bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development and validation of a patient‐information booklet on ureteric stents
Authors: Joshi H.B. , Newns N. , Stainthorpe A. , Macdonagh R.P. , Keeley F.X. , Timoney A.G. 
Published: March 2003

Objective To report a scientific approach incorporating patient preferences towards the development of a patient‐information booklet about ureteric stents. Patients and methods Phase 1 of the study included 35 adult patients with ureteric stents who were surveyed using semi‐structured interviews (four patients) and a questionnaire (31 patients) to assess various issues relating to information given to patients about ureteric stents. In addition, published papers were assessed and clinicians' opinions sought. The results formed the basis for a comprehensive patient‐information booklet about ureteric stents that incorporated patients' views and preferences. In phase 2, the booklet was tested and formally validated by inviting 30 patients, a panel of 20 urologists and general practitioners, and five stent manufacturers to assess the booklet for adequacy, coverage and readability of the content. Results Of the 35 patients, 30 (19 men and 11 women, mean age 49 years, range 20–78) participated in the initial survey; 80% of patients reported dissatisfaction about the information they received. Patients wanted more information about the use, adverse events and effects of stents on daily life; 85% preferred all relevant information about the stents to be in a written format with illustrative drawings. An eight‐page booklet was thus developed. The validation study revealed that the booklet matched patients' experiences (approval score of 9/10, range 8–10) and was reported as satisfactory by clinicians and manufacturers. Conclusions A validated information booklet on ureteric stents was developed, incorporating patients' expectations and views. This booklet is expected to be an effective tool for patient communication that would help patients cope better with indwelling stents and be useful in counselling patients. A similar approach could be adopted for the development of other patient‐information packs.
Cytoreductive nephrectomy: is it a realistic option in patients with renal cancer?
Authors: Bromwich E. , Hendry D. , Aitchison M. 
Published: March 2003

Objective To evaluate the role of cytoreductive nephrectomy (CRN) in improving survival in patients with renal cell cancer. Patients and methods The case‐notes of 268 consecutive patients who presented to our specialized renal cancer clinic between 1998 and 2001 were reviewed. All patients with metastatic disease were assessed for CRN. If their primary tumour was considered operable, they were assessed further using the European Cooperative Oncology Group performance score; only patients with a performance score of 0 or 1 were considered for surgery. Results In all, 168 patients underwent nephrectomy with curative intent for M0 disease and 11 were treated conservatively. Ninety‐four patients with M+ disease (mean age 65 years, range 38–80) were considered for CRN. Thirty‐eight patients had an inoperable primary. Of the remaining 56 patients, 20 had a performance status of 0 or 1 and were offered CRN. Conclusion Metastatic disease at presentation occurred in 34% of all patients referred; 40% patients had an inoperable primary and 38% had a performance score of  2. With an active policy of considering all patients for CRN, only 7% of those with renal cancer were suitable for this procedure. CRN is unlikely to have a significant effect on overall survival within a population of patients with renal cancer.
Cyclic AMP and cyclic GMP activate protein kinase G in cavernosal smooth muscle cells: old age is a negative factor
Authors: Lin C.‐S. , Liu X. , Chow S. , Lue T.F. 
Published: March 2003

Objective To investigate protein kinase G‐I (PKG‐I) expression and activation in cavernosal smooth muscle cells (CSMC) of young and old rats. Materials and methods PKG‐I expression in rat penis was examined by immunohistochemical staining, reverse transcription‐polymerase chain reaction, and Western blot analysis. CSMC isolated from young (16‐week‐old) and old (28‐month‐old) rats were grown as monolayer cell cultures and treated with different dosages of cAMP or cGMP for different periods. Their proteins were then analysed for the expression of vasodilator‐stimulated phosphoprotein (VASP), phosphorylated VASP (at serine 239), PKG‐I, and protein kinase A (PKA). Results PKG‐I expression was detected in the vascular and CSMC of the rat penis. There was little or no difference in the level of PKG‐I expression between young and old rats. Treatment of CSMC with different dosages of cAMP or cGMP did not change the expression levels of VASP throughout the entire test period (up to 24 h). In contrast, the level of VASP phosphorylation at S239, i.e. the level of PKG‐I activation, depended on the dosages of cAMP and cGMP and on the duration of treatment. Prolonged treatment (24 h) with either cAMP or cGMP resulted in down‐regulation of both PKG‐I and PKA. While cAMP and cGMP produced very similar results in nearly every aspect, there was a difference in one test, in which cGMP produced much less activated PKG‐I than cAMP in the CSMC of 28‐month‐old‐rats. Conclusions For the first time we provide evidence for PKG‐I activation in CSMC. Both cAMP and cGMP were capable of activating PKG‐I in CSMC. Age seemed to compromise the ability of PKG‐I in response to cGMP.
Apoptosis‐related proteins in the testes of infertile men with varicocele
Authors: Tanaka Hiroyuki , Fujisawa M. , Tanaka Hirokazu , Okada H. , Kamidono S. 
Published: March 2003

Objectives To assess immunohistochemically the expression of apoptosis‐related proteins in the testes of infertile men, to determine which of these proteins were related to hypospermatogenesis, as a previous report suggested that apoptosis was suppressed in infertile men with varicocele. Materials and methods The expression of Bcl‐2, Bax, caspase‐1 (ICE) and caspase‐3 (CPP32) were examined in bilateral testicular specimens from 26 infertile men with varicocele and six normal testicular specimens, using the avidin‐biotin‐peroxidase complex method. Clinical variables were also assessed. Results Bax, ICE, and CPP32 were expressed in germ cells, while Bcl‐2 was not. Differences in staining in left or right testes were not significant. In both testes of infertile patients with varicocele, significantly fewer germ cells stained for CPP32 than in controls (P < 0.001). For Bax and ICE, total germ cell staining was similar between these groups. Staining was less frequent in infertile patients for both CPP32 and ICE when the analysis was restricted to spermatogonia. Serum luteinizing hormone levels correlated positively with CPP32 staining (P = 0.0457). Conclusions The reduced expression of CPP32 participates in regulating apoptosis in the testes of infertile men with varicocele.
Female urodynamics and lower urinary tract infection
Authors: Okorocha I. , Cumming G. , Gould I. 
Published: March 2003

Objectives To determine the incidence of unsuspected urinary tract infection (UTI) before cystometry, to evaluate reports of a greater tendency to abnormal cystometry in the presence of asymptomatic bacteriuria, and to determine the incidence of iatrogenic significant bacteriuria after cystometry. Patients and methods A prospective study was carried out in the gynaecology department of a district general hospital in collaboration with the medical microbiology department of a university teaching hospital. The period of investigation was 1 year and the study population was a sample of women undergoing urodynamic investigations during this period. Data were collected on age, menopausal status, parity, cystometric diagnosis and voiding dysfunction. Results In all, 117 patients provided a urine sample before cystometry; 12 of these patients had a positive culture, giving an incidence of 10.3% for unsuspected asymptomatic bacteriuria before cystometry. There was a significant association between age and the presence of UTI before cystometry (P = 0.003) and between this UTI and sensory urgency (P = 0.01). There was no similar significant association with detrusor instability or genuine stress incontinence. Nineteen of the 97 patients who had negative bacteriology before cystometry had a positive urine culture afterward. Compared with patients who had a negative sample, there was no significant association with age, parity, menopausal status, abnormal cystometry or voiding dysfunction. Conclusion These results do not support a policy of universal screening for bacteriuria before urodynamic investigation. Asymptomatic bacteriuria did not influence the urodynamic outcome except in patients with sensory urgency. However, we recommend that screening and treatment be considered individually in older women who are being investigated for irritative bladder symptoms. About 20% of the present patients developed UTI after the urodynamic investigation. This information should be included in the counselling before urodynamic investigation and should be incorporated into the patient information leaflet as part of good clinical practice.
The outcome of voiding dysfunction managed with clean intermittent catheterization in neurologically and anatomically normal children
Authors: Pohl H.G. , Bauer S.B. , Borer J.G. , Diamond D.A. , Kelly M.D. , Grant R. , Briscoe C.J. , Doonan G. , Retik A.B. 
Published: March 2003

Objective To describe the tolerability and efficacy of clean intermittent catheterization (CIC) in the management of dysfunctional voiding in patients who are neurologically and anatomically normal. Patients and methods The medical records were reviewed in 23 patients (16 girls, mean age 9 years, range 6–14.5, and seven males, mean age 8 years, range 5–20.5) with urinary incontinence and/or urinary tract infection (UTI) who were offered CIC because they had a large postvoid residual urine volume (PVR). All had extensive instruction before starting CIC. All patients underwent urodynamic studies, and urinary and fecal elimination habits were recorded. Detrusor hyperactivity, when present, was treated with anticholinergic medication. The follow‐up evaluation included tolerance of CIC, continence status and the incidence of UTI. Behavioural modification or biofeedback training was not used in any patient. Results Of the 23 patients, 13 presented with both UTI and urinary incontinence, five with incontinence only, four with UTI only, one with frequency and no incontinence, and one with haematuria. Associated symptoms included frequency/urgency, constipation or soiling, and straining to void or incomplete emptying (in nine each), and infrequent voiding in six. CIC was performed within 2 days by 15 patients, while four others required up to 2 weeks to master CIC. However, three of the four patients (all older girls) who needed 2 weeks to learn the technique did not tolerate CIC and discontinued it within 3 weeks. Four other adolescents (three girls and one boy) refused to learn CIC. Of the 16 patients remaining on CIC only three had cystitis; no patient had a febrile UTI. Once successfully instituted, all patients became continent while on CIC. Six boys (mean follow‐up 4 months) had a marked decrease in their PVR. CIC was discontinued in three girls who voided normally to emptiness within 6 months of starting CIC; they remained dry and infection‐free 16 months (two) and 6 years later. Conclusion CIC is a viable therapeutic option for the treatment of dysfunctional voiding, associated with a large PVR, in the absence of any neurological abnormality. CIC is well tolerated in the sensate patient and provides a means for expeditiously achieving continence and improving bladder emptying cost‐effectively.
Non‐secretor status is associated with female acute uncomplicated pyelonephritis
Authors: Ishitoya S. , Yamamoto S. , Mitsumori K. , Ogawa O. , Terai A. 
Published: March 2003

Objective To retrospectively analyse the secretor status in women with acute uncomplicated pyelonephritis, as non‐secretors of histo‐blood group antigens are reportedly at risk of recurrent urinary tract infections (UTIs). Patients and methods The study included 245 women who had been diagnosed as having acute uncomplicated pyelonephritis in affiliated hospitals over the past 5 years. All women were sent antiseptic swabs, to collect saliva, and a questionnaire to survey their past UTI episodes and menstrual status. Responses with written informed consent were obtained from 106 women (median age 50.5 years, range 17–85). The secretor status was determined using the haemagglutination inhibition assay from the saliva on the swabs. Results Forty‐four (41%) of the women were non‐secretors, a significantly higher frequency than in the (control) Japanese population (217 of 960, 22.6%; P< 0.001). The incidence of non‐secretors was significantly higher (P < 0.01) in premenopausal (26 of 46, 57%) than in postmenopausal women (18 of 60, 30%). Conclusion These results suggest that non‐secretor status is associated with a genetic susceptibility to acute uncomplicated pyelonephritis, especially in premenopausal women.
Tunica albuginea acellular matrix graft for penile reconstruction in the rabbit: a model for treating Peyronie's disease
Authors: Wefer J. , Schlote N. , Sekido N. , Sievert K.‐D. , Wefer A.E. , Nunes L. , Bakircioglu M.E. , Dahiya R. , Tanagho E.A. 
Published: March 2003

Objective To evaluate the use of an acellular matrix graft of the tunica albuginea for functional penile reconstruction in severe cases of Peyronie's disease. Materials and methods In 18 rabbits, an acellular matrix graft of the tunica albuginea was used to cover a 4×8 mm tunical defect, and six animals each were killed 1, 3 and 6 months later; four unoperated animals served as histological controls. Before death an erection was induced by papaverine, with the quality classified on a scale of 0–5, and cavernosography performed. After death the penis was prepared for histological study, and the cell number, collagen and elastic fibre content evaluated in the regenerated matrix, and in control specimens and four unimplanted matrices. Results Of 18 experimental animals, 11 had normal erections before death, four had slight penile deviation and three developed no erection. Failure was caused by severe postoperative haematoma, resulting in scar tissue. There was no graft rejection. Histologically there was no difference between natural and regenerated tunica. The collagen content and cell number were not significantly different in regenerated and control samples. There were significantly fewer elastic fibres in the unimplanted grafts and the 1‐month group, but in later samples this difference was no longer evident. Conclusion The homologous acellular matrix graft of the tunica albuginea warrants further evaluation as an alternative treatment in Peyronie's disease, despite some postoperative failures. The advantage of this orthotopic biomaterial is its rapid integration, with no rejection.
Urodynamic findings 3 months after radiotherapy in patients treated with conformal external beam radiotherapy for prostate carcinoma
Authors: Do V. , Choo R. , Deboer G. , Herschorn S. , Danjoux C. , Chen C.H. , Barak I. 
Published: March 2003

Objective  To quantify the effect of radiotherapy (RT) on urodynamic function 3 months after RT in patients with prostate cancer undergoing definitive external beam RT. Patients and methods  Seventeen patients with clinically localized prostate cancer were accrued into a single‐arm prospective study. Sixteen of the patients completed a scheduled multichannel video‐urodynamic study at baseline and again 3 months after RT; the urodynamic variables were then compared to assess the nature and extent of urodynamic change caused by RT. Correlations were assessed between these quantitative changes and those in self‐assessed qualitative urinary function measured by International Prostate Symptom Score (IPSS), Quality of Life assessment index (QoL) and urinary functional enquiry. Results  There were significant changes detected by the urodynamic study 3 months after RT in bladder volume at capacity (mean decrease 70 mL) and bladder volume at first sensation when supine (mean decrease 85 mL), and a lower postvoid residual volume (mean 50 mL). There was no significant change in the remaining urodynamic variables (including maximum flow rate and voided volume), nor in bladder compliance, bladder instability or bladder outlet obstruction. The self‐assessed qualitative urological function measured by the IPSS, QoL and median urinary frequency/24 h showed no significant change after RT. Conclusions  This is the first quantitative study to prospectively evaluate the effect of RT on urodynamics in patients with prostate cancer. Only a few urodynamic variables changed significantly 3 months after RT, while most, including self‐assessed qualitative urinary function, did not. This finding corresponds well with the notion that most patients tolerate RT well and that acute RT‐induced urinary symptoms resolve successfully, with the return of lower urinary tract function to baseline levels by 3 months after RT.
Periprostatic nerve block gives better analgesia for prostatic biopsy
Authors: Lynn N.N.K. , Collins G.N. , Brown S.C.W. , O'Reilly P.H. 
Published: March 2003

Objective  To prospectively compare two local anaesthetic techniques for prostatic biopsies, which are usually taken with no anaesthesia; because multiple biopsy techniques are becoming more common and there is an increasing need for analgesia/anaesthesia during the procedure. Patients and methods  The study group comprised 86 consecutive men (median age 67.7 years) undergoing prostatic biopsy because of either an abnormality of prostate specific antigen level or digital rectal examination. They were randomized into four groups; men in group 1 received 10 mL of 1% lignocaine infiltrated into the periprostatic nerve plexus bilaterally; men in group 2 received 11 mL of 2% lignocaine gel rectally; men in groups 3 and 4 were recruited as controls, and given either plain gel rectally or an injection with saline into the periprostatic nerve plexus. Sextant prostate biopsies were taken in all cases using a standardized protocol. Immediately after the procedure patients were asked to indicate the degree of pain on a 10‐cm visual analogue scale. Results

Men in group 1 had significantly less pain than the others (
P

< 0.001). There was no statistically significant difference in pain between men who received plain gel rectally or saline injection (
P

=
0.35). The rectal instillation of 2% lignocaine gel did not reduce pain significantly (
P   =  0.186) compared with the controls. Conclusion  A periprostatic nerve block with 1% lignocaine was associated with significantly less pain during prostatic biopsy than was rectal lignocaine gel or placebo.
Vitamin D receptor‐dependent antitumour effects of 1,25‐dihydroxyvitamin D3 and two synthetic analogues in three in vivo models of prostate cancer
Authors: Oades G.M. , Dredge K. , Kirby R.S. , Colston K.W. 
Published: March 2003

Objective
To determine the
in vitro
and
in vivo
effects of 1,25‐dihydroxyvitamin D
3 (calcitriol) and two newer less hypercalcaemic analogues, EB1089 and CB1093 (as the use of calcitriol as a therapeutic agent in humans has been limited by hypercalcaemia) in three rodent models of prostate cancer. Materials and methods
The highly metastatic MAT LyLu Dunning prostate model, PAIII tumours in Lobund‐Wistar rats and LNCaP xenografts in nude mice were used. Vitamin D receptor (VDR) expression and binding were assessed in all cell lines. The effects of calcitriol, EB1089 and CB1093 on tumour growth, cell cycle and angiogenesis
in vitro
, and growth and serum calcium levels
in vivo , were assessed. Results
The growth of prostate adenocarcinoma was inhibited by calcitriol, EB1089 and CB1093 in the Dunning prostate model. Although both analogues increased serum calcium levels, the levels were significantly less than in rats treated with calcitriol. Tumour growth was also inhibited in male athymic nu/nu mice with LNCaP tumour xenografts. PAIII cells failed to express functional VDR and were insensitive to calcitriol and its analogues, either
in vitro
or
in vivo . The analogues of calcitriol did not inhibit angiogenesis in a rat aorta assay. Conclusion
This is the first report comparing the actions of calcitriol and its analogues in different
in vivo
models. The results suggest that the newer less hypercalcaemic analogues of calcitriol may offer a novel therapeutic option for treating prostate cancer. VDR‐dependent growth inhibition and not the inhibition of angiogenesis is the main mechanism of action of these compounds
in vivo.
Prognostic implications of histological features in patients with chromophobe cell renal carcinoma
Authors: Onishi T. , Oishi Y. , Yanada S. , Abe K. , Hasegawa T. , Maeda S. 
Published: March 2003

Objective  To assess the relationship between the histological features of renal chromophobe cell carcinoma (CCC) and clinical outcome in patients with renal cell carcinoma. Patients and methods  From 1957 to 1996, 41 patients with CCC of the kidney (4.9% of all kidney carcinomas) were treated at our university hospitals. Of these histologically defined cases, four who died from other types of cancer and two who were lost to follow‐up were excluded, leaving 35 patients in the study; the carcinoma was classified as the typical variant in 26 and the eosinophilic variant in nine. Based on the differences of the variants, the histological features affecting prognosis were analysed. Results  The overall survival rates at 1, 3, 5, 10, 15 and 20 years were 97%, 82%, 82%, 70%, 62% and 47%, respectively. The prognosis was more favourable in those with the eosinophilic than for the typical variant (there were no cancer‐related deaths in the former). Of those with the typical variant, five died within 2 years of surgery; of these, three with high‐stage disease had various degrees of sarcomatoid change. Conversely, two patients had a recurrence > 10 years after surgery (late recurrence). Both these patients and the others who later died from cancer had no sarcomatoid change in the tumour areas examined. Conclusion  The eosinophilic variant of CCC has a better prognosis; on the contrary, during long‐term surveillance, early recurrence was detected especially in those with sarcomatoid change and late recurrence only in two typical variant. These prognostic implications of the histological differences are important for understanding the outcome of renal CCC.
Effect of chronic renal failure on the purinergic responses of corpus cavernosal smooth muscle in rabbits
Authors: Kilicarslan H. , Yildirim S. , Bagcivan I. , Ayan S. , Sarac B. , Sarioglu Y. 
Published: March 2003

Objective  To examine purinergic relaxation responses in chronic renal failure (CRF) in an experimental rabbit model, and thus evaluate the possible involvement of the purinergic system in erectile dysfunction with CRF. Materials and methods  The relaxant effects of ATP were measured in strips of corpus cavernosum smooth muscle taken from control and CRF rabbits. CRF was induced in New Zealand white rabbits as previously described. Penises were excised from CRF rabbits 4 weeks after inducing uraemia. In an organ bath the strips from controls and CRF rabbit corpus cavernosum were pre‐contracted with phenylephrine and increasing doses of adenosine and ATP added. Results  In the pre‐contracted rabbit cavernosal tissue the relaxations induced by adenosine and ATP were unchanged in CRF. Conclusion  The lack of any relaxant effect of adenosine or ATP on the relaxation of cavernosal smooth muscle in rabbits with CRF might be because the relaxant effects of these agents are endothelium‐independent and the endothelial purinergic receptor density was unchanged in CRF.