bluuebunny/crossref_metadata_2025_split huggingface dataset:
High scrotal orchidopexy for palpable maldescended testes
Authors: JAWAD A.J. 
Published: November 2003

Objective To confirm that most spermatic cords of palpable maldescended testes are long enough to place the testes in the scrotum and therefore that a satisfactory scrotal testicular position can be achieved by a single high scrotal incision with less dissection of the inguinal region.Patients and method Between January 1991 and June 1995, 106 high scrotal orchidopexies (HSOs) for clinically palpable maldescended testes were carried out in 96 patients (mean age 41 months, range 14 months to 11 years). Ten patients had bilateral undescended testes. Regardless of the initial testicular position or the age of the patients, all orchidopexies were commenced with a high scrotal incision. Ninety‐two testes (87%) were placed satisfactorily in the scrotum and the remaining 14 testes (13%) required a second inguinal incision.Results During the follow‐up (mean 16 months, range 8 months to 3 years), 85 testes (80%) showed good anatomical and cosmetic results. Five testes required a repeat conventional orchidopexy 6 months after the HSO. Three testes were excised because they showed atrophic changes; 11 of the 14 testes which required two incisions initially have shown good results.Conclusion High scrotal orchidopexy is a satisfactory approach to any palpable maldescended testis, having the advantage of using a single incision and requiring less dissection and anatomical disruption of the inguinal region, with excellent cosmesis.
Relaxant effects of potassium‐channel openers on normal and hyper‐reflexic detrusor muscle
Authors: MARTIN S.W. , RADLEY S.C. , CHESS‐WILLIAMS R. , KORSTANJE C. , CHAPPLE C.R. 
Published: November 2003

Objective To compare the effects of the potassium‐channel openers, levcromakalim and YM934, in isolated human detrusor muscle from normal and hyper‐reflexic bladders.Materials and methods Strips of human detrusor muscle from normal and hyper‐reflexic bladder were pre‐contracted with carbachol and the potassium‐channel openers (0.1–0.3 &mu;mol/L) were added cumulatively to the organ baths. Other strips were field‐stimulated at frequencies producing 25% and 75% of the maximum response to field stimulation. Contractions could be abolished by atropine (10 &mu;mol/L) and tetrodotoxin (1 &mu;mol/L).Results The hyper‐reflexic bladder was significantly more sensitive to carbachol than the normal bladder but the maximum response was significantly lower in the hyper‐reflexic tissue. There was no significant difference between the potency of the potassium‐channel openers in normal and hyper‐reflexic detrusor muscle. Hyper‐reflexic bladder was significantly more sensitive to electrical field stimulation than was normal bladder; maximum responses to field stimulation were not significantly different. Concentration‐response curves for the potassium‐channel openers were displaced to the left in hyper‐reflexic bladder at both 25% and 75% maximum frequencies; however, only with levcromakalim at 75% of the maximum frequency was the shift significant.Conclusion The greater sensitivity of hyper‐reflexic bladder to carbachol and field stimulation supports existing evidence for post‐junctional supersensitivity in detrusor instability. The results of this study also suggest that there are no appreciable changes in KATP channel function in the unstable bladder.
A prospective randomized trial of interstitial radiofrequency therapy versus transurethral resection for the treatment of benign prostatic hyperplasia
Authors: MOSTAFID A.H. , HARRISON N.W. , THOMAS P.J. , FLETCHER M.S. 
Published: November 2003

Objective To carry out a prospective randomized trial comparing interstitial radiofrequency therapy (IRFT) with transurethral resection of the prostate (TURP) in the treatment of bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia.Patients and methods The change in detrusor pressure at maximum flow (PdetQmax ) was chosen as the primary measure of outcome but the symptom score, Qmax and residual volume were also measured. Patients with urodynamic evidence of BOO were randomized to receive IRFT (n=25) or TURP (n=25); the urodynamics were repeated 6 months after treatment.Results There was a statistically significant reduction in PdetQmax at 6 months for TURP (P<0.001) and IRFT (P<0.01) although the change seen in the latter group was probably not clinically relevant. Nevertheless, a clinically relevant reduction in symptom score occurred in both groups. Both techniques were associated with a low morbidity.Conclusion IRFT is a cheap and safe technique which may be useful in the treatment of lower urinary tract symptoms in certain groups of patients in whom symptomatic improvement is a priority rather than objective outcome. The underlying mechanism for this symptomatic improvement is at present unclear.
The in vitro effect of vitamin D3 analogue EB‐1089 on a human prostate cancer cell line (PC‐3)
Authors: WANG X. , CHEN X. , AKHTER J. , MORRIS D.L. 
Published: November 2003

Objective To determine the effect of vitamin D3 analogue (EB‐1089) on the growth and proliferation of a prostate cancer cell line (PC‐3).Materials and methods PC‐3 cells (104 cells per well) were plated into 24‐well tissue culture plates. After 24 h, the culture medium was replaced with one containing the vitamin D3 analogue EB‐1089; a control treatment using only replacement medium was conducted in parallel. Cell proliferation was measured by the incorporation of 3H‐thymidine 7 and 12 days after the addition of the vitamin D3 analogue. Cells were precipitated with 5% trichloroacetic acid and the radioactivity determined using a scintillation counter. Each experiment was performed at least five times.Results There was a significant dose‐dependent inhibition of cell growth after 7 and 12 days of treatment with EB‐1089, varying from 40 to 70% of the 3H‐thymidine incorporation by controls, respectively. The maximum inhibition occurred with 0.1 μmol/L EB‐1089 on day 7 and day 12 (both P<0.01). Longer incubation times appeared to have a greater effect when higher concentrations of EB‐1089 were used.Conclusion These in vitro studies have shown that the vitamin D3 analogue EB‐1089 can significantly reduce the growth rate of the prostate cancer cell line PC‐3. This would support the hypothesis that deficiency of vitamin D increases the risk of prostate cancer and further in vivo testing of vitamin D is warranted for its potential role in active therapy.
Renal Doppler ultrasonography in children with equivocal obstructive uropathy: effect of intravenous normal saline fluid load and frusemide
Authors: SHOKEIR A.A. , PROVOOST A.P. , EL‐AZAB M. , DAWABA M. , SHOKEIR M.A. , NIJMAN R.J. 
Published: November 2003

Objective To study the effect of hyperhydration with normal saline and frusemide on the renal resistive index (RI) in children with equivocal obstructive uropathy.Patients and methods Twelve children (24 kidneys) with unilateral or bilateral hydronephrosis underwent isotopic diuretic renography and Doppler ultrasonography. All children had equivocal obstruction of the hydronephrotic kidneys with half‐time drainage (T/2) values of 10–20 min. Doppler studies were carried out both at baseline and after the infusion of normal saline and frusemide.Results Of the 24 kidneys, five were normal and 19 were hydronephrotic; compared with normal kidneys, the hydronephrotic units had a significantly lower glomerular filtration rate (GFR) and longer T/2. At baseline, the mean RI values of normal and hydronephrotic kidneys were not significantly different (0.70, sd 0.03 and 0.71, sd 0.04, respectively). After the infusion of saline and frusemide, the mean RI of hydronephrotic kidneys (0.67, sd 0.07) was significantly (P=0.01) higher than that of normal kidneys (0.60, sd 0.02), but the response of RI in hydronephrotic kidneys was variable. Based on the RI at baseline and after infusion, hydronephrotic kidneys could be categorized into three groups. Group 1 (n=6) had an RI<0.7 before and after infusion, group 2 (n=6) had a baseline RI>0.7 and <0.7 after infusion, and in group 3 (n=7) both RIs were >0.7. Kidneys in group 3 had the lowest GFR and the highest T/2 values. Five of these seven hydronephrotic kidneys eventually had deteriorating GFRs requiring surgical correction; the GFR of the remaining hydronephrotic kidneys remained stable.Conclusion In children with equivocal obstructive uropathy based on diuretic renography, the determination of RI before and after infusion of normal saline and frusemide could be helpful in distinguishing obstructed from non‐obstructed kidneys.
Neuroendocrine differentiation and prognosis in prostatic adenocarcinoma
Authors: McWILLIAM L.J. , MANSON C. , GEORGE N.J.R. 
Published: November 2003

Objectives To assess the prognostic importance of neuroendocrine differentiation in conventional (non‐small cell) prostatic adenocarcinoma.Materials and methods Ninety‐two samples from patients with prostatic adenocarcinoma were studied retrospectively. The immunohistochemical analysis of chromogranin A and neuron‐specific enolase in formalin‐fixed, paraffin wax embedded prostatic tissue chips was related to other prognostic variables and patient survival.Results Neuroendocrine differentiation was detected in 48 cases; there was a significant correlation with worsening tumour differentiation, the presence of bone metastases and with worsening survival, but no independent effect of neuroendocrine differentiation on survival.Conclusion The detection of neuroendocrine differentiation in conventional prostatic adenocarcinoma is not an independent indicator of prognosis.
The relationship of smooth muscle damage to age, severity of pre‐operative hydronephrosis and post‐operative outcome in obstructive uropathies
Authors: PINTÉR A.B. , HORVÁTH A. , HRABOVSZKY Z. 
Published: November 2003

Objective To determine the relationship, in patients with pelvi‐ureteric junction (PUJ) obstruction, of histopathological abnormalities to their age at surgery, the severity of pre‐operative hydronephrosis and the post‐operative outcome.Materials and methods Surgical specimens from 60 consecutive PUJ complexes excised at pyeloplasty were evaluated histologically.Results There was a close relationship of smooth muscle abnormality and fibrosis with the severity of pre‐operative hydronephrosis and post‐operative outcome, with no significant correlation between histopathological abnormality and patient age.Conclusion This study appears to support the practice of the initial non‐operative management of congenital PUJ obstruction, potentially reducing the number of early and/or unnecessary interventions. Further investigations and research are necessary to direct appropriate management.
Neuroendocrine stains and proliferative indices of prostatic adenocarcinomas in transurethral resection samples
Authors: SPEIGHTS Jr V.O. , COHEN M.K. , RIGGS M.W. , COFFIELD K.S. , KEEGAN G. , ARBER D.A. 
Published: November 2003

Objective To determine whether the quantification of certain neuroendocrine and proliferative markers would help in the prognostic evaluation of prostatic adenocarcinomas obtained during transurethral resection of the prostate (TURP).Materials and methods Samples from two groups of patients with prostate cancer were examined. One group comprised 23 patients, of whom 12 were stage IV and 11 stage III, all with Gleason scores of ≥7; this group was designated as high‐grade, high‐stage (HGHS). The second group comprised 10 consecutive patients with stage T1a adenocarcinoma of the prostate with Gleason scores of ≤6, designated as low‐grade, low‐stage (LGLS) tumours. Tumour tissue from each TURP was stained with MIB‐1 (an indicator of cell proliferation), neuron‐specific enolase (NSE), chromogranin A (ChA) and synaptophysin (Syn), and 1000 cells counted to determine the percentages of positive cells in both benign and malignant tissue. The percentage of MIB‐1‐positive cells was designated as the proliferative index (PI). Patients were clinically followed to evaluate tumour progression, documented by rising prostate‐specific antigen (PSA) levels, X‐ray evidence of recurrent or metastatic carcinoma, or tissue biopsy showing malignancy.Results The mean number of neuroendocrine cells (NEC) for each marker and the mean PI were greater in the HGHS tumours than in the LGLS tumours or surrounding benign tissue of either group (P<0.01). The LGLS tumours were remarkable for a having mean PI of about twice that of the benign tissue (2.9 and 1.3, respectively, P<0.01); the NEC in these cases were more frequent in the benign than in the malignant tissue. There was no significant difference between the mean PIs and the mean percentages of NEC in the 14 HGHS tumours that progressed and the nine HGHS tumours that did not (P values 0.37–0.96).Conclusions Although the PI assessed by MIB‐1 and the number of NEC‐positive cells were much higher in HGHS than LGLS tumours, this finding did not appear to have independent prognostic significance. The significance of the higher PI in LGLS tumours than in corresponding benign tissue is uncertain; LGLS tumours had fewer NEC than the surrounding benign tissue. The quantification of any of these four markers (MIB‐1, NSE, ChA, Syn) was not prognostically helpful in these groups of cancers present in TURP specimens.
Prognostic significance of microscopic vascularity for clear cell renal cell carcinoma
Authors: DELAHUNT B. , BETHWAITE P.B. , THORNTON A. 
Published: November 2003

Objective To investigate the association between tumour vascularity and patient survival in a series of clear‐cell renal cell carcinoma (RCC), which often metastasizes via the vascular route and frequently has a prominent vascular network.Materials and methods Vessels were labelled in sections from 150 cases of clear cell RCC by factor VIII immunohistochemistry. The mean microvessel density (MMD), expressed as the number of vessels per 10 high‐power fields (HPFs, ×400, aggregate field area 1.452 mm2 ) and tumour microvessel area (TMA), expressed as the percentage of the total tumour area within 10 HPFs, were measured for each case. The relationship between MMD and TMA, tumour stage and grade, and patient survival over a 5‐year follow‐up was determined.Results Tumour MMD ranged from 1 to 238 vessels per HPF, while the TMA was 1.2–60.8%. There was a weak but significant difference for MMD between tumour grades (P<0.01) and stages (P<0.05). There was no significant association between TMA and either tumour stage or grade. Division of cases according to MMD ≤40 and >40 per HPF showed a significant difference in survival curves between both groups, with a higher MMD being associated with longer patient survival. The significant association between MMD and survival was retained for stage 3 tumours only when cases were stratified according to Robson’s stage at presentation. TMA did not correlate with survival.Conclusions The assessment of tumour vascularity is of prognostic significance for clear cell RCC. The significant inverse relationship between MMD and patient survival suggests that for tumours with a poor prognosis, decreased MMD is associated with tumour fibrosis and the development of large diameter vascular channels.
The diagnostic value of urinary Crosslaps and serum alkaline phosphatase in patients with prostate cancer
Authors: NGUYEN‐PAMART M. , CATY A. , FEUTRIE M.L. , FOURNIER C. , GOSSELIN P. , MAZEMAN E. 
Published: November 2003

Objective To determine whether the urinary excretion of Crosslaps and serum alkaline phosphatase (ALP) are useful bone markers in patients with prostate cancer.Patients and methods The study included 112 patients, comprising 25 with benign prostatic hyperplasia and 87 with carcinoma of the prostate, 41 of whom had localized prostate cancer and 46 with bone metastases. In the last group, 16 were stable and 30 were in clinical progression. Prostate‐specific antigen (PSA) and the bone markers serum bone ALP and urinary Crosslaps were determined on the same day.Results The rates of excretion of Crosslaps were significantly greater in patients with than in those without bone metastases. Only Crosslaps showed a significant difference between patients with stabilized metastatic disease and those with no bone involvement. Crosslaps had a higher specificity and positive predictive value than had PSA level in patients with bone metastases, and a higher sensitivity than bone ALP.Conclusion These preliminary findings suggest that Crosslaps may be useful as an additional bone marker in patients with prostate cancer and may provide information of the metastatic spread to bone in these patients. Prospective studies with serial measurements of bone markers are currently underway to relate these results to the progression of disease and to evaluate the response to treatment of bone metastases.
Frequency‐volume chart data from incontinent children
Authors: BOWER W.F. , MOORE K.H. , ADAMS R.D. , SHEPHERD R.B. 
Published: November 2003

Objective To establish the mean and standard deviation about the mean for voiding variables of incontinent children aged 6–11 years as measured on a frequency‐volume chart (FVC), and to determine the effect of type of incontinence, gender and age on these values.Patients and methods All children attending two continence clinics over a 3‐year period completed a FVC as a routine part of their assessment. Voided volume and voiding interval data were collected from these charts. The mean maximum, mean minimum and overall mean voided volume and voiding interval were established for the whole group and then for each age, gender and type of incontinence.Results The voiding patterns of incontinent children were very variable and thus the standard deviation for each voiding parameter was large. Multivariate analysis showed that the only variable that affected any of these apparent storage parameters was the child’s age; gender and type of incontinence did not influence bladder storage patterns. Children with daytime incontinence did not have smaller voided volumes than those with nocturnal enuresis.Conclusion Both the mean and the standard deviation about the mean of all voided volumes varied widely amongst incontinent children. Only age appeared to influence trends in voided volumes. Any clinical investigation using the FVC in children should consider the high standard deviation when calculating sample size.
Soluble urinary CD14 after intravesical bacille Calmette‐Guérin immunotherapy for carcinoma in situ
Authors: JACKSON A.M. , LIEN E. , ALEXANDROFF A.B. , PRESCOTT S. , ESPEVIK T. , JAMES K. , SELBY P.J. , SUNDAN A. 
Published: November 2003

Objective To characterize the production of the monocyte activation marker, soluble CD14 (sCD14), after bacille Calmette‐Guérin (BCG) immunotherapy for superficial bladder cancer.Patients and methods Nineteen patients with carcinoma in situ were treated with a standard regimen of intravesical BCG. Urine samples were collected after each instillation and analysed; the levels of soluble CD14 were determined by an enzyme‐linked immunosorbent assay, the molecular weight confirmed by Western blotting and the possible cell source investigated using immunohistochemistry.Results The mean levels of sCD14 were higher in patients with persistent carcinoma (designated as failures) than in those who had successful complete responses (responders) to BCG immunotherapy. The differences were statistically significant, with P=0.034 at instillation 4 and P=0.027 at instillation 5 for the total mass of sCD14, and P=0.049 at instillation 4 for the concentration of sCD14. The predominant type of sCD14 in urine was the 48 kDa form, although in most patients there was a minor band of reactivity at 54 kDa. A panel of human bladder cancer cell lines did not react with the anti‐CD14 monoclonal antibodies 3C10, 5C5 and BA8, and the antibodies also failed to react with malignant epithelial cells in frozen sections of untreated bladder tumour. Furthermore, sCD14 was not secreted by cultured bladder tumour cells. The source of urinary sCD14 is likely to be the resident and infiltrating macrophages in the bladder wall. Freshly isolated peripheral blood monocytes secreted sCD14 in response to BCG in a manner analogous to stimulation with bacterial lipopolysaccharide.Conclusion A soluble form of CD14 is secreted into the urine of patients who receive intravesical BCG. The measurement of soluble urinary CD14 could be of prognostic significance for the response to immunotherapy.
Prevalence of enuresis and other bladder symptoms in patients with active Graves’ disease
Authors: GOSWAMI R. , SETH A. , GOSWAMI A.K. , KOCHUPILLAI N. 
Published: November 2003

Objective To determine the prevalence of bladder symptoms in patients with Graves’ disease and assess their abnormalities on urodynamic studies.Patients and methods The study comprised 30 consecutive patients (13 female, 17 male, mean age 31 years, sd 10) with active Graves’ disease. Before and after attaining euthyroidism with carbimazole, their bladder symptoms were assessed using a questionnaire adapted from the American Urologic Association voiding symptom score, the serum levels of total triiodo‐l‐thyronine (T3), serum thyroxine (T4) and thyroid‐stimulating hormone (TSH) were measured by radioimmunoassay, and uroflowmetry, cystometry and perineal muscle electromyography were performed.Results Twelve of the 30 patients (40%) had the onset of bladder symptoms 1–6 months after the onset of symptoms of Graves’ disease; four of the 12 patients had enuresis. Urodynamic studies were possible in five patients and showed reduced flow rates in all, a significant post‐void residual volume in four, and enlarged bladder capacity and increased perineal muscle electromyographic activity during the voiding phase in three. Voiding disturbances and urodynamic abnormalities resolved after attaining euthyroidism.Conclusion Significant bladder symptoms can occur in about 40% of patients with active Graves’ disease but resolve on euthyroidism; in some patients, urodynamic studies show significant abnormalities which are also reversible.
Surgical disconnection of lymphorenal communication for chyluria: a 15‐year experience
Authors: PUNEKAR S.V. , KELKAR A.R. , PREM A.R. , DESHMUKH H.L. , GAVANDE P.M. 
Published: November 2003

Objective To present the results of surgical lymphorenal disconnection and its advantages in patients with severe chyluria.Patients and methods Seventy‐eight patients (40 men and 38 women, age 22–58 years) with severe chyluria of variable duration (5 months to 14 years), underwent surgical disconnection of the lymphorenal communication after confirming the diagnosis of chyluria by urine examination for fat globules, lymphangiography to delineate the side, site and extent of lymphorenal communication, and cystoscopy to decide the side to be operated. The areolar tissue containing dilated lymphatics travelling to the kidney in the perirenal and hilar region was dissected and divided between ligatures, thus stripping these structures completely; only one side was operated at a time.Results All 78 patients were available for a minimum follow‐up of 1 year, with the longest follow‐up 15 years. Lymphangiography showed unilateral communication in 52 (66%) and bilateral in 26 (34%). If the patient was given a high‐fat meal before surgery, the intra‐operative visualization of the lymphatics was improved. With unilateral surgery, clearance was achieved in 74 (94%) immediately, with final success in 69 (88%) patients. Of the 26 (34%) patients with bilateral lesions, nine (12%) required bilateral surgery, giving a clearance rate of 97%. In two cases of failure, repeat surgery was successful in one; thus the overall success rate was 98%.Conclusion Lymphorenal disconnection for chyluria is simple, successful as a permanent cure and with almost negligible complications. Bilateral lymphorenal communication seen on lymphangiography does not always warrant bilateral surgery.