bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vasoactive intestinal polypeptide and phentolamine mesylate administered by autoinjector in the treatment of patients with erectile dysfunction resistant to other intracavernosal agents
Authors: Dinsmore  , Alderdice  
Published: March 2003

Objective To study the effect of vasoactive intestinal polypeptide (VIP) and phentolamine mesylate (PM) on patients in whom previous intracavernosal therapy had failed.Patients and method The study comprised 70 consecutive patients attending a clinic for erectile dysfunction, in whom previous therapy with intracavernosal prostaglandin‐E1 (20 μg and papaverine (30 mg) combined with 1 mg PM had failed. They were given intracavernosal injections, initially with 25 μg VIP/1 mg PM (VIP1) and if unsuccessful, 25 μg VIP/2 mg PM (VIP2). Both VIP1 and VIP2 were administered using a pre‐filled ready‐to‐use autoinjector fitted with a 29 G needle. The patients were diagnosed as having spinal cord lesion (eight), diabetes (21), ischaemic heart disease (12), hypertension (six), other diagnoses (nine), or idiopathic causes (14).Result Forty‐seven (67%) of patients achieved erections sufficient for sexual intercourse (33 on VIP1 and 14 on VIP2), initially under clinical supervision and subsequently during home use. Minor side‐effects were transient facial flushing in 37 (53%), truncal flushing in six (9%), bruising in 14 (20%) and pain from the injection needle in eight (11%). No patients reported priapism or other serious adverse events.Conclusion The combination of VIP and PM at the dose used was a safe and effective treatment in patients in whom other therapies had failed.
Comparing neural networks in the discrimination of benign from malignant lower urinary tract lesions
Authors: Pantazopoulos  , Karakitsos  , Iokim‐Liossi  , Pouliakis  , Dimopoulos  
Published: March 2003

Objective To compare the performance of two different neural networks (NNs) in the discrimination of benign and malignant lower urinary tract lesions.Materials and methods A group of patients was evaluated, comprising 50 cases of lithiasis, 61 of inflammation, 99 of benign prostatic hyperplasia (BPH), five of insitu carcinoma, 71 of grade I transitional cell carcinoma of the bladder (TCCB), and 184 of grade II and grade III TCCB. Images of routinely processed voided urine smears were stained using the Giemsa technique and analysed using an image‐analysis system, providing a dataset of 45 452 cells. Two NN models of the back propagation (BP) and learning vector quantizer (LVQ) type were used to discriminate benign from malignant cells and lesions, based on morphometric and textural features. The data from 13 636 randomly selected cells (30% of the total data) were used as a training set and data from the remaining 31 816 cells comprised the test set. Similarly, in an attempt to discriminate patients, 30% of the cases, selected randomly, were used to train a BP and an LVQ NN, with the remaining 329 cases used for the test set. The data used for training and testing were the same for the two kinds of classifiers.Results The two NNs gave similar results, with an overall accuracy of discrimination of ≈90.5% at the cellular level and of ≈97% for individual patients. There were no statistically significant differences between the two NNs at the cellular or patient level.Conclusions The use of NNs and image morphometry could increase the diagnostic accuracy of voided urine cytology; despite the different nature of the two classifiers, the results obtained were very similar.
Inhibitory effects of propiverine, atropine and oxybutynin on bladder instability in rats with infravesical outlet obstruction
Authors: Kwak  , Lee  
Published: March 2003

Objective To compare the inhibitory effects of propiverine HCl (BUP‐4) with those of atropine and oxybutynin on the detrusor instability induced by partial obstruction of the bladder neck of female rats.Materials and methods Partial obstruction was created using partial ligation of the proximal urethra in 20 female Sprague‐Dawley rats. Both the obstructed rats and a control group of 15 rats were evaluated cystometrically about 6 weeks later and the values compared both at baseline and after injection with BUP‐4, atropine or oxybutynin. During cystometry, the bladder capacity (BC), residual volume (RV), compliance and frequency of spontaneous activity (SA) were determined.Results The BC, RV and frequency of SA were significantly increased, and compliance markedly decreased, in obstructed compared with normal rats. The micturition pressure was significantly decreased only after injection with BUP‐4 in both normal and obstructed rats. For both, the BC was increased significantly after injection with atropine or BUP‐4 (P<0.05), with the increase greater after BUP‐4 than after atropine in both groups (P<0.01). After injecting BUP‐4, the RV was significantly increased in both groups (P<0.05); atropine increased the RV only in normal rats (P<0.01) and oxybutynin had no significant effect on RV. Increases in compliance after the administration of each drug were significant only in obstructed rats (P<0.01) and were markedly higher after oxybutynin (780%) than after the other drugs (180–250%). The frequencies and amplitude of SA after injection with each drug were significantly lower only in obstructed rats, but in these rats, there were no significant differences in this reduction after injecting oxybutynin or BUP‐4, whereas they were significantly greater after injecting oxybutynin than after atropine.Conclusion Partial bladder outlet obstruction successfully created a hyperactive (unstable) bladder, typified by increased BC, RV, frequency of SA and a marked decrease in compliance. The greater BC, lower MP and frequency and amplitude of SA were prominent after the administration of BUP‐4. Thus it is suggested that BUP‐4 effectively inhibited bladder instability in rats induced by infravesical outlet obstruction and was more effective than oxybutynin in increasing BC.
Congenital reflux nephropathy: a follow‐up of 108 cases diagnosed perinatally
Authors: Assael  , Guez  , Marra  , Secco  , Manzoni  , Bosio  , Pelegatta  , Acerbi  , Alberto Delli’agnola  , Selvaggio  , Vegni  , Cecchetti  , Cucchi  
Published: March 2003

Objectives To determine: (i) the proportion of vesico‐ureteric reflux (VUR) associated with congenital renal damage and whether it can be severe enough to cause renal impairment from birth; (ii) to evaluate the distribution of males and females affected; and (iii) to describe the course of congenital damage in the first years of life.Patients and methods A total of 108 children (76 male and 32 female, M:F 2.3:1), whose VUR was diagnosed before any infection, were followed from birth for a mean (range) of 4.3 (1–10) years. Renal damage was defined by serum creatinine concentration, creatinine clearance and renal imaging (ultrasonography and renal scintigraphy) performed within the first month of life and periodically thereafter.Results Of the 108 children, 58 had bilateral and 50 unilateral reflux (total number of refluxing units, 166). High‐grade VUR (grade ≥4) was found in 96 (58%) refluxing renal units (RRUs). Males had a prevalence of bilateral severe (≥grade 4) reflux (M:F 5.2:1), while in those with unilateral VUR, the M:F ratio was 1.5:1. At birth, mild to moderate damage was present in 56 (36%) RRUs and only associated with VUR of grade ≥3. Bilateral reflux of grade ≥4 was associated with congenital moderate/severe renal failure in nine neonates (seven males). In infants with grade ≥4 VUR who underwent surgical correction, VUR resolved in 92% of cases. In infants with VUR of grade ≥4 followed medically, the reflux spontaneously resolved in 42% and ameliorated in 16% after 18 months. Serial renal scans during the follow‐up showed no progression of renal damage.Conclusions VUR diagnosed at birth on prenatal ultrasonography is associated with congenital damage, with males affected more often than females. The damage involves both kidneys in a consistent proportion and is an important cause of chronic renal impairment from birth. It does not progress in the first years of life if infections are prevented. It is suggested that males with this condition may constitute a major group at risk of developing chronic renal failure in later life.
‘Nerve‐sparing’ cystectomy and substitution cystoplasty in patients of either sex: limitations and techniques
Authors: Venn  , Popert  , Mundy  
Published: March 2003

Objectives To determine the limitations of cystectomy and orthotopic substitution cystoplasty in men and women with bladder cancer.Patients and methods Cystectomy and orthotopic substitution cystoplasty were carried out in 79 patients (mean age 60 years, range 31–74, including eight women) who were followed for a mean of 7 years (range 1–13) to evaluate continence, potency and survival.Results Overall, 80% of the patients were continent without further treatment and 55% of the men who were potent before surgery remained so afterward. The best results were obtained with retrograde cystectomy in both sexes and are only achievable in women in this way. Continence was achieved more easily in women than in men, although pathological delineation of the tumour preoperatively and technical considerations per‐operatively make both the selection and the procedure more demanding in women than in men.Conclusions Cystectomy and orthotopic substitution cystoplasty is possible in patients of either sex and should be offered to all patients as an alternative to ileal conduit urinary diversion, unless preoperative assessment suggests that the urethra must be removed with the bladder, which is rare in men and uncommon in women. In such patients, a continent diversion may be the preferred option.
Differential alterations of prostacyclin, cyclic AMP and
Authors: Sullivan  , Thompson  , Mikhailidis  , Morgan  , Angelini  , Jeremy  
Published: March 2003

Objective To investigate the effect of alloxan‐induced diabetes mellitus (DM, a major risk factor for erectile dysfunction and associated with impaired endothelial function) on the formation of nitric oxide (NO), prostacyclin (PGI2), cGMP and cAMP in the corpus cavernosum of rabbits.Materials and methods Rabbits were rendered diabetic (hyperglycaemic, nonketotic) with alloxan; after 3 and 6 months, the penises were excised and the corpus cavernosum processed for the study of PGI2, NO, cAMP and cGMP formation, using a range of stimulators and radioimmunoassays.Results PGI2 formation in response to acetylcholine and phorbol ester, but not arachidonate, and cGMP formation in response to A23187 (NO‐release dependent), was significantly diminished in diabetic rabbit corpus cavernosum compared with controls at both 3 and 6 months after the induction of DM. cAMP formation in response to forskolin and prostaglandin E1 was reduced after 6 but not 3 months, although nitroprusside‐stimulated cGMP (activates guanylyl cyclase directly) was unaffected in cavernosal tissue from diabetic rabbits.Conclusions These results show that the formation of NO and PGI2, and adenylyl cyclase activity but not guanylyl cyclase, are impaired in the corpus cavernosum of diabetic rabbits. As NO and PGI2 are produced by the endothelium, these studies consolidate the view that endothelial dysfunction is a major contributor to erectile dysfunction in diabetes mellitus.
The long‐term effects of prostatic infarction in the rat
Authors: Park  , Lee  , Lee  
Published: March 2003

Objective To evaluate the long‐term effects of infarction, which usually induces organ atrophy, on the prostate by examining the changes occurring in rat ventral prostate after infarction.Materials and methods The unilateral arteriolar branches to the ventral prostate were electrocauterized under an operative microscope in 10 adult rats. The gross and histological changes of the treated lobes of the ventral prostate were compared with those of untreated control lobes in the same rats 12 weeks later.Results The size and mean (sd) weight of the treated lobes decreased markedly, to 148 (34) mg, compared with those of the controls, at 698 (62) mg (P<0.01). The treated lobes were composed of both normal and atrophic glandular tissue.Conclusion Prostatic atrophy can be induced by infarction in the rat; prostatic infarction might have potential as a new therapeutic strategy in the treatment of benign prostatic hyperplasia.
Fertility and histological studies of the contralateral testes in two different intra‐ and extra‐abdominal rat models of unilateral cryptorchidism
Authors: Zakaria  , Shono  , Imajima  , Suita  
Published: March 2003

Objective To investigate the effect of location of the testis on both testicular development and fertility in unilateral cryptorchidism.Material and methods Forty‐nine Wistar King A newborn male rats were divided into three groups. In group 1 (15 rats) intra‐abdominal unilateral cryptorchidism were created by the intra‐abdominal fixation of the testis in the neonatal period. In group 2 (16 rats) extra‐abdominal unilateral cryptorchidism was created by extra‐abdominal fixation of the gubernaculum in the neonatal period. In group 3, 18 rats underwent a sham operation as controls. At 90 days of age, fertility was then assessed in each rat by housing it with two mature virgin females for 2 weeks. Thereafter, at 115–120 days of age, the rats were killed and their testes removed for histological examination.Results There was no significant difference in the pregnancy rate between females coupled with rats from any group, but the mean number of offspring was significantly lower in females coupled with rats in group 1 than in group 2. Furthermore, histological examination of both the cryptorchid and contralateral scrotal testes showed more severe changes in the intra‐abdominal than the extra‐abdominal testes.Conclusion These results suggest that intra‐abdominal cryptorchid testes are significantly more impaired than extra‐abdominal cryptorchid testes, and that such impairment might be caused by exposure of the testis to a higher temperature. The more severely impaired undescended testes may thus induce the degeneration of the contralateral scrotal testis and thereby cause subfertility in the intra‐abdominal unilateral cryptorchid rat model.
Metallic ureteric stents: early experience
Authors: Pandian  , Hussey  , Mcclinton  
Published: March 2003

Objective To report our experience with metallic self‐expanding stents in the palliative care of patients with ureteric obstruction caused by advanced pelvic malignancy.Patients and methods Seven patients (five men and two women, mean age 72.8 years, range 58–88) with ureteric obstruction caused by advanced pelvic malignancy were evaluated. Self‐expanding metallic Memotherm™ stents (Angiomed, Karlsruhe, Germany) were deployed using an antegrade approach in all patients. Patients were followed for a mean (range) of 9 (4–13) months to assess renal function and survival.Results All seven patients had good palliation; their quality of life was improved and symptoms such as loin pain were ameliorated. Renal function was preserved; the mean serum creatinine level before and after stenting was 636 and 263 μmol/L, respectively). The mean duration of stent patency was 9 months. Of the five patients who subsequently died, only two had recurrent renal failure, presumably caused by stent occlusion.Conclusions The use of metallic stents in the palliative care of ureteric obstruction caused by advanced pelvic malignancy is a safe and effective treatment.
Lithogenic risk factors in the urine of black and white subjects
Authors: Whalley  , Moraes  , Shar  , Pretorius  , Meyers  
Published: March 2003

Objective To identify biochemical and dietary factors which may play a role in the low incidence of stone formation in the black South African population.Subjects and methods The study included 31 semi‐urbanized black and 29 urbanized white subjects. The protocol and modern laboratory techniques used to assess recurrent stone formers were followed. Urinary sodium, potassium, creatinine, calcium, phosphate and urate levels were measured, and urinary citrate, oxalate and cystine assessed.Results Black subjects ate a diet significantly higher in sodium (P<0.04); there was no difference in serum levels but urinary sodium was significantly higher (P<0.001) in black than in white subjects. Urinary potassium, calcium, citrate, phosphate and cystine were all significantly lower in black than in white subjects (P<0.001 for the first four and P<0.03 for cystine).Conclusion Certain intrinsic factors in South African black subjects may account for their lower frequency of stone formation than in white subjects. Of these, the very low urinary calcium, decreased urinary cystine and different interactions between sodium and calcium/cystine are probably important.
Pelvic fracture injuries of the female urethra
Authors: Venn  , Greenwell  , Mundy  
Published: March 2003

ObjectiveTo review pelvic fracture urethral injuries in women, generally regarded as rare and thus discussed infrequently.Patients and methodsTwelve patients (age range 7–51 years) with such injuries were reviewed; most had associated injuries, generally more severe than seen in males with urethral injuries.ResultsPatients with milder injuries, perhaps damaging just the innervation of the urethra, presented with incontinence; more severe injuries seemed to cause a longitudinal tear in the urethra but again patients presented mainly with incontinence problems. The most severe injuries were associated with complete rupture of the urethra and a distraction defect suggesting an avulsion injury. These problems were difficult to treat both reconstructively and in providing continence.ConclusionsPelvic fracture urethral injuries occur in females, but less often than in males. The female urethra seems relatively resistant to injury; differing degrees of severity of pelvic trauma cause different types of urethral injury but in general, a more severe injury is needed to damage it than is necessary in males.
A comparison of transrectal ultrasonography and endorectal magnetic resonance imaging in the local staging of prostatic carcinoma
Authors: Ekici  , Özen  , Agˇildere  , Ergen  , Özkardeş  , Ayhan  , Kendi  
Published: March 2003

ObjectiveTo compare the staging accuracy of transrectal ultrasonography (TRUS) and endorectal magnetic resonance imaging (eMRI) for organ‐confined prostatic carcinoma.Patients and methodsTwenty‐five patients with clinically confined prostatic adenocarcinoma were evaluated to be candidates for radical prostatectomy. All underwent TRUS and eMRI before surgery. Imaging findings evaluated prospectively in each patient were extracapsular extension (ECE), seminal vesicle invasion (SVI) and the site of involvement. The results of the imaging techniques were compared with the histopathological findings. As two patients with metastatic lymph nodes (detected on frozen‐section examination during surgery) were spared radical prostatectomy, the final evaluation included 23 patients.ResultsEndorectal coil MRI was more sensitive than TRUS for detecting both ECE, SVI and the site of ECE involvement in organ‐confined prostatic carcinoma. TRUS was more accurate than eMRI for detecting the site of SVI involvement. However, the overall staging accuracy rates for both imaging modalities were equal.ConclusionsNeither TRUS nor eMRI was significantly better than the other for determining the local extent of prostatic carcinoma. Therefore, TRUS should be the study of choice until MRI technology improves sufficiently in the preoperative staging of localized prostate cancer.
Panax ginseng protects the testis against 2,3,7,8‐tetrachlorodibenzo‐p‐dioxin induced testicular damage in guinea pigs
Authors: Kim  , Hwang  , Lee  , Song  , Kim  
Published: March 2003

ObjectivesTo investigate histopathologically the beneficial effects of Panax ginseng extract on guinea pig testes damaged by 2,3,7,8‐tetrachlorodibenzo‐p‐dioxin (TCDD).Materials and methodsNinety guinea pigs were divided into six equal groups. The normal controls (group 1) received vehicle and saline; group 2 received TCDD (1 μg/kg) intraperitoneally; group 3 and 4 received 100 or 200 mg/kg per day of Panax ginseng water extract (PG‐WE) intraperitoneally for 28 days from 1 week before TCDD injection; groups 5 and 6 received PG‐WE for 14 days from 1 week after TCDD treatment.ResultsThe gain in body weight was less in groups treated with TCDD than in controls. Moreover, the body weight of group 2 decreased from 14 days after TCDD exposure, while that of groups 3 and 4 increased; there was no decrease in body weight in groups 3–6. The decrease in testicular weight caused by TCDD was prevented by PG‐WE. Light microscopy showed smaller tubules and late maturation arrest in group 2; electron microscopy showed a dissolution of the germinal epithelium, disrupted tight junctions between adjacent Sertoli cells, and altered germ cells at all developmental stages. The maturation arrest in germ cells caused by TCDD was ameliorated in groups 3–6. The testes almost completely recovered in groups 3 and 4 and there was some therapeutic effect of PG‐WE in groups 5 and 6.ConclusionsThese results confirm the protective and therapeutic effects of Panax ginseng on atrophy and testicular damage induced by TCDD, providing evidence that ginseng might be a useful agent in preventing and treating testicular damage induced by environmental pollutants.
The re‐use of irrigating equipment for flexible cystoscopy is not safe
Authors: Molina‐Navarro  , Bhatia  , Awogu  , Ochai  , Jones  
Published: March 2003

ObjectiveTo determine the incidence of fluid reflux from the lower urinary tract into the connecting tubing used for irrigation in patients undergoing flexible cystoscopy.Patients and methodsThe study was conducted in 94 consecutive male and female patients attending routine outpatient flexible cystoscopy lists. A sensor was designed and constructed to determine the presence of any retrograde flow of irrigating fluid, and the volume of any reflux through the connecting tubing. The mean (sd) cystoscope internal channel volume was 2.56 (0.25) mL; the level of significant reflux was set at ≥2.25 mL.ResultsReflux of irrigating fluid occurred in 11 males (17%) and was significant in six (9%) of 65 male patients, with the irrigating fluid reservoir set at a height of 0.78 m above the patient’s mid‐coronal level. No reflux occurred in the 29 females studied.ConclusionsSignificant reflux can occur in males and hence the connecting tubing should be regarded as contaminated. Infection‐control measures must include the prevention of transmission of blood‐borne infections, e.g. hepatitis B and C viruses, and human immunodeficiency virus, because of the risk that blood may contaminate urine, and they should be implemented in all cases regardless of patient risk factors. From the available evidence, flexible cystoscopy should always be performed with single‐use irrigation systems.