bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified plication of the tunica albuginea in treating congenital penile curvature
Authors: Hsieh J.T. , Huang H.E. , Chen J. , Chang H.C. , Liu S.P. 
Published: March 2003

Objective To describe a modified plication technique and compare the results with the Nesbit procedure for treating congenital penile curvature. Patients and methods Eleven men with congenital penile curvature were treated by a modified tunica albuginea plication technique. An artificial erection was induced by normal saline injection; in the areas where plication was planned, Buck's fascia was opened longitudinally and dissected a short distance toward the midline to free the neurovascular bundles. Allis clamps were used to grasp the tunica albuginea and ‘bumps’ created. Two interrupted U‐shaped sutures using 2/0 polyglactin were placed underneath each Allis clamp to secure the bump. The results were analysed retrospectively and compared with the results of 11 other men treated using the Nesbit procedure. Results The mean (range) follow‐up was 25 (12–47) months for the Nesbit procedure and 15 (8–26) months for the modified plication procedure. In the Nesbit group, eight patients had satisfactory cosmetic and functional results; three complained of penile shortening and one had erectile dysfunction. In the modified plication group, 10 patients reported satisfactory cosmetic and functional results; one complained of penile shortening, two were concerned about the indurations of the penis but none had erectile dysfunction. Conclusions The modified plication technique is easier to perform, is more often successful and causes fewer surgical complications than the Nesbit procedure for treating congenital penile curvature.
Histopathological examination of both ipsilateral and contralateral testes with different obstructive models in prepubertal and adult rats
Authors: Altay B. , Hekimgil M. , KEFi A. , Çikili N. 
Published: March 2003

Objective To determine the histopathological changes in both the ipsilateral and contralateral testes of prepubertal and adult male rats 60 days after creating different obstructive models. Material and methods Thirty‐six prepubertal and 32 adult albino male rats were examined in three different obstructive models of the right testis. In group 1 the spermatic cord was ligated, in group 2 the ligation was between the caput epididymis and testis, and in group 3 the vas deferens was ligated. Sixty days after ligation both testes were removed and evaluated for testis diameter, mean seminiferous tubule diameter (MSTD), and degenerative, obstructive and inflammatory changes. Results The diameter of the obstructed right testis and MSTD were significantly greater in prepubertal rats but there was no apparent difference in adult rats. For obstructive changes, sloughing of germ cells in the prepubertal rats and germ cell absence in adult rats were significantly more common in group 3. The contralateral testis diameter and MSTD of group 3 was significantly greater only in prepubertal rats. Statistically significant values of obstructive change, e.g. sloughing of germ cells and apical vacuolation in Sertoli cells, were apparent in prepubertal rats, but tubular ectasis was the only statistically significant criterion of obstruction in adult rats. Conclusion The testes are more susceptible to obstruction of the vas deferens in prepubertal than in adults rats, resulting in increased hydrostatic pressure and oedema of both the ipsilateral and contralateral testes, which might be caused by collateral circulation and rat testicular microcirculation, with a rhythmic pattern of arteriolar dilatation and constriction (vasomotion). Although the presence of oedema and high hydrostatic pressure was not prominent in adults, formation of spermatic granulomas and absence or sloughing of germ cells in the obstructed and contralateral testes reflect the early effects of vas ligation on spermatogenesis in adulthood.
Chronic ethanol consumption impairs adrenoceptor‐ and purinoceptor‐mediated relaxations of isolated rat detrusor smooth muscle
Authors: Utkan T. , Erden F. , Yildiz F. , Özdemirci S. , Ulak G. , Gacar M.N. 
Published: March 2003

Objective To investigate the effects of chronic ethanol consumption on the reactivity of detrusor smooth muscle. Materials and methods Eight male rats received ethanol (7.2% v/v) in a modified liquid diet for 4 weeks. Two control groups were assessed; eight rats in one group were fed sucrose and received a liquid diet, and 12 rats in the second group received standard rat chow and water for 4 weeks. The reactivity of detrusor smooth muscle strips from ethanol‐fed animals and control animals was evaluated in organ chambers. Results The relaxation response elicited by isoprenaline or adenosine was unaffected in the both control groups while it was significantly inhibited, with decreased maximum responses and pD2 values, in the ethanol‐fed group. Contractile responses of detrusor smooth muscle to carbachol or 80 mmol/L KCl and relaxant responses to papaverine were similar in the control groups and the ethanol‐fed group. There was no change in agonist potency among the groups. Conclusion Chronic ethanol consumption impairs β‐adrenoceptor‐ and purinoceptor‐mediated relaxation but not cholinoceptor‐mediated contraction of the rat detrusor smooth muscle. Thus, it appears that different regulatory mechanisms are involved in ethanol‐induced alterations in β‐adrenergic, purinergic and muscarinic receptors in detrusor strip.
Mercurochrome as an adjunct to local preoperative preparation in children undergoing hypospadias repair
Authors: Ratan S.K. , Sen A. , Ratan J. , Pandey R.M. 
Published: March 2003

Objective To determine whether the local application of mercurochrome over genital skin before surgery, in addition to soap/water scrubs, can help to decrease the incidence of infection patients undergoing hypospadias repair, and thereby the incidence of fistula formation. Patients and methods The study comprised 44 consecutive boys undergoing primary or repeat surgery for hypospadias between October 1999 and April 2000. They were arbitrarily divided into two groups; group 1 received a conventional local scrub with soap/water 48 h before surgery and group 2, a conventional local scrub with soap/water was followed by a local application of 2% mercurochrome for 48 h before surgery. Both groups were comparable in age, location of the meatus and stage of repair. All patients were exposed to similar conditions during and after surgery. Urine, skin and wound swabs taken before during and after surgery were assessed microbiologically, using standard precautions. The incidence of infection and complications was then compared. Results Mercurochrome significantly decreased local infection, especially before surgery, but its effect in decreasing fistula formation, although appreciable, was not statistically significant. Conclusion The local application of mercurochrome after a soap/water scrub for at least 48 h before surgery is a simple, economic and effective means to decrease postoperative wound infection. Future studies are needed, keeping other determinants of fistula formation constant, to evaluate its role in decreasing fistula formation in patients undergoing hypospadias repair.
The radiolucent ureteric calculus at the end of a contrast‐medium column: where to focus the shock waves
Authors: Buchholz N.‐P.N. , Van Rossum M. 
Published: March 2003

Objective To compare the outcome of two different targeting strategies for treating radiolucent ureteric calculi by extracorporeal shock wave lithotripsy (ESWL), focusing the shock waves either at the end or 5 mm beyond the column of contrast medium visible in the ureter. Patients and methods A total of 156 patients undergoing ESWL for a radiolucent ureteric stone were randomized into two groups. Group 1 comprised 74 patients in whom the shock waves were focused on the end of the contrast medium column, and group 2 comprised 82 patients in whom the shock waves were focused 5 mm beyond the end of the column. Results Both groups had comparable distributions of age, gender, treatment methods and stone characteristics. There were no adverse reactions to the contrast medium. The stone‐free rate after 2 months was 17% greater in group 2 (91%) than in group 1 (74%; P < 0.05). Conclusions The administration of intravenous contrast medium for ESWL of radiolucent ureteric calculi is effective and safe. We recommend that the shock waves are focused 5 mm beyond the end of the column of contrast medium, except where a stone becomes clearly visible within the column.
Immunohistochemical analysis of Ki‐67, p21waf1/cip1 and apoptosis in marker lesions from patients with superficial bladder tumours treated with vinorelbine intravesical therapy in a preliminary phase I trial
Authors: Bonfil R.D. , Gonzalez A.D. , Siguelboim D. , Cuello Carrion F.D. , Ciocca D.R. , Villaronga A. , Metz L. , Mosso F. , Fayad E. , Reale M. , Schmilovich A.J. 
Published: March 2003

Objective To investigate Ki‐67 and p21Waf1/Cip1 expression and apoptosis, before and after treatment, in tumour biopsies obtained from patients with superficial bladder cancer who underwent vinorelbine intravesical therapy. Patients and methods Twenty patients with high‐risk superficial bladder cancer (including one or more of the following parameters: tumour diameter > 3 cm, histological grade 3, or multicentric tumours) were treated 1–6 times (weekly) with intravesical vinorelbine (50 mg/mL) instillations. Transurethral tumour marker biopsies were obtained one week before the first instillation of the drug and one week after the last. The biopsies were immunostained for Ki‐67 and p21Waf1/Cip1 with monoclonal antibodies, on tissue sections derived from paraffin‐embedded samples obtained before and after vinorelbine treatments. In addition, apoptosis was determined using a terminal deoxynucleotidyl transferase‐mediated dUTP biotin nick‐end labelling (TUNEL) technique. Results There were no significant differences in the cell proliferation marker Ki‐67 in biopsies taken before or after treatment. However, p21Waf1/Cip1 showed significantly higher expression in biopsies obtained after vinorelbine treatment, with median (range) values of 40 (20–90)% before and 70 (50–80)% after (P < 0.001, paired nonparametric Wilcoxon test). The apoptotic index was significantly higher after vinorelbine therapy, with median (range) values of 0.89 (0.06–3.8)% before and 2.25 (0.17–18.7)% after treatment (P < 0.001, paired nonparametric Wilcoxon test). Despite the brief treatment and few patients there was a clinical response in nine patients, together with low toxicity in all. Conclusion The intravesical treatment of tumours with vinorelbine affects p21Waf1/Cip1 expression without blocking cell proliferation, although increasing apoptosis. The preliminary results suggest that vinorelbine may be useful for treating superficial bladder tumours, and thus a phase II study is warranted.
The clinical relevance of sex hormone levels and sexual activity in the ageing male
Authors: Ahn H.S. , Park C.M. , Lee S.W. 
Published: March 2003

Objectives To assess the changes in sex hormone levels with age and the relationship of sexual functioning to testosterone levels, evaluating serum testosterone levels and erectile function in men with lower urinary tract symptoms (LUTS). Patients and methods The study included 213 men with LUTS (age range 31–78 years) who had no confirmed erectile dysfunction. Their serum total and free testosterone, and sex‐hormone binding globulin (SHBG) levels were measured, and they completed the International Index of Erectile Function (IIEF) questionnaire. Results The total and free testosterone levels decreased and SHBG increased with age, but only the change in free testosterone and SHBG were statistically significant. The correlation with age was closer for free testosterone (r = − 0.356, P < 0.001) than for SHBG (r = 0.177, P = 0.010). Regression analysis of the five domain scores of the IIEF and three hormonal levels, after correcting for age, showed that free testosterone level was significantly correlated with erectile function (r = 0.2136, P = 0.005) and orgasmic function (r = 0.179, P = 0.020), but SHBG levels were significantly correlated only with orgasmic function (r = − 0.154, P = 0.046). Total testosterone levels showed no significant correlation with any of the five domains of the IIEF. Conclusions Of the sex hormone levels, the change in free testosterone correlated most closely with ageing and had the closest correlation with sexual activity. Contrary to previous reports, free testosterone and SHBG levels were significantly correlated with orgasmic function and/or erectile function rather than sexual desire. A complete study of sex hormone levels is needed to evaluate patients with erectile dysfunction.
Association of dietary fatty acids with urinary oxalate excretion in calcium oxalate stone‐formers in their fourth decade
Authors: Naya Y. , Ito H. , Masai M. , Yamaguchi K. 
Published: March 2003

Objective To examine the influence of the dietary intake of fatty acid on urinary oxalate excretion in calcium oxalate stone‐formers in their fourth decade, as previous reports show that animal fat intake is associated with urinary oxalate excretion. Patients and methods The dietary intake of 58 idiopathic stone‐formers in their fourth decade was recorded using the dietary‐record method. The patients collected 24‐h urine samples at home and their urinary oxalate excretion was measured in a clinical biochemistry laboratory. The results were used to determine the relationship between the dietary intake of fatty acids and urinary oxalate excretion. Associations between urinary oxalate excretion and dietary contents of animal fat, animal protein and various fatty acids were assessed using Spearman's correlation coefficient and multiple regression. Results The dietary content of arachidonic acid was positively correlated with urinary oxalate excretion, as assessed by univariate and multivariate analysis. Conclusion The association between arachidonic acid and oxalate excretion suggests that arachidonic acid increases the intestinal absorption of oxalate and increases the clearance of oxalate in the kidneys.
A comparative review of extracorporeal shock wave generation
Authors: Wilbert D.M. 
Published: March 2003

SummaryShock waves are specific sound waves produced by shock‐wave generators; the generators currently available have different physical properties and represent different technical solutions. The measurement of shock‐wave pressure is necessary in laboratory settings to define the physical characteristics of a given shock‐wave source. Under clinical conditions other variables, e.g. the stone‐free rate or the percentage of complications, are used to describe the efficacy and safety of a lithotripter.
Gleason score on biopsy: is it reliable for predicting the final grade on pathology?
Authors: Lattouf J.‐B. , Saad F. 
Published: March 2003

Objective  To assess the correlation of the Gleason score on biopsy and the final pathology after radical prostatectomy (RP) for prostate adenocarcinoma.Patients and methods  In a retrospective analysis within a tertiary‐care centre, the charts of 537 patients who had undergone radical prostatectomy from April 1989 to November 2000 were reviewed. The RPs were undertaken in one institution; 167 biopsies were taken and interpreted in the referring centres, and 355 were taken and interpreted in the authors’ institution by up to 15 pathologists. All the final pathology specimens were interpreted by the same group of pathologists. The main outcome measures were: the pathological report of the biopsy including the primary and secondary Gleason grade; the final pathological grade (primary and secondary); the margin status; and the identification of the pathologist for the biopsy and final pathology.Results  In all, 390 patients had inclusion criteria (the Gleason grade before and after RP) available. For the individual scores 38.2% of tumours were undergraded, 32.6% overgraded and only 29.2% had identical grading in preoperative biopsies and final specimens. When grouped into more meaningful categories (Gleason 2–4, 5–6, 7 and 8–10) the correlation improved, with 48.5% of patients remaining in the same group after RP. For 39 patients the same pathologist assessed the biopsy and final specimen; in these cases individual scores were identical in 49% and group scores were identical in 64%.Conclusion  Gleason grading of the prostate biopsy remains a poor predictor of pathological outcome. Assessment by the same pathologist reduces the discrepancy but over half the patients are under‐ or overgraded on final pathology. Clinicians should be aware of these limitations when using the biopsy Gleason grade in decision making.
Healing of unstented tubularized incised plate urethroplasty: an experimental study in a rabbit model
Authors: Hafez A.T. , Herz D. , Bägli D. , Smith C.R. , McLorie G. , Khoury A.E. 
Published: March 2003

OBJECTIVETo develop a rabbit model to study the temporal healing taking place after an unstented tubularized incised plate urethroplasty (TIPU).MATERIALS AND METHODSThe study comprised 13 New Zealand white rabbits (3–4 kg); the ventral wall of the penile urethra was excised to create a hypospadias‐like defect. A vertical incision was made in the dorsal urethral plate and the incised urethra tubularized. Two animals were killed at 2 days and two at 5 days after surgery, and the remainder killed at 2, 6 and 12 weeks (three each). A retrograde urethrogram was taken at autopsy. Serial sections of the penis were stained with haematoxylin and eosin, and Masson trichrome for microscopy.RESULTSThere were no deaths related to the procedure and all animals voided spontaneously. Retrograde urethrograms showed no fistulae or stricture. Microscopic examination at 2 and 5 days showed partial coverage of the incision with regenerating urothelium. At 2 weeks there was full‐thickness urothelium with a mild inflammatory reaction. At 6 and 12 weeks, remodelling of the peri‐urethral connective tissue with minimal fibrosis completed the healing.CONCLUSIONThe mechanism of healing of the incised urethral plate involves normal urothelial regeneration into the depth of the incised defect, which explains the gain in urethral diameter after TIPU. Urine flow, during normal voiding, might be responsible for keeping the incised plate open during urothelial regeneration. A urethral stent was not necessary for normal healing in this model.
Glanular reconstruction and preputioplasty repair for distal hypospadias: a unique day‐case method to avoid urethral stenting and preserve the prepuce
Authors: Gray J. , Boston V.E. 
Published: March 2003

OBJECTIVETo report the early outcome of> 200 boys who underwent a glanular reconstruction and preputioplasty (GRAP) repair for distal hypospadias, to assess the functional and anatomical outcome of the penis at least 10 years after surgery, and to compare these data with otherwise ‘normal’ aged‐matched controls.PATIENTS AND METHODSThe GRAP repair is a novel method for the day‐case reconstruction of distal hypospadias, and uniquely allows the anatomical reconstruction of the prepuce as part of penile reconstruction for hypospadias. We retrospectively reviewed the notes of 205 consecutive cases of distal hypospadias who had a GRAP repair carried out by one surgeon. Of these, there were 63 consecutive patients who had been repaired using the GRAP ≥ 10 years earlier. In these patients a questionnaire was used to assess their perception of the appearance of their penis, the urinary stream, any problems with the foreskin and their recollection of surgery. Similar questionnaire data, except for the latter, were obtained from aged‐matched controls for comparison.RESULTSOf the 205 patients, 183 (89%) were day cases; the remaining 22 remained in hospital overnight for medical or social reasons. Sixteen (7%) developed a urethral fistula, the incidence of which correlated positively with the length of the repair. Four children (2%) were circumcised, in two for phimosis resulting in a spraying stream, in a third for dribbling after voiding, and the fourth for a cosmetically unsatisfactory foreskin. Questionnaire responses were received from 45 boys (71%), while 18 were untraceable. The mean (sd) age at surgery and at survey was 3.25 (2.6) and 14.26 (2.8) years, respectively. Forty‐two (95%) children felt their penis was normal or only slightly different in appearance, two (5%) felt it looked fairly different and only one mostly avoided communal situations because of this. On voiding three boys (7%) sprayed most of the time while the remainder either never or sometimes sprayed. One youth sometimes had to sit to void because of difficulties in directing the stream; the rest (98%) always stood to void. There were no further circumcisions. These results were not significantly different from those of the age‐matched controls. Most children had no (68%) or only slight (30%) recollection of hypospadias surgery.CONCLUSIONThe complication rate and patient satisfaction with GRAP is comparable with those of other techniques. GRAP is a simple day‐case procedure with few complications, thus avoiding an overnight hospital admission for most patients. Importantly, the prepuce can be preserved and refashioned to give a good cosmetic result, with no phimosis, which is increasingly important as circumcision becomes less acceptable to both the general public and the medical profession.
Enterocystoplasty in childhood: a second look at the effect on growth
Authors: Gerharz E.W. , Preece M. , Duffy P.G. , Ransley P.G. , Leaver R. , Woodhouse C.R.J. 
Published: March 2003

OBJECTIVETo re‐evaluate the assumption that enterocystoplasty in children has a detrimental effect on linear growth (which is almost exclusively based upon a chance finding in a retrospective study 10 years ago) in a larger cohort and with a longer follow‐up.PATIENTS AND METHODSThe original 12 children who had impaired linear growth in a previous study 10 years earlier were re‐measured. A larger cohort was identified from the 242 children and adolescents who had undergone enterocystoplasty between 1982 and 1997. Patients with conditions involving organ systems apart from the urinary tract, and those with myelomeningocele, malignant diseases, reduced glomerular filtration rate and incomplete notes were excluded. In the definitive study cohort (123; mean age at operation 8.6 years; mean age at investigation 16.8 years) enterocystoplasty had been undertaken using colon in 70, ileum in 37, a combination of both in 11, ileocaecal segments in three and stomach in two patients.RESULTSOf the original 12 patients, six had regained or surpassed their preoperative position on their growth charts. In all patients with a known target centile range the final height was within their genetic growth potential. In the cohort of 123 patients, 1215 height and weight measurements had been recorded. The distribution of percentile positions before and after enterocystoplasty showed a normal configuration, with 83% and 80% of patients growing within two standard deviations of the 50th percentile. After surgery, 85% either remained on the same or reached a higher centile. Nineteen (15.5%) were in a lower position, with a similar tendency in the weight centile. A clinically relevant growth disorder was recognized in four patients with a complete endocrinological evaluation; in none of these was enterocystoplasty thought to be a causal factor.CONCLUSIONSIt is very unlikely that the loss of the preoperative percentile position on the growth curve in 15% of children after enterocystoplasty is a consequence of the surgery. Rather it is a non‐specific phenomenon that has to be considered in any clinical population of the same size and age distribution after the same length of time.