bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overexpression of RhoA mRNA is associated with advanced stage in testicular germ cell tumour
Authors: Kamai T. , Arai K. , Tsujii T. , Honda M. , Yoshida K. 
Published: March 2003

Objective To clarify the role of Rho small GTP‐binding protein (Rho) in the progression of testicular germ cell tumour (GCT), by examining the expression levels of mRNAs of Rho genes in testicular GCT. Patients and methods The mRNA levels of the RhoA, RhoB and RhoC genes were analysed in the surgical specimens of testicular GCT tissues from 45 consecutive Japanese patients, and in the corresponding unaffected tissue originating from the same patient, using reverse transcription‐polymerase chain reaction. The expression levels in tumour tissues were compared with those in unaffected tissues and the relationship between their expression levels in tumours and tumour stage evaluated. The expression levels of mRNAs of the Rho genes were also evaluated between tumours with seminoma only, and mixed tumours with seminoma and nonseminoma. Results The mRNA levels of RhoA were greater in tumour tissues than in unaffected tissues of the resected testis (P < 0.01); the mRNAs of RhoB and RhoC were not detected in either tissue. The increase in RhoA mRNA levels was related to tumour stage (P < 0.05). The mRNA levels of RhoA in seminomatous and nonseminomatous areas where both were present were higher than those in tumours with seminoma only (P < 0.05). Conclusions These results suggest that RhoA is involved in testicular germinal epithelial carcinogenesis and progression in testicular GCT, indicating that RhoA may be a useful prognostic marker for progression in testicular GCT.
Outpatient ureteric procedures: a new method for retrograde ureteropyelography and ureteric stent placement
Authors: Mcfarlane J.P. , Cowan C. , Holt S.J. , Cowan M.J. 
Published: March 2003

Objective To evaluate a new method for retrograde ureteropyelography and retrograde ureteric stent placement. Patients and methods Procedures were undertaken using a flexible cystoscope and digital C‐arm fluoroscopy in outpatients under sedoanalgesia. The flexible cystoscope was used to identify the ureteric orifice and a straight 0.9 mm hydrophilic guidewire inserted and passed into the renal pelvis under fluoroscopic guidance. A 4 F general‐purpose catheter was then passed over the wire and ureteropyelography performed. To place the stent the hydrophilic guidewire was exchanged for an ultra‐stiff wire, over which the stent was passed directly. Results Over a 47‐month period, 723 procedures were carried out in 472 patients. The clinical indications were ureteric obstruction in 229 (32%), stone disease in 165 (23%), unexplained hydronephrosis in 150 (21%), haematuria in 94 (13%) and others in 85 (12%). Of the 723 procedures, 643 (89%) were technically successful. Failure was most commonly caused by failure to cannulate the ureteric orifice (51, 7%). Just over half the procedures (366, 51%) involved stent placement or replacement. Immediate complications occurred in 17 patients (3%). Of those who were questioned, 94% (282 of 300) reported the procedure to be acceptable. Conclusion Retrograde ureterography and ureteric stent placement may be satisfactorily undertaken with the patient under sedoanalgesia on an outpatient basis. This technique can reduce costs, hospital admissions, general anaesthetic use, demands on theatre time and complication rates.
The information required by patients with early‐stage prostate cancer in choosing their treatment
Authors: Feldman‐stewart D. , Brundage M.D. , Nickel J.C. , Mackillop W.J. 
Published: March 2003

Objective To determine the information that men diagnosed with early‐stage prostate cancer think is necessary to choose their treatment (surgery, radiotherapy or ‘watchful waiting’). Patients and methods All men diagnosed with early‐stage prostate cancer in a regional urology practice in an 18‐month period were surveyed. Respondents considered the treatment decision for a specific hypothetical case and judged whether each of 59 specific information items would be ‘necessary’ to know to make the treatment decision. Respondents provided basic demographic information (age, education and marital status). Results Of 89 patients, 71 (80%) responded; the mean (sd, range) number of items that individual respondents identified as necessary was 32 (12, 9–58). Each item was considered necessary by 54 (18, 20–93)% of respondents. Of the 59 items, only five were necessary to  80% of respondents; 23 were necessary to  67% of respondents and five were not necessary to  67% of respondents. Patients were divided about the remaining 31 items. There were no strong correlations (none accounted for > 20% of the variance) between the responses and demographic characteristics. Conclusions There appears to be large variation among patients with early‐stage prostate cancer in the number of information items deemed necessary to make a treatment decision, and little agreement on the need for most individual items. Demographic characteristics were not useful as predictors of the information needs of each patient. The process of informing patients with early‐stage prostate cancer (and their decision aids) needs to be flexible and able to accommodate a wide range of patients' information needs.
Treatment of Peyronie's disease with local interferon‐α 2b
Authors: Brake M. , Loertzer H. , Horsch R. , Keller H. 
Published: March 2003

Objective To evaluate the efficacy of subcutaneous interferon‐α 2b in the treatment of Peyronie's disease. Patients and methods Twenty‐three men (mean age 53 years, range 27–69) received interferon‐α 2b in an unrandomized prospective study. The drug was injected subcutaneously adjacent to the plaque three times a week for 3 weeks at a dose of 2 × 106 IU. The effect of interferon‐α 2b on the extent of penile deviation, plaque size and erectile pain were investigated, and the drug's side‐effects were documented. The mean (range) follow‐up was 22 (4–48) months Results All patients had pain relief and 13 of 19 with pain before treatment became pain‐free. The penile deviation was reduced in one patient; the deviation increased despite therapy in one patient and remained stable in the others. Plaque size remained unchanged in all patients. Impaired sexual function was improved in seven (30%) of the patients. Side‐effects (myalgia, fever) occurred after only four of 207 injections (2%). Conclusions Subcutaneous interferon‐α 2b is safe, well tolerated and relieves pain. However, with no objective reduction in penile deviation and plaque size, the outcome of interferon‐α 2b therapy is generally unconvincing and the drug cannot be recommended for the conservative treatment of Peyronie's disease.
Are dietary influences on the risk of prostate cancer mediated through the insulin‐like growth factor system?
Authors: Mucci L.A. , Tamimi R. , Lagiou P. , Trichopoulou A. , Benetou V. , Spanos E. , Trichopoulos D. 
Published: March 2003

Objectives To investigate whether dietary factors that appear to affect the risk of prostate cancer may be similarly associated with serum levels of insulin‐like growth factor 1 (IGF‐1). Patients and methods In the context of a case‐control study, 112 men were admitted to three teaching hospitals in Athens, Greece, for disorders other than cancer. Sociodemographic data and detailed histories of smoking, alcohol and coffee consumption were recorded. A validated food‐frequency questionnaire was administered by an interviewer and serological measurements of IGF‐1 and its binding protein‐3 conducted. Results IGF‐1 declined significantly by almost 25% among men aged >75 years and there was a small reduction in IGF‐1 levels with increased alcohol intake, with a mean (95% confidence interval, CI) change of −1.6 (− 2.2 to −0.9)% for an increment of one drink per day. There was no evidence for an effect of either smoking or coffee consumption on IGF‐1 level. Among foods, the consumption of cooked tomatoes was substantially and significantly inversely associated with IGF‐1 levels, with a mean (95% CI) change of −31.5 (− 49.1 to −7.9)% for an increment of one serving per day. Conclusions The strongest known dietary risk factor for prostate cancer (lycopene deficit, as reflected in a reduced intake of cooked tomatoes) and an important endocrine factor in the aetiology of this disease (IGF‐1) seem to be related in a way that suggests that at least one, and perhaps more, exogenous factors in the development of prostate cancer may be mediated through the IGF‐1 system.
Computerized contrast angiosonography:a new diagnostic tool for the urologist?
Authors: Reichelt O. , Wunderlich H. , Weirich T. , Schlichter A. , Schubert J. 
Published: March 2003

Objectives To evaluate the diagnostic potential of echo‐enhanced ultrasonography (US) for depicting the vascularization pattern of renal cell carcinoma (RCC), and calculating the first‐pass effect using harmonic imaging, against that obtained by triphasic helical computed tomography (CT). Patients and methods Sixty patients with surgically confirmed RCC underwent US using B‐mode and power Doppler methods with or without an intravenous microbubble echo‐enhancing agent. After depicting and defining the tumour extent by B‐mode US, the first‐pass effect/enhancement by the echo‐enhancing agent within the lesion, and that of a reference area of unaffected renal cortex, were recorded on‐line by calculating the mean pixel intensity. Time‐intensity curves, i.e. the rise time and gradient of both the suspected tumour and reference areas, were constructed. Results Using B‐mode US, the extent of all tumours was delineated (mean tumour size 3.8 cm, sd 0.6). After applying the microbubble agent all tumours were enhanced, whereas the perfusion was decreased (in 48%), increased (in 16%) or similar (in 36%) compared with the cortical reference area. Using the Hounsfield classification, these results correlated well with the hypo/hypervascularity shown on CT. Conclusion Ultrasonography has considerable potential in diagnosing RCC, if combined with echo‐enhancing methods, harmonic imaging and computer‐based calculation of tumour vascularization. Dynamic US studies should provide a diagnostic yield similar to that of CT.
Factors causing variation in urinary N‐nitrosamine levels in enterocystoplasties
Authors: Woodhams S.D. , Greenwell T.J. , Smalley T. , Mundy A.R. 
Published: March 2003

Objective To establish the presence or absence of any diurnal or long‐term variation in N‐nitrosamine levels (which might be important in the development of cancer in enterocystoplasties) in enterocystoplasty urine, and to assess other factors that might alter enterocystoplasty N‐nitrosamine levels. Patients, subjects and methods Thirty‐six patients with enterocystoplasties and six normal controls were assessed. Urine samples were collected every 4 h over a 24‐h period and N‐nitrosamine levels determined using a modification of the Pignatelli method. An additional urine sample was assessed by microscopy, culture and sensitivity. In a subgroup of 16 patients with an enterocystoplasty, the urinary N‐nitrosamine levels were re‐measured at 3‐monthly intervals. Results No diurnal or long‐term variation in urinary N‐nitrosamine levels was identified. The mean N‐nitrosamine levels were significantly higher in the cystoplasty group than in the controls (1.7 vs 1.0 µmol/L; P = 0.008). Mean N‐nitrosamine levels were also significantly higher in enterocystoplasty patients with sterile pyuria than in those with no pyuria (P = 0.01). Those taking prophylactic antibiotics had significantly lower mean N‐nitrosamine levels than those not doing so (P = 0.05). Individuals with infected urine and those needing to intermittently catheterize had higher N‐nitrosamine levels than their counterparts, but this difference was not significant. Conclusion There were no diurnal or long‐term variations in urinary N‐nitrosamine levels. Levels were consistently higher in patients with inflamed or infected cystoplasties, those using intermittent self‐catheterization and those not taking antibiotic prophylaxis.
A systematic review of intravesical bacillus Calmette‐Guérin plus transurethral resection vs transurethral resection alone in Ta and T1 bladder cancer
Authors: Shelley M.D. , Kynaston H. , Court J. , Wilt T.J. , Coles B. , Burgon K. , Mason M.D. 
Published: March 2003

Objective To assess, in a systematic review, the effectiveness of intravesical bacillus Calmette‐Guérin (BCG) in preventing tumour recurrence in patients with medium/high risk Ta and T1 bladder cancer. Patients and methods An electronic database search of Medline, Embase, DARE, the Cochrane Library, Cancerlit, Healthstar and BIDS was undertaken, plus hand searching of the Proceedings of ASCO, for randomized controlled trials, in any language, comparing transurethral resection (TUR) alone with TUR followed by intravesical BCG in patients with Ta and T1 bladder cancer. Results The search identified 26 publications comparing TUR with TUR + BCG. Six trials were considered acceptable, representing 585 eligible patients, 281 in the TUR‐alone group and 304 in the TUR + BCG group. The major clinical outcome chosen was tumour recurrence. The weighted mean log hazard ratio for the first recurrence, taken across all six trials, was −0.83 (95% confidence interval −0.57 to −1.08, P < 0.001), which is equivalent to a 56% reduction in the hazard, attributable to BCG. The Peto odds ratio for patients recurring at 12 months was 0.3 (95% confidence interval of 0.21–0.43, P < 0.001), significantly favouring BCG therapy. Manageable toxicities associated with intravesical BCG were cystitis (67%), haematuria (23%), fever (25%) and urinary frequency (71%). No BCG‐induced deaths were reported. Conclusion TUR with intravesical BCG provides a significantly better prophylaxis of tumour recurrence in Ta and T1 bladder cancer than TUR alone. Randomized trials are still needed to address the issues of BCG strain, dose and schedule, and to better quantify the effect on progression to invasive disease.
Treatment of primary monosymptomatic nocturnal enuresis with desmopressin: predictive factors
Authors: Kruse S. , Hellström A.L. , Hanson E. , Hjälmås K. , Sillén U. 
Published: March 2003

Objective To investigate predictive factors for the outcome of treatment of primary monosymptomatic nocturnal enuresis (PMNE) with desmopressin. Patients and methods Data from a large open multicentre study were analysed. The study comprised 399 children with PMNE who were recruited for long‐term desmopressin treatment. Before treatment a history was taken and the children observed for 4 weeks. After a 6‐week dose‐titration period with desmopressin, the children were classified into four groups depending on the response rate. Results The children who improved during desmopressin treatment were older, had fewer wet nights during the observation period and had only one wet episode during the night, mostly after midnight. Many of them did not require the maximum dose of desmopressin to become dry. No hereditary factor for the response to desmopressin was found. Conclusion Those most likely to be permanently dry with desmopressin treatment are older children who respond to 20 µg desmopressin and who do not wet frequently.
Capsaicin effectively prevents apoptosis in the contralateral testis after ipsilateral testicular torsion
Authors: Sarioglu‐Buke A. , Erdem S. , Gedikoglu G. , Bingol‐Kologlu M. , Tanyel F.C. 
Published: March 2003

Objective To evaluate the effect of afferent nerve blockage by administration of capsaicin on apoptotic changes in the contralateral testis in rats undergoing ipsilateral testicular torsion. Materials and methods Twenty male albino rats were randomly divided into four groups. In groups 1 and 2, rats underwent a sham operation and testicular torsion, respectively, after the intraperitoneal administration of 0.9% NaCl. Similarly, in groups 3 and 4 the rats underwent a sham operation and testicular torsion, respectively, after an intraperitoneal capsaicin injection. The testes were untwisted 24 h later and the contralateral testes harvested. Apoptosis was assessed in paraffin‐embedded sections stained for nuclear DNA fragmentation. Fifteen cells were counted in each seminiferous tubule and the apoptotic cells recorded. A score was calculated for each group and the results compared using the Kruskal‐Wallis analysis of variance and Mann Whitney U‐tests, with P < 0.05 considered to be significant. Results The mean apoptotic score of group 2 was significantly higher than that of the other groups. There was no difference between the apoptotic scores of groups 1 and 3, 1 and 4, and 3 and 4. Conclusion Capsaicin effectively prevented apoptosis in the contralateral testes of rats that had undergone testicular torsion.
Photodynamic therapy for superficial bladder cancer under local anaesthetic
Authors: Shackley D.C. , Briggs C. , Gilhooley A. , Whitehurst C. , O'Flynn K.J. , Betts C.D. , Moore J.V. , Clarke N.W. 
Published: March 2003

Objectives To evaluate the use of local anaesthesia (LA) in 5‐aminolaevulinic acid (ALA) photodynamic therapy (PDT) for superficial transitional cell carcinoma (TCC) of the bladder, and to provide further toxicity and tolerability data on this new method within the context of a phase 1 trial. Patients and methods ALA PDT was administered to 19 patients with recurrent superficial TCC (stage Ta/carcinoma in situ, grades 1–3) using escalating doses of ALA (3–6%) and 633 nm laser light (25–50 J/cm2) under various LA (lignocaine) protocols. Pain was assessed using a linear analogue scale from 0 to 10. The endpoints of tolerability and toxicity were assessed for the different LA, light and ALA doses, with lignocaine levels. Results ALA PDT is painful and requires some form of anaesthesia. The discomfort was immediate, associated with bladder spasm, and was a function of the ALA concentration rather than the total light dose given. Simple passive diffusion (PD) of 2% lignocaine instilled for 40 min before PDT gave adequate anaesthesia with 3% ALA (n=8; median pain score 1, range 0–2). With 6% ALA the pain was dramatically increased using PD (n=6; median pain score 8, range 5–10) and therefore the more potent LA technique of electromotive drug administration (EMDA) of 2% lignocaine was used, with excellent results (n=3; median pain score 1, range 0–2). All patients had transient bladder irritability that typically lasted 9–12 days, with no subjective/objective change in long‐term bladder function. No other toxicity was reported. Serum lignocaine levels were minimal. Conclusion Bladder ALA PDT is both safe and feasible under LA. At a dose of 3% ALA, the procedure was well‐tolerated using PD of lignocaine. At higher doses (6% ALA) more effective anaesthesia is required and this can be obtained satisfactorily with EMDA of lignocaine. With refinement, ALA PDT may be feasible as an outpatient treatment for superficial bladder TCC.
A preliminary report on a patient‐preference study to compare treatment options in early prostate cancer
Authors: Uro‐oncology Group The North West 
Published: March 2003

Objectives To prospectively record prognostic factors, quality‐of‐life and outcome data in a patient‐preference controlled study comparing radical prostatectomy with radical radiotherapy for the treatment of early prostate cancer. Patients and methods All patients suitable for radical treatment of early prostate cancer were identified and provided with information from a urologist, oncologist and nurse to allow them to choose a treatment option. Prognostic and demographic data were recorded for all patients and patients followed up uniformly, with the additional collection of quality‐of‐life data. Results In a 38‐month period, 196 patients were recruited to the trial; of these, 81 chose surgery, 81 radiotherapy, 30 brachytherapy and four ‘watchful waiting’. The distribution of acknowledged prognostic factors was similar between the groups. Conclusion If patient preference continues to divide this population into roughly equal and comparable arms, it should be possible to answer the underlying questions on the treatment of early prostate cancer using this study design.
The quality of life in men after radical cystectomy with a continent cutaneous diversion or orthotopic bladder substitution: is there a difference?
Authors: Månsson Å. , Davidsson T. , Hunt S. , Månsson W. 
Published: March 2003

Objective  To compare the quality of life (QoL) in men after radical cystectomy who had either a continent cutaneous diversion or orthotopic bladder substitution. Patients and methods  Eighty men with at least 6 months of follow‐up and with no signs of recurrent disease after radical cystectomy for bladder carcinoma, and who had either a continent cutaneous diversion or orthotopic bladder substitution, were sent two types of questionnaire, the Functional Assessment of Cancer Therapy–Bladder Cancer (FACT‐Bl) and the Hospital Anxiety and Depression Scale (HADS), to determine their QoL. Results

The FACT‐Bl and HADS questionnaires were returned by 90% and 71% of the patients, respectively (
P

< 0.05). In the replies to the generic version of FACT‐Bl there were no differences between the groups in any domain, the scores being high in all. In questions covering intestinal, urinary and sexual items, patients with continent diversion had less trouble controlling urine (
P

< 0.0001), had to empty less often (
P

< 0.001), and had fewer symptoms when emptying (
P

< 0.05). Patients with neobladders had a better appreciation of appearance and better preserved erectile function (both
P  < 0.05). In the answers to the HADS, the mean scores were low (within the normal ranges) and did not differ between the groups. Conclusion  Using two instruments tested for validity and reliability, there were no differences between patients with continent diversion and those with orthotopic substitution.
Effects of dimethyl sulphoxide and heparin on stretch‐activated ATP release by bladder urothelial cells from patients with interstitial cystitis
Authors: Sun Y. , Chai T.C. 
Published: March 2003

Objective  To determine whether dimethyl sulphoxide (DMSO) and heparin reduce the greater stretch‐activated ATP release in interstitial cystitis (IC), as ATP serves as a nocio‐neurotransmitter in the bladder, and thus explain their beneficial effects in patients with IC (a disease characterized by hypersensory bladder symptoms). Materials and methods  Bladder epithelia in IC release more ATP in response to stretch than do control samples. Both DMSO and heparin are used intravesically to treat IC; such agents can modulate urothelial function because they directly contact bladder urothelium. Biopsies taken from patients with IC and from control subjects were grown in primary cultures using established cell‐culture techniques. Cultured urothelial cells were stretched with the Flexcell device (Flexcell International Corp., McKeesport, PA, USA) and supernatant ATP was measured, using a luciferin‐luciferase assay. DMSO (0.1%, 0.5% and 1%) or heparin (50, 200, 800 and 1600 U) was added to the cells at the start of the stretch experiments and the ATP released into the supernatant measured. Cell viability was also determined using Trypan Blue staining. Results  IC cells released significantly more ATP in response to stretch than did control cells. This increased release of ATP by stretched IC cells was significantly blocked by adding DMSO or heparin at all concentrations used. Heparin appeared to have a greater dose‐dependent effect on ATP release than did DMSO. Conclusions  These findings are consistent with the hypothesis that the urothelium provides sensory input via ATP release and that this process is increased in IC. Furthermore, stretch‐activated ATP release was blocked by adding DMSO and heparin, both intravesical agents commonly used to treat the symptoms of IC. This study supports the notion that purinergic‐targeted therapy is warranted in treating IC. Further studies are needed to determine the mechanisms of increased ATP release by IC urothelial cells.