase in the incidence of prostate cancer in Scotland between 1981 and 1996 has been caused by increased detection, leading recently to considerable variation among different areas of the country. The extent to which this represents the early diagnosis of tumours which would eventually cause symptoms or be life‐threatening, or detection of latent disease which would never have become symptomatic, is not clear. There is no evidence so far that the increased incidence is associated with any substantial reduction in mortality.
Comparison of the depth of the desiccated zone with selected vaporizing‐cutting electrodes: a basic study in animals
Authors: Ishikawa N. , Goya N. , Iguchi Y. , Toda F. , Nishino S. , Ishijima M. , Toma H. 
Published: March 2003

Objective To evaluate in an animal model the haemostatic efficacy of vaporizing‐cutting (VC) electrodes recently developed for use in high‐energy transurethral resection of the prostate (TURP). Materials and methods Four VC electrodes were assessed for their haemostatic efficacy in the muscle and liver of pigs (in vitro) and dogs (in vivo). The devices tested were the roller‐cutting and Vapor Cut (Karl Storz GmbH, Germany); the Wedge (Boston Scientific Corp., Boston, USA); and the Uroloop (Endocare Inc., Irvine, CA). In each the depth of the desiccated zone was compared with that produced by a standard cutting loop electrode. Each electrode was attached to a scanning system (developed previously) that allowed the electrode pressure on the tissue surface (in 3% sorbitol solution) and the running speed to be adjusted. The same generator was used with all devices. The tissue (muscle or liver) was cut by running the electrode over the surface at 200, 250 or 300 W, with the loop electrode used as the reference. After completing the procedure, the surgical wound and the surrounding tissue were dissected out and the depth of the heat‐affected zone (HAZ, defined as the desiccated zone) measured. Results In pig muscle (stroke speed 5 mm/s) there was no significant difference in the depth of the HAZ between the four VC electrodes and the loop, or among the VC electrodes at any of the power levels tested. In pig liver (stroke speed 5 mm/s), the roller cutting and Vapor Cut electrodes produced a thicker HAZ than the loop at all power levels tested (P < 0.01). The Wedge electrode produced a significantly thicker HAZ than the loop at 200 and 300 W (P < 0.01). There were no significant differences in HAZ among the VC electrodes at any power level. In dog muscle in vivo (stroke speed 10 mm/s), the roller cutting, Vapor Cut and Wedge electrodes produced a significantly thicker HAZ at 250 W than the loop at 150 W (the usual power for TURP) (P < 0.01). There was no significant difference among the VC electrodes. In dog liver in vivo (stroke speed 10 mm/s), the roller cutting electrode produced a significantly thicker HAZ at 250 W than the loop at 150 W (P < 0.01). Conclusions The present VC electrodes produced a thicker desiccation zone at higher powers (200–300 W) than the standard loop at the usual power (150 W). The four VC electrodes produced a similar desiccation zone. With pig muscle and liver in vitro, regular loops used at a higher power created a desiccation zone that was 70–80% of the depth created by the VC electrodes.
The transverse colonic reservoir: the Unicamp technique
Authors: Ferreira U. , Rodrigues Netto N. , Lucena R. 
Published: March 2003

Objective To present the results of a continent and nonrefluxing transverse colonic urinary reservoir technique.Patients and methods Twenty patients who had received high doses of irradiation underwent construction of transverse colonic reservoir as a primary form of urinary diversion. Fourteen patients had a vesicovaginal fistula after definitive radiation therapy for gynaecological tumours and six had radiation therapy for invasive bladder cancer as a definitive treatment. They were followed for a median (range) of 4.5(1–8) years. Intravenous pyelography before diversion showed mild hydronephrosis in 10 patients.Results After diversion, hydronephrosis improved in four patients and no upper tract deteriorated. All but one of the pouchograms showed no ureteric reflux. All the patients required clean intermittent self‐catheterization every 3–4 h. Persistent asymptomatic bacteriuria was present in 14 patients, although clinical urinary tract infections were not reported. A moderate metabolic acidosis was present in 12 patients, but none required treatment. The urodynamic evaluation revealed a median (range) reservoir capacity of 450 (350–600) mL, with no contractions or contractions of < 35 cmH2O.Conclusion These results suggest that the Unicamp technique for constructing a transverse colonic reservoir is a safe and effective diversion, and is recommended as an alternative method for patients treated by pelvic irradiation.
The effect of bladder outlet obstruction on tissue oxygen tension and blood flow in the pig bladder
Authors: Greenland J.E. , Hvistendahl J.J. , Andersen H. , Jörgensen T.M. , McMurray G. , Cortina‐Borja M. , Brading A.F. , Frøkiær J. 
Published: March 2003

Objective To investigate the effect of partial bladder outlet obstruction on detrusor blood flow and oxygen tension (PdetO2) in female pigs.Materials and methods Detrusor‐layer oxygen tension and blood flow were measured using oxygen‐sensitive electrode and radiolabelled microsphere techniques in five female Large White pigs with a partial urethral obstruction and in five sham‐operated controls. The effects of chronic outlet obstruction on bladder weight, and cholinergic nerve density and distribution, are also described.Results In the obstructed bladders, blood flow and oxygen tension were, respectively, 54.9% and 74.3% of control values at low bladder volume, and 47.5% and 42.5% at cystometric capacity. Detrusor blood flow declined by 27.8% and 37.5% in the control and obstructed bladders, respectively, as a result of bladder filling, whilst PdetO2 did not decrease in the controls, but fell by 42.7% in the obstructed bladders. Bladder weight increased whilst cholinergic nerve density decreased in the obstructed animals.Conclusion In pigs with chronic bladder outlet obstruction, blood flow and oxygen tension in the detrusor layer were lower than in control animals. In addition, increasing detrusor pressure during filling caused significantly greater decreases in blood flow and oxygen tension in the obstructed than in the control bladders.
A randomized controlled trial comparing the efficacy of controlled‐release oxybutynin tablets (10 mg once daily) with conventional oxybutynin tablets (5 mg twice daily) in patients whose symptoms were stabilized on 5 mg twice daily of oxybutynin
Authors: Birns J. , Lukkari E. , Malone‐lee J.G. ,   the Oxybutynin CR Clinical Trial Group
Published: March 2003

Objective To compare the efficacy of a controlled‐release (CR) formulation of oxybutynin with that of conventional oxybutynin in patients with detrusor instability or detrusor hyper‐reflexia whose symptoms were stabilized on conventional oral oxybutynin tablets. Patients and methods The study comprised a randomized, double‐blind, parallel‐group trial involving 130 patients drawn from 15 centres in the UK. The study was of 6 weeks’ duration, i.e. 2 weeks of screening whilst taking conventional oxybutynin tablets (5 mg twice daily) followed by 4 weeks of double‐blind treatment with either CR oxybutynin tablets (10 mg once daily) or conventional oxybutynin tablets (5 mg twice daily). Outcome measures were changes in 24‐h frequency and 24‐h incontinence episodes recorded throughout the study on diary charts. Adverse events were recorded by patients in their diary charts and serum concentrations of oxybutynin and its active metabolite, N‐desethyloxybutynin, were measured at baseline and at completion of the study to detect possible drug accumulation. Results The treatments did not differ significantly in any of the outcome measures. The primary efficacy criterion was the daytime continence at completion of the study; 53% and 58% of patients were continent on CR and conventional oxybutynin treatments, respectively (the 95% confidence interval of the difference in the proportion being − 22% to 13%; P = 0.62). The total number of side‐effects experienced by those patients receiving treatment with the CR formulation was 57% of that for patients receiving treatment with conventional oxybutynin. Individual side‐effects showed a similar distribution within treatment groups. There was no evidence of the accumulation of oxybutynin or N‐desethyloxybutynin during the multiple dosing of CR or conventional oxybutynin tablets. Conclusion The CR and conventional formulations of oxybutynin did not differ in their efficacy, and the CR formulation was associated with fewer side‐effects. In addition, CR oxybutynin appeared to maintain therapeutic blood levels over the 24 h dosing interval with no accumulation of oxybutynin or its active metabolite. Once‐daily dosing with a CR tablet is seen as convenient for the patient and is expected to result in improved compliance in patients already stabilized on conventional oxybutynin treatment.
Surgical conversion of genitalia in transsexual patients
Authors: Jarolím L. 
Published: March 2003

Objective To describe the techniques and outcome of genital and urethral reconstructive surgery during gender conversion as part of the treatment of transsexuals. Patients and methods From 1992 to 1999, 82 patients were surgically converted after previous sexual and hormonal therapy. Using the male genital tissue to create new female genitalia, and vice versa, 30 male and 52 female transsexuals were converted. For male‐to‐female transsexuals, the technique of penile skin inversion was used 29 times and sigmoidocolpoplasty five times (in one patient primarily and in four patients to correct inadequate neovaginal size after penile skin inversion). In female‐to‐male transsexuals, 28 meta‐idoioplasties and seven neophalloplasties were performed using the groin skin‐flap technique, with 42 breast reductions also included as a part of the therapy. Results Surgical gender reassignment of the male transsexuals resulted in replicas of female genitalia which enabled coitus with orgasm. Depending on the technique used in the reverse conversion, the patient maintained the ability to attain orgasm, and in many cases had a satisfactory appearance of the neopenis, with the potential to void while standing. Conclusions The morphological proportions of each patient vary, and the different shapes and sizes of the tissues can be used for plastic operations. Thus the modelling of each individual genital in transsexuals can be considered ‘original’.
The postejaculatory refractory period: a neurophysiological study in the human male
Authors: Yilmaz U. , Aksu M. 
Published: March 2003

Objective To investigate changes in the penile sensory threshold, and the variables of cortical somatosensory evoked potential and sacral evoked response tests in the early postejaculatory period in the human male.Subjects and methods Twenty healthy volunteers (mean age 25.3 years, range 17–32) were evaluated before and after ejaculation for penile sensory threshold values, and the variables of sacral evoked response and cortical somatosensory evoked potential tests.Results Three subjects were excluded from the statistical analyses because there were significant differences among the repeated tests. In the remaining 17 subjects the penile sensory threshold was significantly greater in the postejaculatory period (P < 0.05). There were no significant changes in the other variables of both the sacral evoked response and cortical somatosensory evoked potential tests after ejaculation (P > 0.05).Conclusion The postejaculatory refractory period in the human male is accompanied by a greater penile sensory threshold but with no change in the values of the sacral evoked response and cortical somatosensory evoked potential.
Trends in prostate cancer incidence, mortality and survival in England and Wales 1971–1998
Authors: Majeed A. , Babb P. , Jones J. , Quinn M. 
Published: March 2003

Objectives To examine trends in prostate cancer incidence and mortality in England and Wales between 1971 and 1998, using a newly developed and validated national cancer database and the national mortality database.Methods Age‐standardized incidence and death rates were calculated directly and trends in relative survival rates among men with prostate cancer registered during 1971–1990 were examined.Results The annual number of new cases of prostate cancer registered in England and Wales increased by 179% between 1971 and 1993, from 6174 to 17 210. Directly age‐standardized incidence rates increased by 104% between 1971 and 1993, from 29 to 59 per 100 000. The number of deaths from prostate cancer increased by 113% between 1971 and 1998, from 4027 to 8570. Directly age‐standardized death rates increased by 49% between 1971 and 1995 and then decreased by 8% between 1995 and 1998, an overall increase of 38% (20 to 27 per 100 000) between 1971 and 1998. The relative survival rate for prostate cancer among men diagnosed during 1986–1990 was 77% at 1 year and 42% at 5 years, compared with 67% and 33%, respectively, for cases diagnosed during 1971–1975. The increase in survival rates was confined to men diagnosed with prostate cancer up to 1985 and no increase was seen for cases diagnosed after 1985.Conclusions Prostate cancer is becoming a growing burden on the health service. The explanation for the large increase in prostate cancer incidence and mortality is unclear and needs further investigation. The lack of any improvement in survival rates in cases diagnosed after 1985 is of concern, and suggests that the current management of prostate cancer in both primary and secondary care may need to be reviewed.
Effects of finasteride and bicalutamide on prostatic blood flow in the rat
Authors: Lekås E. , Bergh A. , Damber J.‐E. 
Published: March 2003

ObjectiveTo determine whether finasteride and bicalutamide, both currently used in the clinical management of patients with prostate diseases because they have anti‐androgenic properties, have any effects on prostatic blood flow in a rat prostate model, as androgens are known to be involved in the regulation of prostatic blood flow and angiogenesis. Materials and methodsBoth finasteride and bicalutamide were supplied as oral suspensions in water and given daily to rats for 7 days by tube feeding. Blood flows to the ventral and dorsal prostates, and to the kidneys, were measured using the radioactive microsphere technique. In the bicalutamide experiments, some rats were treated with the Leydig cell toxin ethane dimethane sulphonate (EDS), to obtain a castration‐like effect, and one group of these rats received testosterone. ResultsFinasteride induced a clear decrease in blood flow to the ventral and dorsal prostates after 7 days of treatment, with no significant changes in blood pressure or kidney blood flow. Bicalutamide inhibited the testosterone‐induced increment of prostatic blood flow observed in EDS‐treated animals. ConclusionsFinasteride, a blocker of 5α‐reductase, decreases prostate blood flow after 7 days of administration. The response was slower than that after castration, but was of similar magnitude. Blood flow was also decreased after treatment with the androgen‐receptor inhibitor bicalutamide. These observations suggest that prostatic blood flow is increased by dihydrotestosterone, and that the androgen receptor is responsible for mediating this effect.
Treatment of symptomatic benign prostatic hyperplasia with β‐sitosterol: an 18‐month follow‐up
Authors: Berges R.R. , Kassen A. , Senge T. 
Published: March 2003

Objectives
To determine the long‐term effects of phytotherapy with β‐sitosterol (the trade name for β‐sitosterol used in this study is Harzol®) for symptomatic benign prostatic hyperplasia (BPH). Patient and methods
At 18 months after enrolment in a 6‐month multicentre double‐blind placebo‐controlled clinical trial with β‐sitosterol (reported previously), patients were re‐evaluated using the modified Boyarsky score, the International Prostate Symptom Score and quality‐of‐life index, the maximum urinary flow rate (Qmax) and postvoid residual urine volume (PVR). In this open extension of the original trial (after 6 months of treatment or placebo), patients were free to chose their further treatment for BPH. Results
In all, 117 patients (59%) were eligible for analysis during the follow‐up. Of the formerβ‐sitosterol group, 38 patients who continued β‐sitosterol treatment had stable values for all outcome variables between the end of the double‐blind study and after 18 months of follow‐up. The 41 patients choosing no further therapy had slightly worse symptom scores and PVR, but no changes in Qmax. Of the former placebo group, 27 patients who started β‐sitosterol after the double‐blind trial improved to the same extent as the treated group for all outcome variables. The 18 patients choosing no further therapy showed no signs of improvement. Conclusion  The beneficial effects of β‐sitosterol treatment recorded in the 6‐month double‐blind trial were maintained for 18 months. Further clinical trials should be conducted to confirm these results before concluding that phytotherapy with β‐sitosterol is effective.
Would prostate cancer detected by screening withprostate‐specific antigen develop into clinical cancer if left undiagnosed? A comparison of two population‐based studies in Sweden
Authors: Hugosson J. , Aus G. , Becker C. , Carlsson S. , Eriksson H. , Lilja H. , Lodding P. , Tibblin G. 
Published: March 2003

Objective To assess the risk of over‐diagnosing and over‐treating prostate cancer if population‐based screening with serum prostate‐specific antigen (PSA) is instituted.Patients and methods From a serum bank stored in 1980, PSA was analysed in 658 men with no previously known prostate cancer from a well‐defined cohort from Göteborg, Sweden (men born in 1913); the incidence of clinical prostate cancer was registered until 1995. From the same area, and with the same selection criteria, another cohort of 710 men born in 1930–31, who in 1995 accepted an invitation for PSA screening, was also analysed.Results Of men born in 1913, 18 (2.7%) had died from prostate cancer and the cumulative probability of being diagnosed with clinical prostate cancer was 11.1% (5.0% in those with a PSA level of < 3 ng/mL vs 32.9% in those with a PSA level of > 3 ng/mL, P < 0.01). The mean lead‐time from increased PSA (> 3 ng/mL) to clinical diagnosis was 7 years. The prostate cancer detection rate in men born in 1930–31 was 4.4% (22% among those with increased PSA levels) and 30 of 31 detected cancers were clinically localized.Conclusions Screening and sextant biopsies resulted in a lower detection rate (22%) than the cumulative risk of having clinical prostate cancer (33%) in men with increased PSA levels, indicating that under‐diagnosis rather than over‐diagnosis is the case at least with ‘one‐time’ screening. Even if the stage distribution in screening‐detected cancers seems promising (and thus may result in reduced mortality) it is notable that screening 67‐year‐old men will result in treatment a mean of 7 years before clinical symptoms occur and only one in four men anticipated to develop prostate cancer will die from the disease within 15 years. Large randomized screening trials seem mandatory to further explore the benefits and hazards of PSA screening.
Effects of androgen and ageing on gene expression of vasoactive intestinal polypeptide in rat corpus cavernosum
Authors: Shen Z.J. , Lu Y.L. , Chen Z.D. , Chen F. , Chen Z. 
Published: March 2003

Objective To clarify the effects of androgens (testosterone and dihydrotestosterone, DHT) and ageing on gene expression of vasoactive intestinal polypeptide (VIP), assessed as the expression of VIP mRNA, in rat corpus cavernosum. Materials and methods The study comprised 160 male Sprague Dawley rats divided into group A (56 rats, 5 weeks old), group B (50 rats, 10 weeks old) and group C (54 rats, 58 weeks old). Groups A–C were subdivided, respectively, into subgroups 1 (intact controls), 2 (castrated), 3 (castrated but given testosterone undecanoate 25 mg/kg per month by intramuscular injection), 4 (castrated with testosterone undecanoate 50 mg/kg per month) and 5 (treated with finasteride 4.5 mg/kg per day, orally). At 4 and 10 weeks after these treatments half the rats were killed. Serum samples were taken for the measurement of total and free testosterone and DHT, using a radioimmunoassay. Penile samples (corpus cavernosum) were frozen in liquid nitrogen and stored at −80°C. VIP mRNA was estimated using a semi‐quantitative reverse‐transcription polymerase chain reaction. Results There was no significant difference in VIP mRNA in rat corpus cavernosum between intact control and castrated subgroups, or subgroups treated with finasteride, in groups A–C, including both the 4‐ and 10‐week old animals (P > 0.05). Penile VIP mRNA was unchanged at any dose of testosterone in the castrated subgroups in all groups (P > 0.05). There was no significant relationship between penile VIP mRNA and ageing (P > 0.05). Conclusions The gene expression of VIP in rat corpus cavernosum is independent of androgens (testosterone and DHT) and ageing. Androgens probably induce penile erection by pathways other than VIP; ageing may have little effect on penile VIP mRNA.