bluuebunny/crossref_metadata_2025_split huggingface dataset:
A noninvasive test for vesico‐ureteric reflux in children
Authors: Mevorach R.A. , Cilento B. , Zahorian S. , Badgett C. , Walker R. , Atala A. , Iannello S. , Meyer M. 
Published: March 2003

Objective To report the development and testing of a device for the noninvasive diagnosis of vesico‐ureteric reflux (VUR) which avoids the need for urethral catheterization (currently required to reliably determine the presence of VUR), and which thus avoids the anxiety of parents and patients that causes many families to refuse such evaluation.Patients and methods Fifty‐four children (49 girls and five boys, mean age 7.2 years, range 4–14) previously evaluated as having VUR volunteered to participate; no child was symptomatic at the time of the study. Refluxing units were known to be present by voiding cysto‐urethrography (within 1 year, mean 7 months) in 45 and absent in 16. The device developed acquires electronically processed acoustic signals from the child during an observed urination. The signals are then analysed ‘off‐line’ to determine the presence or absence of VUR. The initial preparation for the test included: (i) a full bladder [at least 0.80 ×  {(2 + age) × 30 mL}] measured by ultrasonography; and (ii) localization of the pelvi‐ureteric junction by ultrasonography to accurately place the device's sensors on the child's back. The children were then positioned at a commode after placing the sensors; the recording was started and continued until voiding occurred. The children were tested with the recording and analysis team unaware of the presence and/or degree of VUR. The first 47 studies were single‐kidney examinations and the remaining seven included simultaneous monitoring of both kidneys.Results Sixty‐one renal units were assessed and interpretable signals were obtained from 54 (89%). There were seven episodes of ‘system failure’ when no interpretable data were obtained. One unit with no VUR had a ‘reflux’ signal; in four kidneys, spontaneous (two) and postsurgical (two) resolution of reflux was predicted by the testing and subsequently verified by cyclic radionuclide cystography.Conclusions This noninvasive diagnostic technique detected VUR in 35 of 37 refluxing units and verified no reflux in 16 of 17 units without VUR. Further refinements may allow this technology to be used in all children with suspected VUR.
Endopyelotomy in the symptomatic older child
Authors: Nicholls G. , Hrouda D. , Kellett M.J. , Duffy P.G. 
Published: March 2003

Objective To evaluate the results of endopyelotomy in children, an established method in adult practice as a treatment for pelvi‐ureteric junction (PUJ) obstruction.Patients and methods Endopyelotomies undertaken between 1992 and 1999 by one surgeon in an established endourology unit were reviewed retrospectively. Children aged > 5 years presenting with pain and obstruction on isotope renography were selected for endopyelotomy. Patients with crossing vessels detectable on spiral computed tomography were treated by open pyeloplasty. Access to the renal pelvis was provided by a uroradiologist. Endopyelotomy was carried out through an Amplatz sheath of (median) 26 F. After applying traction to invaginate the PUJ an incision was made postero‐laterally using electrocautery via an 11 F paediatric resectoscope. Stenting was maintained for 6 weeks. In all, 13 patients (median age 10 years, range 5–14) were treated; two had associated calculi.Results The symptoms resolved and the obstruction was relieved in only six patients, with a median (range) follow‐up of 50 (26–68) months. The seven patients in whom endopyelotomy failed, as indicated by persistent pain, proceeded to open pyeloplasty at a median (range) of 4 (1.3–79) months. Of these, two had presented with associated multiple calculi and significant hydronephrosis (one with an associated duplex system) and three had crossing lower pole vessels at open operation. One developed a urinoma after the original endopyelotomy and one had a retained stent fragment removed at the time of pyeloplasty.Conclusions Endopyelotomy in the symptomatic child requires a careful preoperative evaluation. Crossing lower pole vessels warrant an open pyeloplasty.
The serum level of the amino‐terminal propeptide of type I procollagen is a sensitive marker for prostate cancer metastasis to bone
Authors: Koizumi M. , Yonese J. , Fukui I. , Ogata E. 
Published: March 2003

Objective To assess the level of a bone‐formation marker, the amino‐terminal propeptide of type I procollagen (PINP), for its utility in indicating bone metastasis in patients with prostate cancer. Patients and methods Several bone formation markers, i.e. PINP, the carboxy‐terminal propeptide of type I procollagen (PICP), bone‐specific alkaline phosphatase (BALP), and bone Gla protein (BGP), a bone resorption marker (pyridinoline cross‐linked carboxy‐terminal telopeptide, ICTP), and prostate specific antigen (PSA) were measured in 40 patients without and 25 patients with bone metastasis. No patient had undergone previous treatment, except for six who developed bone metastasis while undergoing hormone therapy. Results All markers except BGP were significantly higher in patients with bone metastasis than in those without. The levels of PINP correlated best with the extent of disease, although the levels of PSA, BALP and ICTP also correlated well. While PINP had the largest area under the receiver‐operator characteristic curve, PSA, BALP and ICTP also produced useful curves. Conclusion The bone formation marker PINP seems to be useful for discriminating patients with and without bone metastasis. PINP may help in the early and accurate diagnosis of bone metastasis in such patients.
A multi‐institutional analysis of laparoscopic orchidopexy
Authors: Baker L.A. , Docimo S.G. , Surer I. , Peters C. , Cisek L. , Diamond D.A. , Caldamone A. , Koyle M. , Strand W. , Moore R. , Mevorach R. , Brady J. , Jordan G. , Erhard M. , Franco I. 
Published: March 2003

Objective To combine and analyse the results from centres with a large experience of laparoscopy for the impalpable testis with small series, to determine the expected success rate for laparoscopic orchidopexy.Methods A questionnaire was distributed to participating paediatric urologists; each contributor retrospectively reviewed the clinical charts for their cases of therapeutic laparoscopy for an impalpable testis, detailing 36 variables for each patient. The data were collated centrally into a computerized database. For inclusion, the testis was intra‐abdominal (including ‘peeping’ at the internal ring) at laparoscopic examination, was not managed through an open approach and did not undergo orchidectomy. Three surgical groups were assessed, with success defined as lack of atrophy and intrascrotal position: group 1, primary laparoscopic orchidopexy; group 2, a one‐stage Fowler‐Stephens (F‐S) orchidopexy; and group 3, a two‐stage F‐S orchidopexy.Results Data were gathered from 10 centres in the USA, covering the period 1990–1999; 252 patients representing 310 testes were included and overall, 15.2% were lost to follow‐up. There was no significant difference between success rates in the larger and smaller series. Atrophy occurred in 2.2% of 178 testes, 22.2% of 27 testes and 10.3% of 58 testes in groups 1–3, respectively. Testes were not in a satisfactory scrotal position in 0.6%, 7.4% and 1.7% of groups 1–3, respectively. The mean follow‐up for each group was 7.7, 8.6 and 20.0 months, respectively. The overall success for all groups was 92.8% (97.2% group 1; 74.1% group 2; 87.9% group 3), with an atrophy rate of 6.1%.Conclusion Laparoscopic orchidopexy for the intra‐abdominal testis, in both large and small series, can be expected to have a success rate higher than that historically ascribed to open orchidopexy. Within this series, single‐stage F‐S laparoscopic orchidopexy resulted in a significantly higher atrophy rate than the two‐stage repair. However, when considering both F‐S approaches, the laparoscopic approach gave greater success than previously reported for the same open approaches. Despite the weaknesses inherent in a retrospective unrandomized study, we conclude that laparoscopic orchidopexy is, if not the procedure of choice, an acceptable and successful approach to the impalpable undescended testicle.
A comparison of the lateral and posterior retroperitoneoscopic approach for complete and partial nephroureterectomy in children
Authors: Borzi P.A. 
Published: March 2003

Objective To report the comparative results of a selective posterior or lateral retroperitoneoscopic approach (RPA) for nephroureterectomy in children.Patients and methods Following an established experience with RPA, 36 complete and 19 partial nephrouretectomies were prospectively randomized to a posterior and lateral retroperitoneoscopic approach The patients were aged 4 months to 14 years, with a body weight at operation of 5.7–82 kg. For posterior RPA the child is positioned prone, with three access ports. The operating space was created with balloon dissection and maintained with CO2 insufflation. The child was then rotated 30° with the kidney in the dependent position, and the operator and assistant standing on the affected side. In the lateral approach the child is in the lateral decubitus position with the operator and assistant facing the dorsal aspect of the patient.Results There was no significant difference in operative duration between the lateral and posterior approaches for nephrectomy (65 and 47 min) or partial nephrectomy (85 and 75 min). Two lateral nephrectomies required open conversion (one upper pole and one lower pole).Conclusion The posterior approach gives easy and quick access to the renal pedicle. It is preferable for complete nephrectomy alone and partial or polar excision. In children under 5 years old a near complete ureterectomy can be achieved. The lateral approach creates more inferomedial space, gives better access to ectopic kidneys and allows complete ureterectomy in all cases. Access to the pedicle in the normal position requires more frequent positioning of the kidney. Care must be taken as peritoneal tears are more common.
Prophylactic efficacy of a new gentamicin‐releasing urethral catheter in short‐term catheterized rabbits
Authors: Cho Y.‐H. , Lee S.‐J. , Lee J.Y. , Kim S.W. , Kwon I.C. , Chung S.Y. , Yoon M.S. 
Published: March 2003

Objective To describe an indwelling urethral catheter coated with gentamicin sulphate on the inner and outer surface of the catheter, and to evaluate the efficacy and safety of this catheter in preventing catheter‐associated infections in rabbits. Materials and methods Sixty rabbits were divided equally into control and experimental groups which were then subdivided equally according to the duration of catheterization (1, 3 and 5 days). Silicone‐treated latex catheters were used in the control group and gentamicin‐releasing catheters in the experimental group. Urine samples and surface swabs from the catheter were cultured for bacteriological assessment, and the catheter surface examined by scanning electron microscopy to structurally analyse the biofilms. Results The gentamicin‐releasing catheter reduced the incidence of bacteriuria (defined as  100 c.f.u./mL) after both 3 and 5 days of catheterization (eight and 10 rabbits, respectively, for the control catheter, vs two and four rabbits for the gentamicin‐releasing catheter, P < 0.05). The surfaces of the gentamicin‐releasing catheter were colonized less often than those of the control catheter after both 3 and 5 days (eight and 10, respectively, for the control, vs one and four for the gentamicin‐releasing catheter, P < 0.05). Scanning electron microscopy showed the formation of bacterial biofilm throughout the 3‐day and 5‐day control catheters, but deterioration of the bacterial biofilm was visible on the surface of the gentamicin‐releasing catheters. Conclusion This new gentamicin‐releasing catheter produced an antibacterial barrier which inhibited catheter‐associated urinary tract infection with no toxicity for at least 5 days. These in vivo studies suggest that this new catheter may be useful for controlling infection, with systemic and local safety, in patients undergoing short‐term indwelling urethral catheterization.
Donor fascia in urogynaecological procedures: a canine model
Authors: Fitzgerald M.P. , Mollenhauer J. , Brubaker L. 
Published: March 2003

Objective To explore the in vivo characteristics of donor fascia used in urogynaecological procedures, in a canine model. Materials and methods Two experiments were conducted. In the first, donor fascia grafts were obtained from 12 dogs, the grafts freeze‐dried and half were irradiated. The grafts were used for sacrocolpopexy and suburethral slings in each of five dogs. The dogs were killed at 2, 6 and 12 weeks after graft implantation, the grafts retrieved and assessed using tensilometry. In the second experiment, unirradiated sacrocolpopexy grafts were implanted in eight dogs; four grafts were placed under no tension and four under moderate tension. At 8 weeks, the grafts were retrieved and assessed by tensilometry. Measures of strength in both experiments included the ultimate tensile strength, ultimate strain and stiffness. All measures were compared using Kruskal–Wallis nonparametric tests in both studies. Results In the first experiment, a significant minority (23%) of grafts had complete loss of strength. Measures of graft strength did not vary when analysed according to donor dog, host dog, history of graft irradiation, duration of implantation or location of graft. In the second experiment, grafts placed under no tension tended to have lower tensile strength (χ2(1)= 3.125, P = 0.077), lower stiffness (χ2(1)= 3.125, P = 0.077) and lower ultimate strain (χ2(1)= 3.182, P = 0.074). Conclusion Graft irradiation as an isolated variable did not predispose grafts to failure in vivo. Biomechanical factors at the implantation site are likely to play a critical role in determining ultimate graft strength.
Intravesical Escherichia coli lipopolysaccharide stimulates an increase in bladder nerve growth factor
Authors: Bjorling D.E. , Jacobsen H.E. , Blum J.R. , Shih A. , Beckman M. , Wang Z.‐Y. , Uehling D.T. 
Published: March 2003

Objective To investigate the effects of the intravesical instillation of Escherichia coli lipopolysaccharide (LPS) on nerve growth factor (NGF, which may mediate the pain associated with inflammation) protein and mRNA in the bladders of mice. Materials and methods
E. coli LPS was instilled into the bladders of female mice; the whole‐bladder NGF content was then determined by an enzyme‐linked immunosorbent assay and the NGF mRNA content of the bladder determined by semiquantitative reverse transcription‐polymerase chain reaction. Bladder NGF was also evaluated by immunohistochemistry in some of the mice. Results LPS stimulated a significant increase in bladder NGF 90 min after instillation, but bladder NGF content was significantly less than that in bladders of control mice 3 and 7 h after LPS instillation. Twenty‐four hours after the intravesical infusion of saline or LPS, there was no difference in NGF content in bladders from saline or LPS‐infused mice. Immunohistochemistry confirmed the presence of increased NGF in the mucosa of detrusor from bladders 90 min after LPS instillation. Bladder NGF mRNA increased more slowly in response to LPS, and 7 and 24 h after LPS instillation the relative abundance of NGF mRNA was 1.5 and 2.0 times greater in LPS‐infused bladders, respectively. Conclusions
E. coli LPS can stimulate increased NGF message and protein in the bladder. The increase in NGF protein preceded the increase in mRNA, suggesting that this increase was not the result of gene transcription. It is possible that NGF participates in the pathogenesis of pain associated with bacterial cystitis.
Does age influence the behaviour of localized prostate cancer?
Authors: Parker C.C. , Gospodarowicz M. , Warde P. 
Published: March 2003

Objective To assess, in a meta‐analysis of published studies, whether age influences the behaviour of localized prostate cancer. Methods The Medline database was searched from 1966 to 2000 to identify studies analysing the outcome of localized prostate cancer by age, using disease‐specific outcome measures, and having controlled for the established prognostic factors of grade, T stage and, where available, serum prostate‐specific antigen (PSA) level. Results In all, 34 studies were identified, which included a total of 27 551 patients. The incomplete and heterogeneous nature of the reports precluded any quantitative overview. The findings of these reports are described and methodological shortcomings discussed. Conclusion The evidence suggests that young age was an adverse prognostic factor in some series of radiation therapy before the advent of PSA assays, when men typically presented clinically with locally advanced disease, but that age has no significant prognostic effect in contemporary series of localized prostate cancer. Possible explanations for this difference are discussed, together with implications for further studies.
Variation in percentage‐free prostate‐specific antigen (PSA) with prostate volume, age and total PSA level
Authors: Törnblom M. , Norming U. , Becker C. , Lilja H. , Gustafsson O. 
Published: March 2003

Objective To examine the correlation between prostate volume, patient age and total prostate‐specific antigen (tPSA) with the percentage‐free PSA (f/tPSA) in a population‐based cohort of men with no prostate cancer and with a tPSA of < 10.0 ng/mL. Subjects and methods Men who in 1988–1989, after randomized selection in the general population, participated in a population‐based screening study for prostate cancer, were investigated. In all, 1622 of the men (aged 55–70 years) were considered free from prostate cancer and had a tPSA level of < 10.0 ng/mL. The f/tPSA and tPSA were determined in frozen sera from each individual, and related to prostate volume and age measured at the time of the study. The entire population was investigated, as were four subpopulations based on tPSA levels (<2.0, 2.0–3.9, 4.0–6.9 and 7.0–9.9 ng/mL). Statistical calculations included multiple regression and correlation analysis. Results The f/tPSA level varied with prostate volume and age, but the decisive factor for this variation was the tPSA level. The closest correlation was in the tPSA interval 7.0–9.9 ng/mL, where volume and age together explained 47% of the variation in f/tPSA. Also, for men with tPSA levels in each of the intervals 2.0–3.9, 4.0–6.9 and 7.0–9.9 ng/mL, the f/tPSA increased with higher prostate volumes and age. In men with tPSA levels of < 2.0 ng/mL the f/tPSA was not affected by variations in prostate volume or age. Conclusion The variation in f/tPSA with prostate volume, age and tPSA is highly dependent on the tPSA level. Volume and age in the tPSA interval 7.0–9.9 ng/mL can explain almost half the variation in f/tPSA, whereas this influence is insignificant in men with a tPSA of < 2.0 ng/mL.
Increased endothelin‐1 and decreased adrenomedullin gene expression in the stenotic tissue of congenital pelvi‐ureteric junction obstruction in children
Authors: Knerr I. , Nyul Z. , Miller J. , Rösch W. , Dötsch J. , Repp R. , Weidner W. , Rascher W. 
Published: March 2003

Objectives To test the hypothesis that the gene expression of endothelin‐1 and adrenomedullin may be altered in stenotic tissues of patients with congenital hydronephrosis caused by pelvi‐ureteric junction (PUJ) obstruction. Materials and methods Using real‐time reverse transcription‐polymerase chain reaction, mRNA of smooth muscle‐constricting endothelin‐1 and of smooth muscle‐relaxing adrenomedullin was quantified in tissue specimens of 20 patients with PUJ obstruction (mean age 5.1 years, sd 7.0) and of 21 controls with normal PUJs (mean age 23.5 years, sd 24.2). Results The amount of endothelin‐1 mRNA in stenotic specimens was higher than in the controls, indicated by significantly lower threshold cycles (Ct values) in real‐time PCR for the target gene in the obstructive tissue, with mean (sd) values of 24.9 (1.6) and 26.0 (2.1) (P < 0.05), respectively. The endothelin‐1/CD31 ratio was significantly higher in the patients (P < 0.05) than in controls. In addition, adrenomedullin gene expression in the obstructed junctions was significantly lower than in normal junctions, with higher Ct values for the patient group of 26.7 (1.6) vs 25.2 (1.8) (P < 0.05) and lower adrenomedullin mRNA when standardized to glyceraldehyde‐3‐phosphate dehydrogenase (GAPDH) (P < 0.05), CD31 (P < 0.01) and smooth muscle α‐actin mRNA (P < 0.01). The two groups showed no significant differences for GAPDH and CD31 mRNA content, whereas there was about twice as much α‐actin mRNA in stenotic tissues than in unaffected PUJs, shown by the lower Ct values for the patient group of 16.9 (2.0) vs 17.9 (2.6) (P < 0.05). Furthermore, endothelin‐1, adrenomedullin and α‐actin mRNA amounts were independent of age. Conclusion Taken together these results provide evidence that the production of autocrine/paracrine acting endothelin‐1 and adrenomedullin is altered in tissues of patients with genuine PUJ obstruction, and may be involved in the pathogenesis of congenital hydronephrosis.
The protective effects of captopril and nitric oxide on solitary kidney after chronic partial ureteric obstruction
Authors: Öztürk H. , Dokucu A.I. , Otçu S. , Gezici A. , Ketani A. , Yildiz F.R. , Özdemir E. , Yücesan S. 
Published: March 2003

Objective To determine whether vasodilator agents (captopril and nitric oxide) change the morphological and functional effects of chronic partial ureteric obstruction in solitary kidney tissue in unilaterally nephrectomized rats. Materials and methods Each of 50 prepubertal Wistar albino rats underwent right nephrectomy and were then assigned to one of five groups. Rats in group 1 underwent a sham operation (control) and in the other groups the ureter of the remaining kidney was partially obstructed by surgery. In group 2, no drug treatments were given; in groups 3, 4 and 5 captopril, l‐arginine methyl ester (L‐Arg) or NG‐ nitro‐l‐arginine‐methyl ester, respectively, were given for 3 weeks. In all rats, diuretic scintigraphy was used to measure kidney perfusion, glomerular filtration rate (GFR) and concentration. Blood urea nitrogen (BUN), serum creatinine levels, kidney parenchymal weight and pelvic volume were measured and the kidneys evaluated histopathologically. Results Renal perfusion was significantly greater in both group 3 and 4 than in group 2. The GFR was 18% greater in group 3 and 22.3% greater in group 4 than in group 2. The GFR was decreased by 67% in group 5 compared with the control group. The mean parenchymal weight, mean pelvic volume, BUN and serum creatinine in the four groups with a partially obstructed ureter were significantly different from the control group. There also were significant differences between group 2 and groups 3–5, and between group 2 and group 3. Histological damage was severe in all four groups with partial ureteric obstruction, but in the drug‐treated groups, medullary fibrosis was less frequent. Conclusion After 3 weeks of treatment, captopril and l‐Arg both improved kidney perfusion, GFR, BUN and serum creatinine levels, but were less effective in preventing parenchymal atrophy and changes in pelvic volume.