bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of the serum prostate‐specific antigen‐α1‐antichymotrypsin complex and its density as a predictor for the extent of prostate cancer
Authors: Hara I. , Miyake H. , Hara S. , Yamanaka N. , Ono Y. , Eto H. , Takechi Y. , Arakawa S. , Kamidono S. 
Published: March 2003

Objective To determine whether serum levels of the prostate‐specific antigen‐α1‐antichymotrypsin complex (PSA‐ACT) and its density (ACTD) in patients scheduled to undergo radical prostatectomy for clinically localized prostate cancer can predict organ‐confined vs extraprostatic disease. Patients and methods Serum samples were obtained from 62 patients with clinically localized prostate cancer before they underwent radical prostatectomy. PSA and PSA‐ACT were measured using immunofluorometric techniques with different monoclonal antibodies against PSA and ACT, respectively. Furthermore, the PSA and PSA‐ACT densities of the whole prostate (PSAD and ACTD, respectively) were calculated. The relationships of serum PSA, PSA‐ACT, PSAD, ACTD and the pathological stage of the prostatectomy specimens were analysed. Results The disease was organ‐confined or extraprostatic in 30 and 32 men, respectively. In men with organ‐confined cancer, the mean PSA and PSA‐ACT levels were significantly lower than in those with extraprostatic disease. Furthermore, there were significantly higher mean PSAD and ACTD levels in men with extraprostatic than with organ‐confined disease. There were also significant differences in PSA, PSA‐ACT, PSAD and ACTD levels at each pathological stage, whereas there was no significant association between these variables and the Gleason score. Receiver‐operating characteristic curve analysis for detecting organ‐confined disease showed that PSA‐ACT and ACTD had a larger area under the curve than PSA and PSAD, respectively, but these differences were not significant. Furthermore, PSA‐ACT and ACTD provided significantly better sensitivity for detecting organ‐confined disease than PSA and PSAD, respectively. Conclusions Measuring PSA‐ACT and ACTD may improve the preoperative evaluation of patients scheduled to undergo radical prostatectomy, because these factors better differentiate extraprostatic from organ‐confined disease than PSA and PSAD.
Brucellar epididymo‐orchitis in Saudi Arabia: a retrospective study of 26 cases and review of the literature
Authors: Memish Z.A. , Venkatesh S. 
Published: March 2003

Objective To review the clinical and laboratory features and response to treatment of patients with acute brucellar epididymo‐orchitis reporting to a tertiary care hospital in Riyadh, and to compare these with other cases reported previously. Patients and methods In this retrospective study, records of all 26 adult patients with brucellosis, who presented with epididymitis or epididymo‐orchitis at a tertiary hospital in Riyadh from 1983 to 2000, were reviewed. Positive blood culture or high agglutination titres of  1 : 320 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Among these cases, epididymitis or epididymo‐orchitis was diagnosed on the basis of a typical history of gradual onset of scrotal pain and findings of enlarged tender testes and/or epididymis. Results Epididymo‐orchitis occurred in 1.6% of all patients with brucellosis. Most (58%) were 25–44 years old; ≈ 77% of the patients presented with acute symptoms of < 2 weeks' duration. All patients complained of swollen painful testicles. Other presenting symptoms included undulant fever (96%), chills (54%) and arthralgia (23%). Four patients had dysuria and one haematuria. Ten patients gave a positive history of ingestion of raw milk and milk products; one patient had laboratory‐acquired brucellosis. Six patients had unilateral epididymo‐orchitis (two with features of florid presentation); the remaining 20 had only orchitis (bilateral in two, right in 10 and left in eight). Leucocytosis was present in six patients; 25 had initial agglutination titres of > 1 : 320 and the remaining patient had a positive blood culture. All patients received combined therapy with streptomycin for the first 2 weeks (or oral rifampicin for 6 weeks) with doxycycline or tetracycline for 6 weeks. All showed improvement, fever subsided in 2–5 days and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year. Conclusion In brucellosis‐endemic areas, clinicians encountering epididymo‐orchitis should consider the likelihood of brucellosis. A careful history, a meticulous physical examination and a rapid laboratory evaluation help in diagnosis. Clinical and serological data are sufficient for diagnosis. Leucocytosis is not an atypical feature of brucellar epididymo‐orchitis and so cannot be used for differentiating it from the nonspecific variety. Conservative management with combination antibiotic therapy is adequate for managing brucellar epididymo‐orchitis.
p53, p21 and mdm2 expression vs the response to radiotherapy in transitional cell carcinoma of the bladder
Authors: Røtterud R. , Berner A. , Holm R. , Skovlund E. , Fosså S.D. 
Published: March 2003

Objective To identify, in a retrospective study, possible molecular markers predictive of radioresponsiveness in patients with transitional cell carcinoma (TCC) of the bladder. Patients and methods Patients with T2–T4a TCC treated with preoperative radiotherapy and cystectomy were included in the study if their cystectomy specimen was pT3b (in 42) or pT0 (in 17). Because treatment schedules changed over time, radiotherapy was given either as 2 Gy × 23 over 4–5 weeks with cystectomy 4–5 weeks later (in 23), or as 4 Gy × 5 during 1 week with cystectomy in the following week (in 36 patients). Protein expression of p53, mdm2 and p21 (CDKN1 A/WAF1/CIP1/SDI1) was assessed immunohistochemically in biopsies taken before radiotherapy. Results There was no difference in protein expression when comparing all patients with pT0 and pT3b. However, for patients receiving 46 Gy, increased p53 expression (but not p21 or mdm2) predicted the absence of residual tumour (P = 0.005): six of seven patients with > 50% p53 expression had pT0 in the cystectomy specimen, whereas 10 of 12 patients with  5% expression had pT3b. Over‐expression of p53 correlated with longer overall (P = 0.045) and cancer‐specific survival (P = 0.020). Conclusion The expression of mdm2 or p21 did not predict radioresponsiveness in patients with TCC of the bladder. The role of p53 remains unclear; the view that p53 over‐expression confers radioresistance in bladder cancer is not supported.
An autoradiographic study of regional blood flow distribution in the rat kidney during ureteric obstruction— the role of vasoactive compounds
Authors: Sweeney P. , Young L.S. , Fitzpatrick J.M. 
Published: March 2003

Objective To determine the changes in regional renal blood flow during ureteric obstruction and to examine the role of vasoactive mediators in effecting these changes. Materials and methods Renal blood flow in Sprague–Dawley rats was assessed after periods of ureteric obstruction using a quantitative autoradiographic technique based on Kety's theory of diffusion of an inert tracer (14C‐iodoantipyrine). Prostaglandins, thromboxanes and renin‐angiotensin were inhibited pharmacologically using diclofenac sodium and enalapril. Results Baseline blood flow to the outer cortex, inner cortex and medulla was 807, 258 and 105 mL/100 g/min, respectively. There was an increase in outer cortical blood flow after 10 min of ureteric obstruction which became significant at 30 min (P < 0.05). There was a significant decrease in inner cortical and medullary blood flow at 30 min, to 210 and 68 mL/100 g/min, respectively (P < 0.05). Diclofenac sodium abolished the increase in outer cortical blood flow. After 24 h of unilateral ureteric obstruction, outer cortical blood flow decreased to 492 mL/100 g/min; inner cortical blood flow also decreased but to a lesser extent, to 190 mL/100 g/min. Inhibition of prostaglandins, thromboxanes and the renin‐angiotensin system reduced the degree of renal vasoconstriction but there was still a significant decrease in outer cortical perfusion despite the presence of these blocking agents. Conclusions The control of the renal vasculature involves a complex interplay between a variety of vasoactive mediators. Quantitative autoradiography offers the opportunity to evaluate changes in regional renal perfusion with high resolution and will allow a greater understanding of the pathophysiology of renal diseases.
The association of androgen‐ and oestrogen‐receptor gene polymorphisms with urolithiasis in men
Authors: Chen W.‐C. , Wu H.‐C. , Lin W.‐C. , Wu M.‐C. , Hsu C.‐D. , Tsai F.‐J. 
Published: March 2003

Objective To evaluate the association of urolithiasis with polymorphic microsatellite (encoding cytosine, adenine, and guanine, CAG) repeats in the exon 1 region of the androgen receptor (AR) gene and thymine/adenine (TA) repeats in the oestrogen receptor (ER). Patients and methods Patients with urolithiasis (149) and a group of normal controls (102) were examined and compared. The CAG repeats of the AR gene and TA repeats of the ER gene were detected by polymerase chain reaction. The CAG repeats ranged from 171 bp (10 CAG repeats with 141 bp of amplified flanking sequences) to 270 bp (43 CAG repeats). The TA repeats ranged from 160 bp to 194 bp. Associations between calcium oxalate stone disease and the CAG repeats in AR gene and TA repeats in ER gene were then evaluated. The results were classified according to sex and peaks in allelic frequency distribution. Results There was a significant difference between the male stone patients and the normal controls in the distribution of CAG repeats in the AR gene. Both groups showed a high percentage of 21‐repeats in the allelic distribution, at 17 (16%) and 20 (37%) in stone patients and normal controls, respectively. The results indicate that 21‐CAG repeats might be related to a lower risk of stone formation in men (P < 0.05). In the ER gene, the peak allelic distribution of TA repeats was 14, showing a significant difference between male stone patients and the normal control subjects (P < 0.01). There were no statistical differences between female stone patients and the control subjects in either the AR or the ER gene. Conclusion Urolithiasis among men appears to be associated with AR gene CAG repeat and ER gene TA repeat polymorphisms, whereas there was no significant association among female stone patients. These sex hormone receptors seem to be related to the higher incidence of stone formation among men.
Perimesenteric detubularization of ileum for ileocystoplasty improves compliance and increases capacity
Authors: Nikolaev V.V. 
Published: March 2003

Objective To describe a modified form of detubularization using a perimesenteric incision of the ileal segment, which increases the capacity of the neobladder and reduces the length of the ileal segment required. Patients and methods From February 1993 to November 1999, ileocystoplasty was undertaken in 20 patients (mean age 8.4 years, range 4–16). Six had myelodysplasia, four had primary epispadias, five had bladder exstrophy, three had post‐traumatic lesions and two had cloacal exstrophy. The patients were divided into two groups; in the first (eight patients, mean age 9.6 years, range 5–15) the ileal segment was opened along the antemesenteric border and in the second (12 patients, mean age 7.7 years, range 4–16) the ileal segment was opened adjacent to the mesentery, perimesenterically. Each segment was then folded and the perimesenteric edges sutured to form the pouch. Results The patients were assessed at 1 year after surgery; the neobladder capacity was evaluated as ((neobladder capacity − bladder capacity)/body weight), which shows the relative increase of bladder capacity after enterocystoplasty per unit of weight. There was a statistically significant increase in neobladder capacity in group 2 (perimesenteric transection; Kruskal–Wallis chi‐square, P = 0.005; Mann–Whitney U‐test, P = 0.006). Conclusion These results indicate that augmentation can be carried out by perimesenteric transection of the intestinal segment, which improves compliance and increases capacity of the neobladder.
The cloacal plate: the missing link in anorectal and urogenital development
Authors: Penington E.C. , Hutson J.M. 
Published: March 2003

Objective To determine whether differences in the embryology of the anorectal and urogenital area, previously examined in sheep, pigs, rats, rabbits and guinea pigs, producing varying conclusions, may be secondary to differences in species development. Materials and methods Rat and human embryos were studied at the time of genital tubercle development and cloacal partition by standard serial‐section histology, and by immunohistochemistry, dissection and scanning electron microscopy. The images obtained were compared with those previously reported for pig and sheep embryos. Results The cloacal plate, a vertically orientated midline plate of epithelial cells in the caudal half of the genital tubercle, was the key structure that varied between the different species. In rats the plate maintained a vertical height along its length, while in humans and pigs it reverted to a two‐layer membrane dorsally, shortly before it degenerated to expose both the anorectal and urogenital tracts. In sheep the plate was taller ventrally than in the other species but also reverted to a short membrane dorsally that exposed the hindgut when it degenerated. The anterior part of the cloacal plate persisted in all embryos as the urethral plate, which then participated in the formation of the urethra in the male and the vestibule in the female. The animal that most closely resembled humans in anogenital development was the pig. Conclusions The cloacal plate is the key to understanding early anorectal and urogenital development and yet it is barely recognized in published reports. An appreciation of its relevance helps to explain the variations in the described embryology of the region, and is mandatory when interpreting embryological findings in animal models of human anomalies. Given the similarities between porcine and human development, the pig may be the most legitimate animal model for the study of anorectal and urogenital anomalies in humans.
Possible autocrine loop of the epidermal growth factor system in patients with benign prostatic hyperplasia treated with finasteride: a placebo‐controlled randomized study
Authors: TØrring N. , MØller‐Ernst Jensen K. , Lund L. , Nielsen J.E. , Djurhuus J.C. , Poulsen S.S. , NexØ E. 
Published: March 2003

Objective To analyse the expression of the epidermal growth factor (EGF) system in prostate tissue and secretions obtained from patients with benign prostatic hyperplasia (BPH) treated with or without finasteride (which primarily targets the androgen‐sensitive secretory epithelial cells in the prostate, with little effect on basal epithelial and stromal cells). Patients and methods The expression of the EGF system was evaluated by enzyme‐linked immunosorbent assay and immunohistochemistry in samples of prostate tissue and secretions from patients with BPH randomized for treatment with finasteride or placebo for 3 months before surgery. Results Prostate tissue expressed the EGF receptor (HER1) and HER2, and the ligands EGF, transforming growth factor α (TGFα), heparin‐binding (HB) EGF, betacellulin and amphiregulin. Treatment with finasteride produced greater concentrations of amphiregulin (P < 0.05) than did placebo, did not change the level of TGFα, HER1 and HER2, and tended to decrease the concentration of EGF, betacellulin and HB‐EGF in prostate tissue. Using immunohistochemistry, HER1 and TGFα were both localized to the basal epithelial cells, and there was a strong positive correlation among the tissue concentrations of HER1, HER2 and TGFα. Amphiregulin localized to the luminal secretory epithelium. Prostate secretions contained only EGF, which was at levels ≈ 150 times higher than in prostate tissue; treatment with finasteride did not affect the concentration of EGF in prostate secretion. Conclusions There were only minor changes in the expression of TGFα, HER1 and HER2 after finasteride treatment. This may represent an important system for the continuous growth and homeostasis of the androgen‐independent basal epithelial cells in the prostate.
Innervation of congenitally hydronephrotic and normal porcine upper urinary tract
Authors: Rolle U. , Andersen H.L. , Puri P. , Djurhuus J.‐C. 
Published: March 2003

Objective To investigate the intrinsic innervation of the upper urinary tract in congenitally hydronephrotic and normal Goettingen minipigs, using the whole‐mount preparation technique. Materials and methods Whole‐mount preparations of hydronephrotic (two with bilateral ectopic ureters, one with left distal ureteric stenosis) and normal (three) porcine upper urinary tracts were examined by immunohistochemistry with tyrosine hydroxylase (TH) and neurofilament and by histochemical staining with NADPH‐diaphorase and acetylcholinesterase. Staining results were evaluated using normal bright‐field and confocal laser scanning microscopy. Results Neurofilament‐, TH‐immunoreactive and acetylcholinesterase‐positive nerve fibres and neuronal networks were identified in the adventitial, muscle and subepithelial layers of the whole upper urinary tract. An NADPH‐diaphorase‐positive network was expressed in the subepithelial layer and less densely in the muscle layer. The general distribution of the identified neuronal networks was similar in hydronephrotic and normal upper urinary tracts, but the density of these neuronal networks was less in the former. The most striking observation was the absence or marked reduction of neuronal networks in the stenotic part of the ureter in the pig with left distal ureteric stenosis. Conclusion Whole‐mount preparations provide a method for assessing the three‐dimensional topography of neuronal networks in the different layers of the porcine upper urinary tract. Although the macroscopic differences between the hydronephrotic and normal porcine upper urinary tracts were striking, changes in the innervation pattern were less obvious, except in distal ureteric stenosis.
Evaluation of the influence of systemic neoadjuvant chemotherapy on the survival of patients treated for invasive bladder cancer
Authors: Kolaczyk W. , Dembowski J. , Lorenz J. , Dudek K. 
Published: March 2003

Objective To assess the influence of neoadjuvant systemic chemotherapy using a modified methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) scheme in patients with invasive bladder cancer. Patients and methods Two groups of patients were reviewed retrospectively; group 1 included 51 who received chemotherapy before cystectomy and group 2 included 62 who were treated only with surgery. The mean (range) duration of follow‐up was 3.2 (0.25–10.25) years. The patients in group 1 were divided into two subgroups: those with tumour confined to the bladder (T1, T2 and T3a) and the remaining patients with tumour beyond the bladder (T3b, T4a,b). The chemotherapy was administered as routine MVAC, except vinblastine and methotrexate were given at 15 and 22 days during the cycle. A mean of three cycles were administered. Results The 5‐year survival rate in group 1 and 2 was 66% and 58%, respectively (P > 0.3); after 8 years of follow‐up the survival rates were 58% and 33%, respectively, and significantly different (P < 0.01). Conclusion Systemic chemotherapy using the modified MVAC scheme in patients subsequently undergoing radical cystectomy improved the survival rate after 8 years of follow‐up.
The correlation between pretreatment serum hormone levels and treatment outcome for patients with prostatic cancer and bony metastasis
Authors: Chen S.S. , Chen K.‐K. , Lin A.T.L. , Chang Y.‐H. , Wu H.H. , Chang L.S. 
Published: March 2003

Objective To evaluate whether pretreatment serum hormone levels are a prognostic factor for prostatic cancer with bony metastasis under hormonal treatment. Patients and methods Between 1980 and 1994, 96 patients with prostate cancer and bony metastasis were included for an evaluation by a retrospective review of their charts. All 96 had received hormonal treatment after a diagnosis of metastatic prostatic carcinoma. Serum testosterone, luteinizing hormone (LH), follicle‐stimulating hormone (FSH) and prolactin were assessed before treatment. The patients were divided into two groups according to their response during the follow‐up. Group 1 (good response) had no change or resolution of metastatic lesion(s) on the bone scan and a declining prostate‐specific antigen (PSA) level. Group 2 had increased PSA or progression of metastatic lesion(s) on the bone scan. Tumours were graded as low (2–4), intermediate (5–7) and high (8–10) using the Gleason score. Results There were 43 patients in group 1 and 53 in group 2; the overall mean (sd) age was 72.5 (6.8) years and the follow‐up 29.5 (0.5) months. The respective mean (sd) levels of testosterone, LH, FSH and prolactin before treatment were 4.6 (1.6) ng/mL, 20.2 (13.3) mIU/mL, 19.6 (18.6) mIU/mL and 20.7 (12.1) ng/mL in group 1, and 2.6 (1.0) ng/mL, 27.3 (11.0) mIU/mL, 27.1 (9.8) mIU/mL and 41.3 (28.4) ng/mL in group 2. The level of testosterone was significantly higher in group 1 than in group 2, while LH, FSH and prolactin were significantly lower in group 1 than in group 2. When stratified by tumour grade, patients in group 1 still had significantly higher pretreatment testosterone and lower LH, FSH and prolactin than those in group 2. Conclusion Higher testosterone and lower LH, FSH and prolactin levels were good prognostic factors for patients with metastatic prostatic cancer under hormonal treatment, irrespective of tumour grading.
The clinical utility of the prostate specific membrane antigen reverse‐transcription/polymerase chain reaction to detect circulating prostate cells: an analysis in healthy men and women
Authors: Llanes L. , Ferruelo A. , Páez A. , Gómez J.M. , Moreno A. , Berenguer A. 
Published: March 2003

Objective To evaluate the overall specificity of nested reverse transcriptase‐polymerase chain reaction (RT‐PCR) to detect prostate‐specific membrane antigen (PSM) mRNA in peripheral blood samples of healthy donors. Subjects and methods Peripheral blood samples were taken from 60 healthy blood‐donors (30 men and 30 women aged < 50 years) and analysed for PSM‐mRNA using nested RT‐PCR (in ‘hot‐start’ conditions and confirmed using nested EcoRI restriction enzyme). Intron‐spanning primer pairs specific for human PSM were deduced from the GenBank sequence (M99487) using gene software. The outer primer pair for PSM was: fwd: 1368 5′‐TCACCGGGACTCATGGGTGT‐3′; reverse: 1860 5′‐GCCTGAAGCAATTCCAAGTCGG‐3′. Inner primer pair for PSM was: fwd: 1480 5′‐AAGGAAGGGTGGAGACCTAG‐3′; reverse: 5‐ACTGAACTCTGGGGAAGGAC‐3′. The integrity of cDNAs was checked using primer pairs specific for the housekeeping gene β‐actin. The specificity and false‐positive rate were calculated assuming that the underlying prostate cancer incidence was nil. Results The first PCR was negative for all samples (100% specificity; 0% false‐positive rate). The nested PCR detected 23 positive samples (23/60, 38%) with an overall specificity of 62% (false positive rate, 38%). Conclusion Nested RT‐PCR of PSM‐mRNA in peripheral blood is highly unspecific. Its clinical utility in the management of prostate cancer must be low. Further development is needed of quantitative RT‐PCR, primers that identify prostatic PSM or another prostate‐specific marker gene to differentiate PSM mRNA from circulating prostate cells and from non‐prostatic tissues.