bluuebunny/crossref_metadata_2025_split huggingface dataset:
The significance of serum levels of insulin‐like growth factor‐1 in patients with prostate cancer
Authors: Kurek R. , Tunn U.W. , Eckart O. , Aumüller G. , Wong J. , Renneberg H. 
Published: March 2003

Objectives To compare the serum levels of insulin‐like growth factor‐1 (IGF‐1) in patients with prostate cancer and in control patients with no malignancy, and to evaluate any possible influence of testicular androgen withdrawal on the level of IGF‐1 in patients with prostate cancer. Patients and methods IGF‐1 was measured in serum samples from 238 patients using both a chemiluminescence method and a radio‐immunoassay. From a subgroup of 19 patients presenting with newly diagnosed carcinoma of the prostate, IGF‐1 and testosterone values were measured before and during the course of testicular androgen with‐drawal, achieved by the administration of luteinizing hormone‐releasing hormone (LHRH) analogues combined with anti‐androgens. Results There were no significant differences in the mean serum levels of IGF‐1 patients with and without prostate cancer (158.6 and 159.1 ng/mL, respect‐ively). There were no significant differences in mean IGF‐1 levels before and after antiandrogen therapy; the mean (median, sd, range) levels of testosterone (µg/L) and IGF‐1 (ng/mL) before androgen withdrawal were 4.81 (4.84, 1.26, 3.11–6.93) and 157.1 (152.5, 26.7, 122.8–195.1). After androgen withdrawal the corresponding values were 0.303 (0.218, 0.24, 0.13–0.81) and 169.7 (31.7, 168.6, 124.9–227.6). A linear regression analysis (P = 0.76) and Spearman rank order correlation test (correlation coefficient –0.0613, P = 0.64) showed no association between levels of testosterone and IGF‐1. Freeze and thaw cycles applied to the samples had no effect on the IGF‐1 values measured. Conclusions There was no significant association between IGF‐1 serum levels and prostate cancer. Short‐term androgen withdrawal using LHRH anal‐ogues combined with anti‐androgens had no effect on the levels of IGF‐1.
Penile fibrotic changes after radical retropubic prostatectomy
Authors: Ciancio S.J. , Kim E.D. 
Published: March 2003

Objective To investigate the type of penile deformity, response to treatment of and predictive factors for the formation of penile fibrotic changes after radical retropubic prostatectomy (RRP). Patients and methods Between July 1996 and September 1998, 110 men who had undergone RRP a mean (SD, range) of 35 (20, 5–145) months previously were evaluated by one physician for their erectile dysfunction. Those men affected by penile fibrotic changes were advised to initiate medical therapy for possible Peyronie’s disease; their charts were reviewed and they were interviewed to determine the outcome. Results Overall, 45 of 110 patients (41%) with erectile dysfunction after RRP had penile fibrotic changes, representing 11% of all patients undergoing RRP in the specified period. The primary clinical presentation included penile curvature in 42 men (93%) and ‘waistband’ deformity in 11 (24%; some had both); palpable plaques were present in 31 (69%). On assessing the outcome in 40 men, 16 (40%) felt that their condition had improved, half were unchanged and 10% progressed, within a mean follow‐up of 24 months after diagnosis. Of the 16 improved, 14 were regularly using a vacuum constriction device or injection therapy. No significant factors predictive of the fibrotic changes could be identified, including the use of intracavernosal injection therapy before onset, neurovascular bundle resection, operative duration, estimated blood loss and pathological tumour grade or stage. Conclusions Penile fibrotic changes are a significant but previously undescribed problem in men after RRP. Although predisposing factors could not be identified, most men felt that their condition stabilized or improved during treatment. Corroborative confirmation of this association and its aetiology will require prospective studies.
Apoptosis in the erectile tissues of diabetic and healthy rats
Authors: Alici B. , Gümüstas M.K. , Özkara H. , Akkus E. , Demirel G. , Yencilek F. , Hattat H. 
Published: March 2003

Objective To compare the frequency of apoptosis in the erectile tissue of chronic diabetic and healthy rats. Materials and methods Fourteen chronic diabetic and 10 healthy Sprague–Dawley rats were killed, their penises harvested and stored at –70°C until staining and flow cytometric analysis for apoptosis. A cell suspension was obtained from the penile tissue by scraping the inside of the cavernosum with a scalpel and filtering through a mesh. Samples of the cell suspension (0.5 × 106 cells) were stained with Annexin V (an indicator of apoptosis) and propidium iodide (PI, which stains dead cells), incubated for 15 min at room temperature and analysed by flow cytometry. The DNA content was also analysed in each sample. Results In normal erectile tissue, a mean of 6.2% of cells were stained with Annexin V, while only 2.7% were stained with PI; DNA content analyses showed 7.5% were hypodiploid cells. In diabetic rats 19.5% of cells were stained with Annexin V and 5.2% with PI; 22.9% of cells were hypodiploid. Conclusion The ratio of apoptotic cells in the erectile tissues of diabetic rats was significantly greater than in normal rats. The high rate of apoptosis in diabetic rats may play a role in the pathophysiology of erectile dysfunction.
Testicular adenomatoid tumours: clinical and ultrasonographic characteristics
Authors: Kassis A. 
Published: March 2003

Objective To determine if benign testicular tumours can be identified clinically and ultrasonographically before surgery. Patients and methods The clinical and ultrasonographic findings of six patients with testicular adenomatoid tumours and 16 with testicular germ cell tumours were assessed retrospectively and compared. Results All adenomatoid tumours were characterized on physical examination by a well‐defined, painful and unfixed nodule, contrasting with the painless and ill‐defined malignant lesions. On ultrasonography, of the six adenomatoid tumours, two appeared hypoechoic, one hyperechoic, two isoechoic and one was normal, whereas none of the 16 tumours appeared normal or isoechoic. Conclusions While isoechogenicity was not apparent in the group of testicular malignancies, the two groups had hypo‐ and hyperechoic patterns. Small, superficial, painful and unfixed testicular tumours that appear isoechoic on ultrasonography should be biopsied through an inguinal approach, with frozen sections assessed, instead of the patients undergoing immediate radical orchidectomy.
Transurethral implantation of silicone polymer for stress incontinence: evaluation of a porcine model and mechanism of action in vivo
Authors: Radley S.C. , Chapple C.R. , Lee J.A. 
Published: March 2003

Objective To evaluate the anatomical location, histological appearances and mechanism of action of sili‐cone polymer (Macroplastique®) after transurethral implantation. Materials and methods An in vivo pig model was developed to investigate the organization of Macroplastique 6 weeks after injection. The results were compared with the immediate appearance of injected Macroplastique in a surgical training device (using isolated pig urethrae) and with the histological appearances of Macroplastique in an explanted human specimen. Results Macroplastique was subserosal in all specimens; it provoked a marked foreign‐body inflammatory reaction, producing firm nodules 6 weeks after implantation. The histological appearances in the in vivo pig model and the human specimen were indistinguishable. Conclusions These findings indicate that the mechanism of action of Macroplastique is to augment pressure transmission to the proximal urethra by producing focal but firm expansion of periurethral tissues.
The production of nerve growth factor by human bladder smooth muscle cells in vivo and in vitro
Authors: Tanner R. , Chambers P. , Khadra M.H. , Gillespie J.I. 
Published: March 2003

Objective To measure the concentrations of nerve growth factor (NGF) in tissue biopsies taken from subjects with a normal bladder and from patients diagnosed to have idiopathic detrusor instability (associated with a reduction in the density of motor nerves), and to use anin vitromodel to study the mechanisms of NGF expression.Materials and methods Biopsy specimens were obtained during endoscopic and open surgery from patients undergoing routine bladder surgery. The patients were divided into two categories based upon urodynamic characterization. The NGF content in samples from 11 normal bladders and seven idiopathic unstable bladders were measured using an enzyme‐linked immunosorbent assay. The mechanisms influencing net NGF production were explored using detrusor cellsin vitro.Results The mean (sem) NGF content was significantly higher in unstable tissues, at 0.96 (0.05) pg/µg protein, than in the normal bladder, at 0.53 (0.05) pg/µg protein. In the cell model, acetylcholine (10 µmol/L), noradrenaline (1 and 10 µmol/L) and ATP (1 µmol/L) caused a significant increase in net NGF production; acetylcholine at 1 µmol/L had no effect. Direct stimulation of protein kinase C (PKC) by phorbol ester (33 ng/mL) or elevation of cAMP using forskolin (10 µmol/L) increased NGF, suggesting that at least two intracellular pathways (PKC‐ and PKA‐dependent) are involved. The expression ofc‐Foswas increased by phorbol 12‐myristate 13‐acetate added before NGF, suggesting thatc‐Fosmay be involved in regulating NGF production.Conclusion These data suggest a role for NGF in the physiology and pathophysiology of the human bladder, and indicate some of the possible mechanisms which might regulate NGF production.
Delayed testosterone replacement restores nitric oxide synthase‐containing nerve fibres and the erectile response in rat penis
Authors: Baba K. , Yajima M. , Carrier S. , Morgan D.M. , Nunes L. , Lue T.F. , Iwamoto T. 
Published: March 2003

Objective To elucidate the effect of testosterone on penile innervation. Materials and methods Three groups of six rats each were assessed; two groups (1 and 2) were castrated and the third (group 3) underwent a sham operation (control). Eight weeks after castration, group 2 received a subcutaneous injection with testosterone. At 8 weeks, the rats in group 1 and 3 underwent a final functional analysis while those in group 2 did so at 12 weeks. The evaluation included a subcutaneous injection with apomorphine to study centrally mediated erection, and cavernosal nerve electrostimulation and papaverine injection to study peripherally mediated erection. At death a penile mid‐shaft specimen was taken for NADPH‐diaphorase staining. Results In the apomorphine study, castration resulted in significantly fewer yawns and erections than in the control, and those in group 2 significantly better central erectile function than in the controls. The mean (
sem) number of nitric oxide synthase (NOS)–containing nerve fibres in the corpora cavernosa and both dorsal nerves of castrated rats, at 46.2 (9.1) and 203 (32.1), respectively, were significantly lower than in rats in group 2, at 84.1 (11.2) and 300.6 (17.1), and than in the controls, at 88.6 (10.9) and 306.3 (22.9), respectively. The intracavernosal pressure decreased significantly in the absence of testosterone, both after electrostimulation and intracavernosal papaverine injection. However, there was no difference between the control and group 2 rats in either the number of NOS‐containing nerve fibres or in the peripheral erectile functional study. Conclusions Testosterone acts on the nervous system to mediate erection; when it is absent there may be down‐regulation of both the production and activity of NO, thereby decreasing the response to peripheral stimulation via the NO pathway. The restoration of erectile function seen in rats in group 2 supports this phenomenon. Delayed testosterone replacement has no detrimental effect on the restoration of the erectile mechanism after castration.
Doxazosin: a new cytotoxic agent for prostate cancer?
Authors: Cal C. , Uslu R. , Gunaydin G. , Ozyurt C. , Omay S.B. 
Published: March 2003

Objective To determine the sensitivity of drug‐resistant prostate cancer cell lines to doxazosin‐mediated cell death, and the effects of combining doxazosin and chemotherapeutic agents on these cell lines. Materials and methods The cytotoxic effect of doxazosin was initially evaluated in the prostate carcinoma cell lines DU145 and PC‐3. Doxazosin was combined either with adriamycin, etoposide or paclitaxel after its cytotoxic effects were detected in these cell lines. The tetrazolium dye (MTT) assay and trypan blue dye‐exclusion tests were used to determine drug‐mediated cytotoxicity. Experiments were performed at least three times and representative data are presented. Results Both cell lines were sensitive to doxazosin‐mediated cytotoxicity and the maximum cytotoxicity was achieved after 72 h. While cell death increased with increasing concentrations of doxazosin, 60 µmol/L doxazosin killed more than half of the cells in these cell lines. The combination of doxazosin with both adriamycin and etoposide resulted in significant synergistic cytotoxic activity at subtoxic concentrations of the drugs. Interestingly, the combination of doxazosin and paclitaxel resulted in antagonistic activity. Conclusion Doxazosin‐mediated cytotoxicity in the drug‐resistant human prostate carcinoma cell lines was confirmed. Combinations of doxazosin with either adriamycin and etoposide, but not paclitaxel, had synergistic cytotoxic activity in these tumour cell lines. These results suggest that doxazosin could be a new cytotoxic agent, either used alone or combined, in the treatment of prostate cancer.
Clinical, physical, sperm and hormonal data in 251 adults operated on for cryptorchidism in childhood
Authors: Gracia J. , Sánchez Zalabardo J. , Sánchez García J. , García C. , Ferrández A. 
Published: March 2003

Objective To determine the clinical, physical, sperm and hormonal status during adulthood in cryptorchid patients operated on during childhood, and to assess these variables according to the age at surgery and preoperative testicular position.Patients and methods A letter was sent to all 890 patients > 18 years old who underwent surgery for cryptorchidism during childhood; 274 responded and were assessed using a sexual history, physical examination, pituitary axis study and sperm analysis. Data were complete for 251 patients (mean age 21 years, range 18–30); 196 had unilateral (25 anorchic) and 55 had bilateral cryptorchidism. Clinical, surgical and anatomopathological records at surgery during childhood were also reviewed.Results The mean (sd) age at orchidopexy was 6.4 (3.3) years and the mean age at assessment 21.1 (2.7) years. Semen samples generally showed abnormalities; 10 patients (4%) with bilateral and 57 (23%) with unilateral cryptorchidism had semen values within the normal range. There was no correlation between the sperm count and age at surgery for unilateral or bilateral cases (Spearman test). There was a significant correlation (r = − 0.41) between the sperm count and level of follicle‐stimulating hormone (FSH). There were no significant differences in the sperm count for patients with different testicular locations (anova) or in those treated or untreated with human chorionic gonadotrophin (Student’s t‐test). The only significant relationship (P < 0.001) was between the sperm count and unilateral or bilateral cryptorchidism.Conclusions The sperm quality of adults operated on for cryptorchidism during childhood is independent of the age at surgery or testicular location, but is influenced by whether the cryptorchidism was unilateral or bilateral. FSH levels were negatively correlated with sperm density.
A urethral stent for the treatment of detrusor‐striated sphincter dyssynergia
Authors: Chartier‐Kastler E.J. , Thomas L. , Bussel B. , Chancellor M.B. , Richard F. , Denys P. 
Published: March 2003

Objective To assess the technique, efficacy and complications of the Ultraflex® urethral stent (Boston Scientific Corp., Boston, MA) for the treatment of detrusor‐striated sphincter dyssynergia (DSD). Patients and methods Forty consecutive patients with DSD who had a Ultraflex® stent placed in the membranous urethra were evaluated prospectively. DSD was caused by spinal cord injury in 30, multiple sclerosis in six and other neurological diseases in four. All patients were either tetraplegic or paraplegic and unable to use intermittent self‐catheterization. Previous bladder management consisted of an indwelling catheter in 15 patients, chronic suprapubic catheters in two, intermittent catheterization in nine, and trigger reflex micturition in 14. The Ultraflex stent was placed under local anaesthesia. The stents were 50 mm long in 36 patients, 45 mm in two and 40 mm in two. The mean (sd) follow‐up was 16.9 (13.8) months. Results The mean (sd) residual urine decreased from 245.9 (117) mL before stenting to 65.2 (19.3) mL at 12 months afterward (n = 19). One stent was removed at 13 months for chronic prostatic and urinary tract infection leading to autonomic dysreflexia. There was no stent stenosis and 17 of 18 stents had  > 75% epithelial coverage at one year. None of the stents migrated. Seven patients underwent secondary bladder neck incision through the stent. The stent length was increased in four patients using a second overlapping distal stent, twice during the first procedure and twice within 6 months because the sphincter was inadequately covered. Conclusions The Ultraflex® stent achieved the expected results for a prosthetic sphincterotomy and appears to be an appropriate but less invasive treatment for DSD.
The role of the activated form of matrix metalloproteinase‐2 in urothelial cancer
Authors: Kanda K. , Takahashi M. , Murakami Y. , Kanayama H. , Kagawa S. 
Published: March 2003

Objective To investigate the expression of matrix metalloproteinase‐2 (MMP‐2, reportedly associated with cancer cell invasion and metastasis in many human cancers) in urothelial tumours and thus define its role in this disease. Materials and methods The expression of both the activated form of MMP‐2 and total MMP‐2 (activated + latent form) was measured using gelatine zymography in tissue obtained surgically from 61 patients with urothelial cancer. The correlation between the level of the activated form of MMP‐2 and clinical and histological variables was assessed. Results The expression of activated and total MMP‐2 were significantly higher in invasive tumour tissue and both levels were correlated with histological grade. In particular, the level of activated MMP‐2 was more closely correlated than that of total MMP‐2 in invasive tumour tissue. Moreover, high levels of activated MMP‐2 were strongly associated with shorter disease‐specific survival (P = 0.0016). Conclusion These findings suggest that activated MMP‐2 plays a significant role in invasion of urothelial cancer and that the level of activated MMP‐2 expression is a useful prognostic indicator.
The contribution of cholinergic detrusor excitation in a pig model of bladder hypocompliance
Authors: Mills I.W. , Drake M.J. , Greenland J.E. , Noble J.G. , Brading A.F. 
Published: March 2003

Objective To investigate the role of cholinergic excitation in mediating changes in detrusor compliance (manifested on conventional cystometry as an incremental rise in detrusor pressure as bladder volume increases) under conditions of propofol‐sedation in the pig. Materials and methods Consecutive cystometrograms (CMGs) were obtained from eight female Large White pigs at a bladder filling rate of 50 mL/min. The first CMG was obtained while the pig was awake and unsedated. Two subsequent CMGs were obtained after light to moderate sedation with propofol (2–8 mg/kg/h) before and after the administration of intravenous atropine (0.02 mg/kg). Results All bladders were highly compliant over the volumes instilled (before sedation) with a maximum pressure during the filling phase of 0.9 cmH2O and a compliance of 943 mL/cmH2O. After sedation with propofol, the maximum pressure during the filling phase increased to 14 cmH2O with a compliance of 69 mL/cmH2O. Atropine antagonized this change in compliance; after sedation and atropine, the maximum pressure during the filling phase decreased to 4 cmH2O (P < 0.05) and the compliance increased to 337 mL/cmH2O (P < 0.05). Conclusion The decrease in compliance seen in the pig bladder after sedation with propofol is mediated via muscarinic excitation. This probably occurs as a result of low‐level tonic release of acetylcholine by the efferent parasympathetic nerves. The existence of such efferent excitatory activity during the storage phase in the overactive human bladder might explain the efficacy of bladder‐selective muscarinic antagonists in a proportion of patients with detrusor hyper‐reflexia and instability.
Iliac nodal metastases from carcinoma of the penis treated surgically
Authors: Lopes A. , Bezerra A.L.R. , Serrano S.V. , Hidalgo G.S. 
Published: March 2003

Objective To evaluate survival in patients with metastatic iliac nodal involvement from carcinoma of the penis. Patients and methods Thirteen patients with metastases to the iliac nodes were selected from 68 with squamous cell carcinoma of the penis who had undergone amputation and bilateral ilio‐inguinal lymphadenectomy. The 1978 Tumour‐Nodes‐Metastasis system was used for staging. Deep and superficial lymph nodes were removed during the inguinal procedure. Lymph nodes below the common iliac artery (external and obturator) were removed and histologically evaluated for the presence of metastases. Results The mean (median, range) follow‐up was 55.5 (8.8, 0.3–235) months, at the end of which five patients were free of cancer, seven had died from cancer or treatment‐related complications and one was lost to follow‐up. Four of the five survivors had metastases to only one iliac lymph node. Conclusion Ilio‐inguinal lymphadenectomy may have a significant role in increasing the survival of patients with metastases to only one iliac lymph node.
Computed tomography 21 days after chemotherapy, three‐dimensional estimates of metastatic volume and the need for surgery in patients with germ cell cancer
Authors: Bozcuk H.S. , Ravi R. , Turner B. , Tsetis D. , Thomas J.M. , Chan O. , Reznek R. , Hendry W.F. , Oliver R.T.D. 
Published: March 2003

Objective To assess whether the response visible on computed tomography (CT) 21 days after the first course of chemotherapy in patients with nonseminomatous germ cell tumour predicts the need for surgery and whether three‐dimensional (3D) reconstruction adds to the diagnostic accuracy. Patients and methods CT scans from 52 patients treated with cisplatin‐based chemotherapy were assessed for tumour shrinkage by measuring the changes of a one‐dimensional (1D) measurement of the maximum transverse diameter, and comparing CT scans before, 21 days after the first course and at the end of chemotherapy (1D method). In a subset of patients, using a special formula, the 1D‐derived 2D and 3D shrinkage (2Dder and 3Dder) were compared with four other computed or calculated methods (1D, 2D, 3Dcalc, 3Dcomp). Results At day 21, in 32 of 52 patients (62%) there was < 50% tumour shrinkage using the 1D assessment; 21 of them (66%) needed surgery, compared with none of the 20 patients with > 50% tumour shrinkage by day 21 (χ2 = 22.83, P < 0.001). The 1D method showed significantly less shrinkage than all the other methods but when this was used to derive a 3D shrinkage, assuming the mass to be spherical (3Dder), it was not statistically different from that of 3Dcomp. Conclusions The assessment of the response from 1D CT scan estimates 21 days after initiating chemotherapy identifies a subgroup of patients who have a high probability of needing surgery. Although expected to be more accurate, the 3Dcomp estimate of tumour shrinkage was no better than the 3Dder estimate.