bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multimodal management of urolithiasis in renal transplantation
Authors: Challacombe Ben , Dasgupta Prokar , Tiptaft Richard , Glass Jonathan , Koffman Geoff , Goldsmith David , Khan Mohammed S. 
Published: July 2005

OBJECTIVETo report the largest single series of renal transplant patients (adults and children) with urolithiasis, assess the risk factors associated with urolithiasis in renal transplant recipients, and report the outcome of the multimodal management by endourological and open procedures.PATIENTS AND METHODSThe records of all patients undergoing renal transplantation between 1977 and 2003 were reviewed. In all, 2085 patients had a renal transplant at our centre and 21 (17 adults and four children) developed urinary tract calculi. Their mode of presentation, investigations, treatments, complications and outcomes were recorded. Investigations included one or more of the following; ultrasonography (US), plain abdominal X‐ray, intravenous urography, nephrostogram and computed tomography. Management of these calculi involved extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopy and in situ lithotripsy, percutaneous nephrolithotomy (PCNL), open pyelolithotomy and open cystolitholapaxy.RESULTSThirteen patients had renal calculi, seven had ureteric calculi and one had bladder calculi. The incidence of urolithiasis was 21/2085 (1.01%) in the series. Urolithiasis was incidentally discovered on routine US in six patients, six presented with oliguria or anuria, including one with acute renal failure, four with a painful graft, three with haematuria, one with sepsis secondary to obstruction and infection and in one, urolithiasis was found after failure to remove a stent. Ten patients (63%) had an identifiable metabolic cause for urolithiasis, two by obstruction, two stent‐related, one secondary to infection and in six no cause was identifiable. Thirteen required more than one treatment method; 13 (69%) were treated by ESWL, eight of whom required multiple sessions; eight required ureteric stent insertion before a second procedure and four required a nephrostomy tube to relieve obstruction. Two patients had flexible ureteroscopy and stone extraction, three had a PCNL and one had open cystolithotomy. PCNL failed in one patient who subsequently had successful open pyelolithotomy. All patients were rendered stone‐free when different treatments were combined.CONCLUSIONSThe incidence of urolithiasis in renal transplant patients is low. There is a high incidence of metabolic causes and therefore renal transplant patients with urolithiasis should undergo comprehensive metabolic screening. Management of these patients requires a multidisciplinary approach by renal physicians, transplant surgeons and urologists.
Asymptomatic bacteriuria in men with orthotopic ileal neobladders: possible relationship to nocturnal enuresis
Authors: Abdel‐Latif Mohamed , Mosbah Ahmed , Bahnasawy Magdy S. El , Elsawy Essam , Shaaban Atallah A. 
Published: July 2005

The role of asymptomatic bacteriuria in patients with urinary diversion in general has been reported as having a significant role prognostically in several published studies. Authors from Mansoura, with considerable experience in the constructing the orthotopic ileal neobladder, have evaluated the incidence of asymptomatic bacteriuria in such patients prospectively, and have assessed its possible effect on neobladder function. OBJECTIVETo assess prospectively the incidence with time of asymptomatic bacteriuria in patients with orthotopic ileal neobladders, and the possible effect on neobladder function.PATIENTS AND METHODSIn all, 47 patients (mean age 52.7 years, sd 8.7, range 31–68) with uncomplicated orthotopic ileal neobladders were prospectively evaluated. With no antibiotic manipulation, consecutive urine cultures were assessed monthly. Continence was assessed by direct information from the patients at each follow‐up visit.RESULTSOverall, 797 samples were cultured from the 47 patients (mean 17.6, sd 7.1). There was a steady decrease in the incidence of positive cultures, from 74.5%, to 35.6% and 6.7% at 1, 6 and 18 months, respectively. While there was persistently sterile urine in only eight patients (17%), 32 had occasional and seven had persistent bacteriuria. Escherichia coli was the commonest organism (76.6%) followed by Klebsiella pneumonia (15.7%); 54% of E. coli and 38% of K. pneumonia infections were sensitive to nitrofurantoin. Diurnal continence was achieved in 98% of the patients at 6 months after surgery. There was a gradual decrease in the frequency of nocturnal enuresis (NE) with time, from 87%, to 42%, 28% and 27% at 1, 6, 12 and 18 months, respectively. There was a significant correlation between the presence of bacteriuria and NE during the first 6 months, but it was not sustained after that. The age of the patients was also related significantly to the incidence of NE; at 6 months, only one of 18 men aged ≤ 50 years had NE, while 19 of 29 aged > 50 years had (P < 0.001). At 1 year all patients aged ≤ 50 years were nocturnally continent, while half of those aged > 50 years had NE (P = 0.001).CONCLUSIONSIleal neobladders are associated with a high incidence of asymptomatic bacteriuria during the first year after surgery. There was spontaneous clearance of bacteriuria with time, with no antimicrobial manipulation. Soon after surgery there was a significant association between bacteriuria and NE. The effect of antimicrobials on patients with NE should be evaluated.
Vesicostomy revisited: the best treatment for the hostile bladder in myelodysplastic children?
Authors: Morrisroe Shelby N. , O'Connor R. Corey , Nanigian Dana K. , Kurzrock Eric A. , Stone Anthony R. 
Published: July 2005

Vesicostomy is a well‐known management of the neuropathic bladder in children, and authors from Sacramento describe their experience with this in what they very appropriately name the “hostile bladder” of myelodysplastic children. Other papers in this section suggest that inguinal hernia in female infants should act as a cue to check the sex chromosomes, evaluate nocturnal enuresis in children at 7.5 years old, and describe the efficacy of tolterodine as a first‐line treatment for non‐neurogenic voiding dysfunction in children. OBJECTIVETo evaluate the effects of vesicostomy on the urinary tract of myelodysplastic children in whom conservative bladder management with clean intermittent catheterization (CIC) has failed to preserve upper and lower urinary tract function.PATIENTS AND METHODSSixteen children with myelodysplasia underwent vesicostomy. Indications included worsening hydronephrosis, vesico‐ureteric reflux (VUR), recurrent urinary tract infections (UTIs), and increasing renal insufficiency despite CIC and/or difficulty with CIC. The mean (range) age at vesicostomy was 36.5  (9–82) months and the follow‐up 7.4  (2–16) years.RESULTSHydronephrosis resolved or improved in 12 of 14 children, the incidence of UTI decreased to one or fewer per year in 10, VUR resolved or improved in nine, and renal function improved or stabilized in six of seven patients. One patient initially presented with renal insufficiency and subsequently required dialysis despite vesicostomy. Complications occurred in three of 15 children, and included stomal stenosis and bladder calculi. The vesicostomy was closed in six patients after a mean of 4.4 (1.5–9) years. Four of these patients required concomitant bladder augmentation.CONCLUSIONSVesicostomy in myelodysplastic children is effective in preventing and/or resolving the deleterious consequences of a ‘hostile’ bladder. The procedure is uncomplicated, well tolerated, reversible and should be considered in managing children in whom conservative management by CIC has failed.
Inguinal hernia in female infants: a cue to check the sex chromosomes?
Authors: Deeb Asma , Hughes Ieuan A. 
Published: July 2005

OBJECTIVESTo review the clinical presentation of complete androgen insensitivity syndrome (CAIS) and assess the current practice of considering the diagnosis of CAIS in female infants presenting with inguinal hernia.PATIENTS AND METHODSAIS arises from target tissue resistance to the actions of androgens due to molecular abnormalities in the androgen receptor. Patients with CAIS are born with normal external female genitalia, and although inguinal hernias are uncommon in female infants, they are a well‐known presentation of CAIS. Such patients were identified from the Cambridge Intersex Database and details of presentation, presence and laterality of inguinal hernia and contents, and family history of CAIS, were recorded. A questionnaire detailing different indications for considering CAIS in female infants with a hernia was distributed to members of the British Association of Paediatric Surgeons and the British Society for Paediatric Endocrinology and Diabetes.RESULTSMore than half of patients with CAIS presented with inguinal hernia, of which half were bilateral and a third contained gonads. Completed questionnaires were returned by 87 surgeons and 64 endocrinologists, and most of the surgeons and endocrinologists would consider CAIS in all female infants with a hernia. Bilateral hernias, hernias containing gonads and a family history of CAIS would prompt clinicians to consider the diagnosis.CONCLUSIONMost clinicians agreed that CAIS should be considered in all female infants with inguinal hernia, as this is the commonest mode of presentation in childhood. Macroscopic inspection of the internal genital structures coupled, perhaps, with gonadal biopsy is recommended. Fluorescence in situ hybridization offers a rapid and reliable method to check the sex chromosomes. Liaison between the paediatric surgeon and endocrinologist is essential in management of infants with CAIS.
Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs
Authors: Butler Richard J. , Golding Jean , Northstone Kate ,   The ALSPAC Study Team
Published: July 2005

OBJECTIVETo determine the prevalence of nocturnal enuresis (NE) in a large cohort of children at 7.5 years old, and to examine the frequency of variables such as gender, severity, associated elimination problems, and clinical signs within the identified group.SUBJECTS AND METHODSOf an original cohort of 13 971 infants alive at 12 months, 11 251 who were still active in the Avon Longitudinal Study of Parents and Children (ALSPAC) survey, were followed at 91 months. The mother or main carer was given a questionnaire which asked, amongst other items, about the presence and frequency of bedwetting, other elimination problems, and signs related to the wetting behaviour; 8269 (73.5%) questionnaires were returned and 8151 contained information on the frequency of bedwetting.RESULTSIn all, 1260 children (15.5%) at 7.5 years wet the bed, but most wet once or less a week, and only 215 (2.6%) met the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) criteria of NE (wetting at least twice a week). A higher prevalence was reported in boys than girls and 266 children (3.3%) had both daytime wetting and bedwetting, with 189 (2.3%) having both daytime soiling and bedwetting. Daytime urgency increased with severity of bedwetting and occurred in 28.9% of children with NE.CONCLUSIONAt 7.5 years old the incidence of bedwetting is high, but only 2.6% of this large population‐based sample wet at a frequency meeting the definition of NE. Although a small percentage of children had both daytime wetting and bedwetting, the evidence suggests that these are discrete problems. Amongst children with NE, indicators of bladder overactivity were present, supporting the view of heterogeneity and the importance of individual assessment in deciding on appropriate treatment.
Efficacy of tolterodine as a first‐line treatment for non‐neurogenic voiding dysfunction in children
Authors: Ayan Semih , Kaya Kemal , Topsakal Kahraman , Kilicarslan Hakan , Gokce Gokhan , Gultekin Yener 
Published: July 2005

OBJECTIVETo assess the effect of antimuscarinic treatment with tolterodine combined with behavioural modification as a first‐line treatment, before invasive investigation, in children with non‐neurogenic voiding dysfunction but no obvious anatomical or neurogenic cause.PATIENTS AND METHODSThe study comprised 44 children presenting with voiding dysfunction (30 girls and 14 boys, mean age 7 years, range 5–14); all had a noninvasive evaluation consisting of a history, urine analysis, renal and bladder ultrasonography and physical examination, with specific emphasis on the voiding pattern. Anticholinergic treatment with tolterodine (1 mg twice daily) was started in all patients; they were also informed about conservative management, including timed voiding, double voiding and relaxation of the pelvic floor during voiding. At the start and after 3 months, the dysfunctional voiding symptom score (DVSS) was completed twice by all patients.RESULTSFor all patients the mean (sd) DVSS was 14.0 (2.67) and 6.68 (3.67) before and after treatment, respectively; the difference was statistically significant (P < 0.001). The mean scores for girls and boys, respectively, were 13.8 (2.79) and 14.5 (2.44) before and 6.43 (3.79) and 7.50 (3.34) after treatment.CONCLUSIONTolterodine combined with behavioural modification for dysfunctional voiding in children with no neurological or anatomical abnormality can be recommended as a first‐line treatment before invasive evaluation. Additionally, the DVSS appears to provide accurate and objective data for monitoring the effect of treatment in such children.
The src‐family kinase inhibitor PP2 suppresses the in vitro invasive phenotype of bladder carcinoma cells via modulation of Akt
Authors: Chiang George J. , Billmeyer Brian R. , Canes David , Stoffel John , Moinzadeh Alireza , Austin Christina A. , Kosakowski Monika , Rieger‐Christ Kimberly M. , Libertino John A. , Summerhayes Ian C. 
Published: July 2005

OBJECTIVETo evaluate PP2 as a modulator of the cadherin/catenin complex in late‐stage bladder carcinoma cells, and to assess its potential invasion‐suppressor activity in this model.MATERIALS AND METHODSA panel of five human bladder carcinoma cells, characterizing late‐stage disease, was used to determine the concentration for 50% inhibition of PP2 in cell‐proliferation assays. Modulation of cadherin/catenin expression by PP2 was determined in Western blot analysis, with an assessment of the activation status of mitogen‐activated protein kinase and Akt signalling pathways. Altered invasive capacity linked to these variables was determined in standard in vitro invasion assays.RESULTSPP2 elicited concentration‐dependent growth inhibition in all bladder cell lines within the panel, with growth suppression recorded at 10–35 µmol/L PP2. Distinct morphological changes were recorded in cell lines exposed to PP2, accompanied by up‐regulation of plakoglobin expression in a subset of lines. Exposure of cells to PP2 resulted in inactivation of Akt in all cells and a concomitant reduction in in vitro invasive capacity.CONCLUSIONSThese results show that PP2 inhibits bladder carcinoma cell growth and can modulate plakoglobin expression in a subset of cell lines. In addition, PP2 can suppress the in vitro invasive capacity of bladder carcinoma cells by modulating the activation status of Akt.
Sildenafil inhibits the formation of superoxide and the expression of gp47phox NAD[P]H oxidase induced by the thromboxane A2 mimetic, U46619, in corpus cavernosal smooth muscle cells
Authors: Koupparis Anthony J. , Jeremy Jamie Y. , Muzaffar Saima , Persad Raj , Shukla Nilima 
Published: July 2005

OBJECTIVETo assess the effect of sildenafil on superoxide formation and p47phox (the active subunit of NADPH oxidase) expression in cultured corpus cavernosal smooth muscle cells (CVSMCs).MATERIALS AND METHODSCVSMCs derived from rabbit penis were incubated with U46619 (thromboxane A2 analogue) with or without sildenafil for 1 or 16 h at 37°C. Superoxide dismutase‐inhibitable superoxide formation was assessed using the reduction of ferricytochrome c measured spectrophotometrically, and gp47phox assessed using Western blot analysis. The role of NAD[P]H oxidase and cGMP was further studied by using specific inhibitors of each.RESULTSSuperoxide formation was significantly greater in cells incubated with U46619 after 1 and 16 h incubation than in controls, an effect blocked by NADP(H) oxidase inhibitors. These effects of U46619 were inhibited by sildenafil (1 and 10 nmol/L), which in turn were negated by the guanylyl cyclase inhibitor, ODQ; 10 nmol/L sildenafil inhibited p47phox expression induced by U46619.CONCLUSIONSSildenafil is a potent inhibitor of superoxide formation in CVSMCs. This effect is mediated through the inhibition of PDE‐5 which in turn augments the inhibitory action of the NO‐cGMP axis on NAD[P]H oxidase expression and activity. This mechanism constitutes a new pharmacological action of sildenafil, consolidates the potential role of superoxide in ED, and indicates that thromboxane A2 may be an important mediator of intrapenile oxidative stress.
Loss of ryanodine receptor calcium‐release channel expression associated with overactive urinary bladder smooth muscle contractions in a detrusor instability model
Authors: Jiang Hai‐Hong , Song Bo , Lu Gen‐Sheng , Wen Qian‐Jun , Jin Xi‐Yu 
Published: July 2005

OBJECTIVETo investigate the changes in spontaneous bladder smooth muscle contractions that occur during detrusor instability (DI), and to test the possibility that altered function or expression of ryanodine receptors (RyRs) could account for the increased bladder contractions.MATERIALS AND METHODSAfter 8 weeks of partial bladder outlet obstruction, DI was confirmed in female experimental rats by filling cystometry. Muscle strips were dissected from freshly isolated bladders, and isometric tension recorded in strips from DI and normal bladders. The contractions were recorded during electrical stimulation or exposure to various agents. Western blot analysis was used to determine RyR expression in DI and normal bladder muscle.RESULTSIn DI bladder muscle, spontaneous contractile activity persisted in the presence of blockers for known neurotransmitter receptors in the bladder wall. The RyR blocker ryanodine significantly increased the spontaneous contractile frequency in normal bladder strips, but failed to affect spontaneous contractions in DI muscle. Caffeine inhibited spontaneous contractile activity in both the DI and normal strips. After administering the l‐type Ca2+ channel antagonist nimodipine, the myogenic contractile activity was abolished in normal strips; in contrast, in DI strips, the amplitude of contractions was reduced but the frequency of contractions was unchanged. Western blot analysis showed that RyR expression was lower in DI muscle than in normal bladder muscle.CONCLUSIONThese results provide the first characterization of a loss of regulation of spontaneous contractile activity by RyRs in DI muscle associated with a significant decrease in RyR expression. RyRs in normal detrusor muscle act as negative‐feedback regulators of spontaneous contractile activity, presumably by releasing Ca2+ that activates Ca2+‐dependent K+ channels to decrease contractility. This mechanism might be weakened in DI muscle, resulting in spontaneous contractile overactivity.
Biosynthesis and differential processing of two pools of amyloid‐β precursor protein in a physiologically inducible neuroendocrine cell
Authors: Collin Rob W. J. , Van Den Hurk Wilhelmina H. , Martens Gerard J. M. 
Published: July 2005

AbstractThe amyloid‐β precursor protein (APP) is linked to Alzheimer's disease through its pathological proteolytic processing in the secretory pathway. Nevertheless, surprisingly little is known about the biosynthesis of endogenous APP. We therefore decided to investigate the intracellular fate of newly synthesized APP in a physiologically inducible neuroendocrine cell, the Xenopus intermediate pituitary melanotrope cell. We found that the level of both APP mRNA and protein was about threefold induced in the activated cells of black‐adapted animals. Intriguingly, two pools of APP were found, only one of which was up‐regulated. This induced pool became readily N‐ and subsequently O‐glycosylated and was eventually proteolytically processed by an α‐secretase‐like cleavage event resulting in a secreted N‐terminal and a cell‐associated C‐terminal APP fragment. Conversely, only the other (non‐induced, non‐glycosylated and uncleaved) pool became phosphorylated. Thus, we report on the biosynthesis of APP in a physiological context and illuminate the occurrence of two pools of APP, one of which is linked to neuroendocrine cell activation.
Literature Can Close the Fear Gap
Authors: RUSHDIE SALMAN 
Published: July 2005

Post‐national literature is a new genre of writing for a new era beyond boundaries. In this section, we present interviews and comments adapted from conversations with authors from India, Iran, Lebanon, Turkey, Argentina, China and Austria—all but one of whom now live outside their countries, often writing in a language not their own.Most of the conversations and interviews were conducted by Michael Skafidas, the former editor of Greek NPQ, in New York at the time of the PEN Festival of International Literature, organized by Salman Rushdie. Ha Jin was interviewed by Jehangir Pocha. Gao Xingjian's contribution is adapted from his lecture upon winning the Nobel Prize for Literature.
Serotonin transporter gene polymorphism (5‐HTTLPR) in patients with recurrent aphthous stomatitis
Authors: Victoria Junia Maria Netto , de Fátima Correia‐Silva Jeane , Pimenta Flávio Juliano , Kalapothakis Evanguedes , Gomez Ricardo Santiago 
Published: July 2005

Background: Considerable evidence indicates that serotonergic mechanisms, particularly the serotonin transporter (5‐HTT) may be involved in psychological alterations. Recent findings have demonstrated that depression and stress are influenced by polymorphism of the promoter region of 5‐HTT (5‐HTTLPR) and that the short allele (S) is associated with reduced transcriptional efficiency resulting in reduced serotonin expression and uptake. As psychological and genetic factors have been implicated in the pathogenesis of recurrent aphthous stomatitis (RAS), the purpose of the present study was to investigate 5‐HTTLPR polymorphism in patients with RAS compared with control subjects.Methods: Sixty‐nine consecutive subjects affected by minor and major forms of RAS and 70 healthy volunteers were genotyped at 5‐HTTLPR. The chi‐square test was used for statistical analysis.Results: A significant increase in the genotype of SS (P = 0.05) and of the alleleS(P = 0.04) in the group of RAS were observed.Conclusion: Our findings demonstrate that RAS patients have a tendency to show polymorphism associated with anxiety‐related traits.