bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of ethanol and its metabolite acetaldehyde on responses of the rat bladder
Authors: Kim  , Moon  , Sohng  , Lee  , Lee  , Lee  
Published: March 2003

ObjectiveTo investigate the pharmacological effects of ethanol and its metabolite acetaldehyde on isolated rat bladder muscle, and thus assess the potential influence of ethanol ingestion on the risk of urinary retention in patients with benign prostatic hyperplasia.Materials and methodsIsometric tension changes of isolated rat bladder muscle strips were recorded in an organ bath using a pressure transducer. The acute or prolonged effects of ethanol (1–4%) or acetaldehyde (0.01, 0.1 or 1 mmol/L) were assessed on resting tension, electrical field stimulation (EFS), and bethanechol‐ (0.5 mmol/L), ATP‐ (2 mmol/L) or KCl‐ (127 mmol/L) induced contraction. To determine the mechanism of acetaldehyde‐induced stimulation, an antihistamine, diphenhydramine was used after bethanechol stimulation.ResultsAt the concentrations used, ethanol and acetaldehyde did not change the pH of the bathing medium. The resting tension of the muscle was not changed by ethanol, and acetaldehyde caused only a small increase in baseline tone at 1 mmol/L. Incubation with ethanol or acetaldehyde significantly suppressed contractility induced by EFS, bethanechol, ATP or KCl at each concentration (P<0.05). Contractions induced by all drugs were not changed significantly by the acute application of ethanol and the acute application of acetaldehyde did not affect contractions induced by ATP or KCl. However, EFS‐ or bethanechol‐induced contractions were significantly enhanced (P<0.05). The acetaldehyde‐induced effects were completely blocked by the H1 antagonist, diphenhydramine (10 μmol/L).ConclusionsEthanol did not affect resting tension but acetaldehyde and ethanol suppressed bladder muscle contractions. However, direct acetaldehyde‐stimulation may release histamine and enhance contractility. This suggests that chronic alcoholism rather than acute intoxication is more likely to provoke urinary retention.
The histological extent of the local spread of carcinoma of the penis and its therapeutic implications
Authors: Agrawal A. , Pai D. , Ananthakrishnan N. , Smile S.R. , Ratnakar C. 
Published: March 2003

Objective To explore the possibility of reducing the margin of clearance at surgery for carcinoma of the penis without causing an increase in the incidence of local tumour recurrence, so that the functional and cosmetic compromise associated with penectomy might be minimized. Patients and methods Sixty‐four patients underwent partial or total penectomy based on the extent of tumour. The specimens were evaluated histologically for grade and for proximal microscopic extensions beyond the grossly visible tumour margin, by examining serial proximal 5 mm sections. The histological grade of the lesion was correlated with its clinical site, morphology and proximal microscopic spread. Differences were assessed using the chi‐squared test. Results Of 64 tumours, 31% were grade 1, 50% grade 2 and the remaining 19% grade 3. Higher grade lesions were more likely to involve the penile shaft. The maximum proximal histological extent was 5 mm for grades 1 and 2, and 10 mm for grade 3 tumours; there was no discontinuous spread. Conclusions Histological grading is mandatory in the management of carcinoma of the penis. A 10‐mm clearance is adequate for grade 1 and 2 lesions, and 15 mm for grade 3 tumours. This approach would qualify more patients for partial rather than total amputation; the residual length of the penis would then be cosmetically and functionally more acceptable.
A pilot study of a bioabsorbable self‐reinforced poly L‐lactic acid urethral stent combined with finasteride in the treatment of acute urinary retention from benign prostatic enlargement
Authors: Isotalo T. , Talja M. , Välimaa T. , Törmälä P. , Tammela T.L.J. 
Published: March 2003

ObjectiveTo assess whether patients with acute urinary retention from benign prostatic enlargement can be treated with a combined therapy comprising a bioabsorbable self‐reinforced poly L‐lactic acid (SR‐PLLA) urethral stent and finasteride. Patients and methodsEleven men in acute urinary retention were treated as outpatients; they had a suprapubic catheter inserted and the SR‐PLLA stent placed cystoscopically. The patients were allowed to attempt to void spontaneously after 2 days. ResultsAll patients started to void spontaneously within 2 weeks. There was a steady improvement in urinary flow rates up to 9 months, followed by a slight impairment after the bioabsorption of the stent. During the mean (range) follow‐up of 24 (23–26) months only three patients required surgical treatment. ConclusionThe bioabsorbable SR‐PLLA stent combined with finasteride therapy provides a promising new alternative in the treatment of acute urinary retention, especially in patients unfit for surgical therapy. Larger, placebo‐controlled studies are needed to establish the efficacy of this combined therapy.
Conservative treatment of urge urinary incontinence in women: a systematic review of randomized clinical trials
Authors: Berghmans L.C.M. , Hendriks H.J.M. , De Bie R.A. , Van Waalwijk E.S.C. , Van Doorn  , Bø K. , Van Kerrebroeck PH.E.V. 
Published: March 2003

Objective To assess the efficacy of physical therapies for first‐line use in the treatment of urge urinary incontinence (UUI) in women, using a systematic review of randomized clinical trials (RCTs). Materials and methods A computer‐aided and manual search was carried out for RCTs published between 1980 and 1999 investigating the treatment of UUI defined by the keywords ‘physical therapies’, e.g. bladder (re)training (including ‘behavioural’ treatment), pelvic floor muscle (PFM) exercises, with or without biofeedback and/or electrical stimulation. The methodological quality of the included trials was assessed using methodological criteria, based on generally accepted principles of interventional research. Results Fifteen RCTs were identified; the methodological quality of the studies was moderate, with a median (range) score of 6 (3–8.5) (maximum possible 10). Eight RCTs were considered of sufficient quality, i.e. an internal validity score of  5.5 points on a scale of 0–10, and were included in a further analysis. Based on levels‐of‐evidence criteria, there is weak evidence to suggest that bladder (re)training is more effective than no treatment (controls), and that bladder (re)training is better than drug therapy. Stimulation types and parameters in the studies of electrical stimulation were heterogeneous. There is insufficient evidence that electrical stimulation is more effective than sham electrical simulation. To date there are too few studies to evaluate effects of PFM exercise with or without biofeedback, and of toilet training for women with UUI. Conclusion Although almost all studies included reported positive results in favour of physical therapies for the treatment of UUI, more research of high methodological quality is required to evaluate the effects of each method in the range of physical therapies.
Telomerase activity as a potential marker in preneoplastic bladder lesions
Authors: Lancelin F. , Anidjar M. , Villette J.‐M. , Soliman A. , Teillac P. , Le Duc A. , Fiet J. , Cussenot O. 
Published: March 2003

Objective To assess telomerase activity (involved in cell immortalization and detectable in most malignant tumours but not in normal somatic tissues) as a marker in cancer diagnosis.Patients and methods Tissue telomerase activity was assayed by two different techniques, the telomeric repeat amplification protocol‐polymerase chain reaction (TRAP‐PCR) and a telomerase PCR‐enzyme linked immunosorbent assay. Malignant and inflammatory bladder lesions and their adjacent normal tissues were assessed for telomerase activity in a group of 18 patients, 14 of whom had urothelial carcinoma and four a nonspecific inflammatory lesion of the bladder.Results Eleven of the 14 tumour samples analysed were telomerase‐positive and two of the three telomerase‐negative tumour samples had a detectable ‘telomerase inhibitor’. In the apparently normal tissues next to bladder tumours, four of the 14 specimens were telomerase‐positive. Interestingly, these lesions were always next to high‐grade muscle‐invasive bladder tumours (pT2G3). Two of the four nonspecific inflammatory lesions (one of cystitis glandularis and one of severe dysplasia), known to be preneoplastic lesions, were also telomerase‐positive.Conclusion These results strongly suggest that the reactivation of telomerase may be an early event in bladder carcinogenesis, preceding morphological changes related to malignant transformation. Telomerase activity may therefore be useful both as an indicator of malignant potential in preneoplastic lesions, e.g. cystitis glandularis and severe dysplasia, and as a prognostic marker of bladder tumour relapse or progression.
Surveillance for bladder cancer: the management of 4.8 million people
Authors: Wright M.P.J. , Jones D.J. 
Published: March 2003

Objective To document the workload of bladder cancer surveillance on the British urologist.Methods Thirty‐one consultant urologists serving a population of 4.8 million were sent postal questionnaires eliciting their views on the management of superficial bladder cancer. The number, type and outcome of cystoscopies performed over a 6‐week period throughout the region was then assessed prospectively.Results One person in 1450 in the South‐west region is undergoing follow‐up for bladder cancer. Of the responding consultants, 36% would give a single dose of intravesical chemotherapy within 24 h of resection for a G1/2 pTa tumour and 84% would perform the first check cystoscopy at 3–4 months. Over the 6‐week period of the study, 696 cystoscopies were performed; there was considerable variation among centres in the choice of cystoscopy type, with 3–80% being rigid cystoscopies. Overall, there was a positive finding in 31% of the assessments.Conclusion This study documents the practice of a significant number of UK urologists in the management of superficial bladder cancer. There are considerable variations among individuals in the type and timing of check cystoscopy.
A 10‐year follow‐up after Kegel pelvic floor muscle exercises for genuine stress incontinence
Authors: Cammu H. , Van Nylen M. , Amy J.J. 
Published: March 2003

Objective To determine the outcome 10 years after an individual course of pelvic floor muscle (PFM) exercises for genuine stress incontinence. Patients and methods Postal questionnaires were sent to 52 women who had undergone PFM training 10 years earlier, and their medical files were reviewed. The main outcome measures were the patients’ self‐assessment of therapy outcome, the frequency of PFM exercises at home, and the demand for surgery after physiotherapy. Results Forty‐five women (87%; mean age 61 years) were suitable for analysis. On completing the course of PFM exercises, physiotherapy had been apparently successful in 24 (53%), and considered to have failed in 21 women (47%). Sixteen of the 24 successful patients remained satisfied with their urinary continence when reassessed 10 years later; two women had undergone surgery (8%). In the group where physiotherapy initially failed, five women (24%) who had not had surgery claimed to be much improved; 13 women (62%) had undergone surgery. Overall, women in whom the conservative treatment of stress incontinence had produced an improvement over the 10 years had practised PFM exercises more regularly (76%) than the others (55%; not significant). However, an active voluntary PFM contraction before a sudden intra‐abdominal pressure rise (‘perineal lock’) appeared to be responsible for most of the success. Conclusions When PFM training is initially successful, there is a 66% chance that the favourable results will persist for at least 10 years.
The protective effects of nitric oxide on the contralateral testis in prepubertal rats with unilateral testicular torsion
Authors: Dokucu A.I. , Öztürk H. , ÖzdemiR E. , Ketani A. , Büyükbayram H. , Yücesan S. 
Published: March 2003

Objective To investigate histological changes in the contralateral testis of rats with unilateral testicular torsion and the protective effects of nitric oxide (NO) on possible damage. Material and methods Twenty‐eight prepubertal male Sprague‐Dawley rats were divided into four equal groups. Group 1 underwent a sham operation of the right testis under general anaesthesia. Group 2 underwent a similar operation but the right testis was rotated 720° clockwise for 6 h, maintained by fixing the testis to the scrotum, and saline infused during the procedure. Group 3 underwent similar torsion but
l‐arginine methyl ester (a precursor of NO) was infused during the procedure. In Group 4, NG‐nitro‐l‐arginine‐methyl ester, a NO synthase inhibitor, was infused separately during the administration of
l‐arginine methyl ester and torsion. All the left (untwisted) testes were removed from rats 21 days after surgery and evaluated histologically, assessing seminiferous tubule diameter, loss of sperm and spermatids, loss of germ cell layers, disarray of germ cell layers, rupture of tubules, Leydig cell proliferation and reaction in the ruptured tubules, and oedema. Results There was a significant difference in the indicators of histological damage between groups 2 and 4 and groups 1 and 3, except for the Leydig cell reaction in the ruptured tubules and oedema. The damage was significantly less in group 3 than in groups 2 and 4. Conclusion These results suggest that long‐term histopathological changes in the contralateral testes are important after unilateral testicular torsion and that NO has a protective effect on the contralateral testis.
Role of C‐afferent fibres in the mechanism of action of sacral nerve root neuromodulation in chronic spinal cord injury
Authors: Shaker H. , Wang Y. , Loung D. , Balbaa L. , Fehlings M.G. , Hassouna M.M. 
Published: March 2003

Objective  To determine whether sacral root neuro‐modulation (a promising therapeutic modality in patients with refractory voiding and storage problems) has its effect through the blockade of C‐afferent fibres that form the afferent limb of a pathological reflex arc responsible for the dysfunction of bladder storage. Materials and methods  The study comprised 39 female Sprague Dawley rats divided into three equal groups: normal controls (group 1); spinally transected at T10 (group 2); spinally transected and electrically stimulated bilaterally at S1 for 6 h daily (group 3). Three weeks after transection the rats were assessed using urodynamics; substance P, neurokinin A and calcitonin gene‐related peptide (CGRP) were extracted from the dorsal root ganglia (DRG) of the L5 and L6 roots and quantified by radioimmunoassay. Results  Spinally transected rats developed urinary bladder hyper‐reflexia after 3 weeks. This was associated with a significant increase in the neuropeptide content of the DRG of L6. Electrostimulation of S1 significantly decreased the neuropeptide content of L6. In contrast, transection and S1 neurostimulation did not affect the neuropeptide content of the L5 DRG, except for CGRP, which increased after spinal transection and decreased with neurostimulation. Conclusions  In spinally transected rats, sacral root neurostimulation abolished bladder hyper‐reflexia and attenuated the rise in neuropeptide content of the L6 DRG. These results suggest that the blockade of C‐afferent fibre activity is one of the mechanisms of action of sacral root neuromodulation.
Efficacy of trospium chloride in patients with detrusor instability: a placebo‐controlled, randomized, double‐blind, multicentre clinical trial
Authors: Cardozo L. , Chapple C.R. , Toozs‐hobson P. , Grosse‐freese M. , Bulitta M. , Lehmacher W. , Strösser W. , Ballering‐brühl B. , Schäfer M. 
Published: March 2003

Objectives To assess the efficacy and safety of trospium chloride (TCl, 20 mg twice daily) in the treatment of detrusor instability, compared with placebo. Patients and methods In all, 208 patients were allocated at random to either TCl or placebo in a double‐blind clinical study; the patients were treated for 3 weeks. Urodynamic values were measured at the beginning and end of the treatment period. Adverse events were recorded on patient diary cards. A confirmatory adaptive procedure with one planned interim analysis was used to evaluate efficacy. Results Trospium chloride produced significant improvements in maximum cystometric bladder capacity (median treatment effect 22.0 mL, mean 37.3 mL, one‐sided P = 0.0054) and urinary volume at first unstable contraction (median treatment effect 45.0 mL, mean 63.6 mL, one‐sided P = 0.0015). The patients’ assessment of efficacy showed significantly greater clinical improvement in the TCl group than in the placebo group (two‐sided P = 0.0047). Furthermore, TCl was well tolerated, with similar frequencies of adverse events reported in both groups (68% in the TCl and 62% in the placebo group). Conclusion Trospium chloride (20 mg twice daily) is an effective and safe option for the treatment of detrusor instability.
The significance of the free‐to‐complexed prostate‐specific antigen (PSA) ratio in prostate cancer detection in patients with a PSA level of 4.1–10.0 ng/mL
Authors: Okegawa T. , Kinjo M. , Watanabe K. , Noda H. , Kato M. , Miyata A. , Murata A. , Yoshii M. , Nutahara K. , Higashihara E. 
Published: March 2003

Objective To compare the ratio of free prostate specific antigen (fPSA), total PSA (tPSA) and complexed PSA (cPSA, measured using a novel immunoassay) with other variables used to detect prostate cancer in patients with intermediate serum PSA levels of 4.1–10.0 ng/mL. Patients and methods  From July 1997 to August 1998, 140 consecutive patients were assessed; all had intermediate serum PSA levels and/or abnormal findings on a digital rectal examination. All patients underwent transrectal ultrasonography (TRUS)‐guided biopsy, and the prostate and transition zone volumes were determined by TRUS. Free and tPSA were measured using the Tandem‐R assay (Hybritech Corp., San Diego, CA). PSA complexed with α1‐antichymotrypsin (cPSA) was measured using an appropriate assay. The ability of cPSA, free‐to‐total PSA ratio (f/tPSA), free‐to‐complexed PSA ratio (f/cPSA), tPSA density of the whole prostate (PSAD), of the transition zone (tPSATZ), and cPSA density of the whole prostate (cPSAD) and of the transition zone (cPSATZ) to improve the power of PSA in detecting prostate cancer was evaluated using receiver operating characteristic (ROC) curves. Results Of the 140 patients, 126 had histologically confirmed benign disease and 14 had prostate cancer. The cPSA alone had better specificity for detecting prostate cancer than had tPSA alone but the difference was not significant. The area under the ROC curve for f/cPSA was larger than those for all other variables. With a 93% sensitivity for detecting prostate cancer, a f/cPSA threshold of 25% would result in fewer unnecessary biopsies (40% f/cPSA specificity) than with all other PSA variables. The difference in the resolution was significant between f/cPSA and tPSA, cPSA, tPSAD and tPSATZ, but not with f/tPSA, cPSAD or cPSATZ. In patients with a prostate volume of < 30 mL, the cPSATZ showed better specificity for prostate cancer than tPSA alone. Conclusion  Measuring the level of cPSA and its derivatives may provide better differentiation of prostate cancer and benign disease than tPSA alone in patients with a tPSA level of 4.1–10.0 ng/mL.
A novel basic protein from human kidney which inhibits calcium oxalate crystal growth
Authors: Selvam R. , Kalaiselvi P. 
Published: March 2003

Objectives To isolate calcium oxalate‐binding proteins from human kidney and characterize the functional properties. Materials and methods Calcium oxalate crystals were prepared and allowed to interact at two different pH values with Triton‐extracted human kidney homogenate. The proteins in the homogenate were isolated and fractionated on a cellulose column, and purified by high‐performance liquid chromatography. The protein with the greatest oxalate binding activity at pH 4.5 was analysed for its amino‐acid composition and characterized by Scatchard plot analysis, crystal growth, nucleation and aggregation studies. Results Three major protein fractions were eluted when calcium oxalate monohydrate was adsorbed at both pH values (designated as fractions I–III, according to their order of elution). The yield of fraction I and III was increased when adsorbed at an acidic pH. However, only fraction III had maximum oxalate binding activity at pH 4.5. When purified, this protein had maximum oxalate binding activity of ≈ 270 pmol/mg protein and a molecular weight of ≈ 23 kDa. Amino acid analysis showed that 18% of the total molar proportion was of basic amino acids, e.g. lysine and arginine, while acidic amino acids accounted for only 11%. Both alanine and glycine constituted ≈ 41% of the total molar proportion. Modifications to the lysine group abolished oxalate‐binding activity of the protein. The protein inhibited crystal growth by 82% at 0.8 µmol/L, while it inhibited the nucleation and aggregation of the crystals by 6% and 28%, respectively, at 49 nmol/L. The inhibition of both nucleation and aggregation was higher at pH 5.7 than at pH 7.4. Significantly, the protein induced the formation of intertwined calcium oxalate dihydrate crystals in a medium known to induce the formation of individual dihydrate crystals. Conclusion The protein described here is the first reported basic inhibitor of calcium oxalate crystal growth with oxalate‐binding activity at pH 4.5 that modulates calcium oxalate crystallization. It is suggested that this protein may play a physiologically significant role in inhibiting stone formation in acidic urine.
Incidence of bone fracture in patients receiving luteinizing hormone‐releasing hormone agonists for prostate cancer
Authors: Hatano T. , Oishi Y. , Furuta A. , Iwamuro S. , Tashiro K. 
Published: March 2003

Objective To investigate the incidence of bone fractures in patients receiving luteinizing hormone‐releasing hormone agonists (LHRH‐a) for prostate cancer (in whom a continued low testosterone level after the long‐term administration of these drugs reduces bone mineral density), and thus determine the risk of secondary osteoporosis. Patients and methods Between 1994 and 1999, 218 patients (mean age 77.3 years) were treated for  6 months with LHRH‐a for prostate cancer; of these, 14 (6%) had a bone fracture during their treatment. Patients with fracture associated with motor vehicle accidents were excluded. The bone density in the third lumbar vertebra was meas‐ured using quantitative computed tomography. Osteocalcin, 1,25‐(OH)2 vitamin D, urinary type 1 collagen cross‐linked N‐telopeptides (NTx), parathyroid hormone and calcitonin were measured as metabolic markers. Results The mean age of the patients with fracture was 78 years; the mean (range) interval from the start of treatment to fracture was 28 (11–46) months. There was no case of a bone fracture at the site of a metastasis from prostate cancer. The bone density was significantly lower in the patients with a fracture than in those without. Of the bone metabolic markers, NTx was higher in those with a fracture. Conclusion There is a need to measure bone mineral density and bone metabolic markers periodically, and to evaluate secondary osteoporosis in patients receiving long‐term LHRH‐a for prostate cancer.