bluuebunny/crossref_metadata_2025_split huggingface dataset:
The evaluation of sympathetic system‐related contractile activity of the rat vas deferens after ligation and intra‐abdominal placement of the testis
Authors: Türken  , Yenisehirli  , Onur  , Tanyel  
Published: March 2003

ObjectiveTo evaluate the contractile response of the vas deferens in a model of stress, to determine any changes in sympathetic activity as a result of stress in the ipsilateral testis, which decreases blood flow to the contralateral testis.Materials and methodsThe study comprised two groups of six rats each; group 1 underwent a sham operation, and in group 2 the right testis was placed into the abdominal cavity and the vas deferens ligated. After 30 days, the vasa deferentia were resected bilaterally and their isometric contractions recorded. Electrical‐field stimulation (EFS) was applied through a pair of platinum electrodes and concentration‐response curves constructed for noradrenaline at 37°C and to a solution containing 80 mmol/L K+ .ResultsThe vasa deferentia in both groups showed similar contractile responses to EFS, which were frequency‐dependent and maximal at 80 Hz. Noradrenaline‐induced contractile activity was lower in amplitude in the vasa deferentia of group 2 than in the contralateral and ipsilateral vasa deferentia of group 1, which were not significantly different from each other. All groups responded similarly to high K+ .ConclusionIntra‐abdominal placement of the testes with vas deferens ligation decreased the contractile response to noradrenaline in the ipsilateral vas deferens without altering the contractile response to EFS and high K+ . This difference could be caused by a reduction in the number of postjunctional α‐adrenergic receptors or decreased receptor sensitivity. Both possibilities suggest that the vas deferens may initiate sympathetic activity, which may be responsible for contralateral testicular deterioration.
A double‐blind, randomized, controlled multicentre study to compare the efficacy of ciprofloxacin with pivampicillin as oral therapy for epididymitis in men over 40 years of age
Authors: Eickhoff  , Frimodt‐Møller  , Walter  , Frimodt‐Møller  
Published: March 2003

Objective To compare the efficacy and safety of ciprofloxacin 500 mg orally twice daily with pivampicillin 700 mg orally twice daily for 10 days in men with acute epididymitis and over 40 years of age.Patients and methodsThe study comprised 172 men who entered a prospective, controlled, randomized, double‐blind, trial of pivampicillin and ciprofloxacin. The median (range) age of the 158 patients eligible for the efficacy analysis was 58 (41–85) years; 41% had previously had a urinary tract infection and 27% had previously had epididymitis. Only one patient had a urethral catheter and 38% were sexually active. About half of the patients were admitted to hospital.ResultsNo bacteria could be cultured from samples in 53% of the patients; Escherichia coli could be cultured from 35% and the remaining isolates were the expected urinary pathogens. None of the patients had Gonococci and only one in each group had Chlamydia. Mycoplasma hominis was detected in three patients only and M. genitalium was detected in three, while Ureaplasma was detected in 24 (15%). The treatment failed in 48 patients; in 15 of 76 (20%) receiving ciprofloxacin andin 33 of 82 (40%) receiving pivampicillin. This corresponds to a reduction in the risk of failure of 20.5% (95% confidence limits 6.6–40.2%, P=0.006). The principal cause of failure was an unsatisfactory clinical response requiring changed antibiotic treatment in 27 patients; adverse events were responsible for failure in 14. The in vitro resistance of cultured bacteria was low in both groups, at ≈4%. Adverse events, mainly gastro‐intestinal, occurred in 17 of 83 (21%) patients starting on ciprofloxacin and in 33 of 89 (37%) receiving pivampicillin (P=0.04).ConclusionFor epididymitis in men over the age of 40 years ciprofloxacin 500 mg orally twice daily is more effective than pivampicillin 700 mg orally twice daily. Furthermore, ciprofloxacin has a lower incidence of adverse events.
Testicular prostheses: body image and sexual functioning
Authors: Incrocci  , Bosch  , Slob  
Published: March 2003

ObjectivesTo evaluate retrospectively the body image and sexual functioning in patients who have a testicular prosthesis (TP).Patients and methodsThe medical charts were evaluated for 30 adult patients who received 32 TPs between 1985 and 1997. A questionnaire was mailed to each patient, asking about body image, satisfaction with the implant and with sexual functioning.ResultsOf the 30 patients, 22 (73%) replied; their mean (range) age was 30 (18–47) years. Most of the patients had a silicone gel‐filled TP. No complications were reported in 25 (83%) patients and 80% reported no sexual problems; 20% felt uncomfortable in intimate contacts, 68% found their body image improved after having a TP, 58% were satisfied with their current sexual life, 90% had no erectile dysfunction and 45% reported premature ejaculation.ConclusionsPatients who have lost a testis for any reason should be informed about the availability of a TP. Prostheses were well accepted and no systemic disease was reported. Almost all patients reported an improvement in their body image. Sexual life and performance were apparently not compromised by having a TP. New surgical procedures are recommended to improve the cosmetic appearance of a TP in the scrotum.
Tubularization of the incised urethral plate (Snodgrass procedure) for primary hypospadias surgery
Authors: Sugarman I.D. , Trevett J. , Malone P.S. 
Published: March 2003

ObjectiveTo evaluate the Snodgrass procedure for patients with hypospadias who have not undergone previous surgery and whose urethral plate is too narrow for tubularization alone.Patients and methodsThirty‐two boys (mean age 18 months) underwent primary hypospadiac surgery performed by one surgeon (P.S.M.). Twenty‐five boys had a distal hypospadias (coronal, subcoronal) and seven had a more proximal defect (penile shaft, penoscrotal). The operation involved incision of the urethral plate, which was then tubularized (Snodgrass procedure). The neourethra was then covered with a de‐epithelialized pedicled dartos flap from the inner prepuce before glans and skin closure.ResultsWith a mean follow‐up of 10 months (range 2–14) there were two complications; one child with a coronal hypospadias developed a fistula whist one with a penile shaft defect had complete breakdown of the neourethra. The cosmetic appearance in the other 30 patients is that of a normal slit‐like terminal meatus.ConclusionTubularization of the incised urethral plate is a safe advance in the surgery of hypospadias. We recommend it for both distal and proximal defects, in patients where the urethral plate is insufficient for tubularization alone.
Analysis of the biological properties and use of comparative genomic hybridization to locate chromosomal aberrations in the human testicular seminoma cell line JKT‐1 and its highly metastatic cell line JKT‐HM
Authors: Jo  , Kinugawa  , Matsuki  , Morioka  , Tanaka  
Published: March 2003

ObjectiveTo examine the biological properties, and utility of comparative genomic hybridization (CGH) to locate chromosomal aberrations, in a new human testicular seminoma cell line, JKT‐1, and a highly metastatic cell line, JKT‐HM, developed as an animal model of spontaneous metastasis.Materials and methodsJKT‐HM was isolated by transplanting cells of JKT‐1 into the dorsal skin of nude mice, using methods developed previously. The biological properties of JKT‐1 and JKT‐HM cells were examined using assays of cell proliferation and in vitro tumour cell invasion, and the DNA index (by flow cytometry). CGH was used to analyse chromosomal aberrations and to detect chromosomal regions causing metastasis in the testicular seminoma cell lines.ResultsThe JKT‐1 and JKT‐HM cells showed no difference in morphology or cell proliferation. After transplanting JKT‐HM into mice, the cells metastasized to the lung and lymph nodes in all five mice by 50 days. The in vitro tumour cell invasion and animal assays suggested potential invasion and metastasis of JKT‐HM. The DNA index was 1.48 for JKT‐1 and 1.50 for JKT‐HM. CGH analysis revealed various chromosomal aberrations undetected by examining their karyotypes, e.g. loss of 18p, Yq and gain of Xq, and the technique has potential to detect genetic aberrations related to metastasis in this model.ConclusionsThe two cell lines JKT‐1 and JKT‐HM, and the metastatic animal model used, were useful in studying human testicular seminoma and the metastatic behaviour of cancer. In addition, CGH was useful for analysing the chromosomes of two different cell lines derived from the same parent line.
Treating men with predominantly nonpsychogenic erectile dysfunction with intracavernosal vasoactive intestinal polypeptide and phentolamine mesylate in a novel
Authors: Dinsmore  , Gingell  , Hackett  , Kell  , Savage  , Oakes  , Frentz  
Published: March 2003

ObjectiveTo study the effect of intracorporeal injection (IC) of vasoactive intestinal polypeptide (VIP) and phentolamine mesylate (PM) on men with erectile dysfunction (ED) of nonpsychogenic aetiology.Patients and methodsThe study comprised 236 men with primarily nonpsychogenic ED attending sexual dysfunction clinics at eight institutions. In an initial dose‐assessment phase, the men were given IC injections of 25 μg VIP combined with PM 1.0 mg (VIP/P‐1) or 2.0 mg (VIP/P‐2) in a prefilled, single‐use auto‐injector. The main aetiologies of ED were arteriogenic (38), diabetes mellitus (DM) (39), neurogenic (35), mixed (90), and venous leakage (30). In a placebo‐controlled phase, 171 patients were subsequently treated and self‐administered up to 12 injections over a 6‐month interval.ResultsIn the dose‐assessment phase there was an overall response rate of 82%, with responses by aetiology as follows: arteriogenic (82%), DM (85%), neurogenic (86%), mixed (80%), and venous leakage (77%). In a subgroup of 159 patients who withdrew from previous IC therapies for ED, 64% responded with an erection suitable for intercourse. Of the 171 patients treated in the placebo‐controlled phase, 75% responded to VIP/P‐1 and 12% to placebo (P<0.001); 66% responded to VIP/P‐2 and 18% to placebo (P<0.001), with a median duration of erection of 56 min. The principal adverse event was transient facial flushing accompanying 40% of 1711 injections. There was no pain after injection and one episode of priapism (0.06%); only seven patients withdrew because of adverse events. Over 88% and 92% of patients were satisfied with the drug and auto‐injector, respectively. More than 85% of patients and 77% of partners reported an improved quality of life.ConclusionThe combination of VIP and PM at the dose used is a safe and effective means of treating male ED of primarily nonpsychogenic aetiology.
Prostate specific antigen is detectable in formalin‐fixed semen
Authors: Eyre  , Yin  , Kiessling  
Published: March 2003

ObjectiveTo conduct a pilot study to test whether or not prostate specific antigen (PSA) and/or PSA‐positive cells can be detected and characterized in semen specimens archived in aldehyde fixative.Materials and methodsSpecimens from 12 men were examined, six before elective vasectomy and six undergoing infertility evaluation. Fixed semen elements were assessed immunocytologically using monoclonal antibodies against PSA and leucocyte common antigen, CD 45, as a control.ResultsPSA was detectable in the semen from the fertile men as amorphous protein and contained within round vesicles (prostasomes). Semen from men undergoing infertility evaluation contained a greater variation in detectable forms and amount of PSA than the specimens from the fertile men, including PSA associated with some nonspermatozoal cells (NSCs).ConclusionPSA is detectable by immunocytological analysis of semen specimens archived in aldehyde‐based fixative. Three forms of PSA were detected; within round vesicles characteristic of prostasomes, associated with some NSCs, and as amorphous protein. The detected variations suggest that analysis of PSA‐positive semen elements may provide important insights into prostate physiology.
Monocyte tissue factor levels in patients with urological tumours: an association between tumour presence and progression
Authors: Lwaleed  , Francis  , Chisholm  
Published: March 2003

ObjectiveTo examine the hypothesis that increased monocyte tissue factor (mTF) levels may reflect urological tumour presence and progression.Patients, subjects and methodsUsing a two‐stage kinetic chromogenic assay, mTF levels were measured in 60 controls (normal subjects [60] and patients awaiting hernia repair or cholecystectomy [60]), patients with benign and malignant disease of the bladder (73), or prostate (81), and in patients with and without recurrent malignant disease of the bladder (30). The levels were assessed under fresh resting conditions (baseline) and after incubation for 6 h without (unstimulated) and with (stimulated) Escherichia coli endotoxin. Each benign disease group was subdivided into inflammatory and non‐inflammatory categories.ResultsPatients with bladder and prostate malignancy showed significantly higher mTF levels than did each control for baseline and stimulated cells. The benign inflammatory groups for both organs had significantly higher mTF levels than had each control for baseline cells. There was no difference between malignant and benign inflammatory groups. Stimulated mTF levels showed better discrimination between the study groups. The mTF levels were associated with histological tumour progression, serum prostate specific antigen level and static bone scan images. Levels were also higher in patients with bladder cancer recurrence than in those with a normal check cystoscopy.ConclusionStimulated mTF levels are raised in malignant and inflammatory disease compared with controls and patients with non‐inflammatory conditions, and give maximal discrimination between these groups. mTF levels showed an association with tumour grade and other markers of tumour progression.
A new staging criterion for bladder carcinoma using gadolinium‐enhanced magnetic resonance imaging with an endorectal surface coil: a comparison with ultrasonography
Authors: Hayashi N. , Tochigi H. , Shiraishi T. , Takeda K. , Kawamura J. 
Published: March 2003

ObjectiveTo evaluate the accuracy of a new staging criterion, submucosal linear enhancement (SLE) on gadolinium‐diethylenetriamine‐pentaacetic acid‐enhanced T1‐weighted magnetic resonance imaging (MRI) using an endorectal surface coil (endorectal enhanced MRI), and to compare the accuracy of this method with that of transurethral ultrasonography (TUUS). Patients and methodsThe study included 71 patients with bladder tumours (63 men and eight women, mean age 65.5 years, range 31–85). The SLE coincided with abundant submucosal vascular beds, as reported in a previous study. When the SLE beneath the tumour maintained continuity, the tumour was diagnosed as superficial ( T1), but if the SLE was interrupted by the tumour, the disease was considered invasive ( T2a). Superficial muscle invasion (less than half the muscle layer) and deep muscle invasion (more than half the muscle layer) were classified as T2a and T2b, respectively. When the tumour formed an extravesical mass, the tumour was classified as T3b. ResultsThe staging accuracy for bladder tumours using SLE on endorectal‐enhanced MRI or TUUS was 83% and 60%, respectively (P < 0.01). Using the SLE, muscle invasion of bladder tumour was diagnosed with an accuracy of 87%, a sensitivity of 91% and a specificity of 87%; this was significantly better than with TUUS (P < 0.01). ConclusionThe criterion of SLE on Gd‐DTPA enhanced T1‐weighted MRI using an endorectal surface coil is useful for staging bladder tumour, and the staging accuracy is significantly better than with TUUS.
Evaluation of fine‐needle aspiration cytology for renal masses
Authors: Brierly R.D. , Thomas P.J. , Harrison N.W. , Fletcher M.S. , Nawrocki J.D. , Ashton‐key M. 
Published: March 2003

Objective To evaluate the accuracy and use of fine‐needle aspiration (FNA) cytology for the diagnosis of renal masses because with the improved quality and increasing use of ultrasonography and computed tomography (CT), asymptomatic renal masses, par‐ticularly small (< 5 cm) tumours, are being discovered more frequently. Patients and methods Between 1995 and 1997, 49 patients (mean age 67.5 years, range 42–88, 34 men and 14 women) underwent FNA of a solid or complex cystic mass under radiological guidance. All masses were further evaluated and staged by CT. Solid masses were divided according to size (< 5 cm and  5 cm). Patients were followed up to the determination of a final diagnosis on tissue histology, after nephrectomy where possible. Results Thirty‐six patients had histologically confirmed carcinoma at nephrectomy, and nine had presumed carcinoma (four unfit for surgery, five with advanced malignancy). The remaining four patients had benign diagnoses. FNA produced insufficient sample in eight cases (16%). The sensitivity was 89% for large ( 5 cm) solid masses, 64% for small (< 5 cm) solid masses and 50% for complex cysts. Conclusion FNA does not contribute to the diagnosis of malignancy in large (> 5 cm) masses, as good radiological imaging is nearly always diagnostic. For smaller (< 5 cm) masses and complex cysts, FNA can occasionally confirm malignancy, but lack of diagnostic yield and low sensitivity means that FNA is unreliable as a diagnostic tool and will rarely help in the routine management of these patients.
The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia
Authors: Chen S.‐S. , Hong J.‐G. , Hsiao Y.‐J. , Chang L.S. 
Published: March 2003

ObjectiveTo assess in a prospective study the use of a new variable, the residual prostatic weight ratio (RPWR), for evaluating the clinical outcome after transurethral resection of the prostate (TURP). Patients and methodsFrom April 1996 to June 1997, 40 men (mean age 70.4 years, range 53–85) with symptomatic benign prostatic hyperplasia were evaluated using the American Urological Association (AUA) symptom score, measurements of the mean and maximum urinary flow rate (Qave and Qmax), and by transrectal ultrasonography (TRUS) before and 16 weeks after TURP. The estimated total prostate weight was derived as 0.52 × length × width × height × the specific gravity of the prostate (1.010). The RPWR was calculated as the prostate weight after TURP divided by the initial weight, where the value after TURP was the initial weight minus that of the TURP specimen. The clinical outcome was evaluated by the difference (Δ) in AUA score, Qmax and Qave before and 16 weeks after surgery. ResultsThere was a close correlation between the estimated prostate weight and the actual weight of the TURP specimen (r = 0.82 and 0.80 for the adenoma and total prostate, respectively). The mean (sd) RPWR, ΔAUA score, ΔQmax and ΔQave were 50.1 (17.1)%, 11.5 (5.3), 9.0 (4.2) mL/s and 6.2 (2.9) mL/s, respectively. There was a negative correlation between the RPWR and the ΔAUA, ΔQmax and ΔQave (r = −0.81, −0.68, and −0.70, respectively, P < 0.05). The prostate volume estimated by TRUS decreased significantly 16 weeks after TURP. ConclusionsTRUS is a useful tool for estimating prostate weight before surgery. The smaller the RPWR at 16 weeks after TURP, the better the clinical outcome.
Early experience of intra‐ureteric capsaicin infusion in loin pain haematuria syndrome
Authors: Armstrong T. , Mclean A.D. , Hayes M. , Morgans B.T. , Tulloch D.N. 
Published: March 2003

Objectives To evaluate early results of the intra‐ureteric instillation of capsaicin for the treatment of loin pain haematuria syndrome (LPHS). Patients and methods Ten patients with LPHS were treated using intra‐ureteric capsaicin instillation. A solution of capsaicin was infused into the affected ureter through an embolectomy catheter, under anaesthesia. The success of the treatment was assessed using patient questionnaires and the quantitative reduction in the patients’ analgesic requirements measured. Results During a mean follow‐up of 6 months, six of the 10 patients had short‐ to medium‐term symptomatic relief after one or more treatments; four had no relief from their symptoms. One patient had a mucosal ulceration in the bladder after extravasation of the capsaicin solution. Two patients subsequently underwent simple nephrectomy for symptomatic nonfunctioning kidneys. Conclusion These results are consistent with other preliminary reports of the efficacy of capsaicin treatment in LPHS and such treatment therefore has a definite therapeutic role in this difficult condition. We are uncertain if the treatment contributed to the deterioration of the excised kidneys. This early experience suggests a need for careful consideration when contemplating this treatment, with attention directed to both the initial diagnosis and possibly the technique of capsaicin/instillation. We include a protocol to follow when preparing patients for capsaicin treatment.
An in vitro assessment of the flow characteristics of spiral‐ridged and smooth‐walled JJ ureteric stents
Authors: Stoller M.L. , Schwartz B.F. , Frigstad J.R. , Norris L. , Park J.B. , Magliochetti M.J. 
Published: March 2003

Objective To assess drainage through spiral‐ridged and smooth‐walled JJ ureteric stents (designed to ensure upper tract drainage) and thus determine whether drainage preferentially occurs around rather than through the spiral‐ridged stent, promoting renal flow and potentially facilitating the passage of urinary stone fragments. Materials and methods A mechanical ureteric model was constructed to mimic the funnel characteristics of the renal pelvis. A motor pump was used to help simulate respiratory and skeletal movement, resulting in differential motion between the intraluminal stent and the surrounding ureteric wall. Tubes of varying internal diameters were used to simulate different sizes of ureter. Flow rates of standard 7 F smooth‐walled stents were compared with 7 F spiral‐ridged stents with and without occluded lumens, and with and without standardized excursions. Results Extraluminal flow (mean rates) with and without movements simulating respiratory excursions were significantly higher with the spiral stent for all stent diameters evaluated. All flow rates increased as the ureteric diameter increased. Total flow past the spiral stent was significantly greater than flow with the smooth‐walled stent under all conditions tested. Flows measured around the spiral stent under conditions of excursion were the highest of all categories, 20‐fold higher than in smooth‐walled, closed, stationary stents. Conclusion Spiral‐ridged JJ stents provided substantially greater flow in this in vitro model. Extraluminal flow was markedly increased with the spiral‐ridged configuration. The difference in flow rates was more pronounced at the smaller pseudo‐ureteric tube diameters, simulating dimensions found in clinical practice. The flow rate also was increased when the central lumen remained open, and was greater still when there was dynamic excursion with respiratory movements.