bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of aspiration and sclerotherapy with laparoscopic de‐roofing in the management of symptomatic simple renal cysts
Authors: Okeke A.A. , Mitchelmore A.E. , Keeley F.X. , Timoney A.G. 
Published: September 2003

OBJECTIVESTo present the results of a minimally invasive treatment of symptomatic simple renal cysts, and to propose an algorithm for their management.PATIENTS AND METHODSSeventeen patients presenting with suspected symptomatic simple renal cysts were referred for trial aspiration; 16 presented with loin pain and one with a flank mass. If the cyst and symptoms recurred after a temporary response, they were managed by re‐aspiration with sclerotherapy using 95% ethanol, or by laparoscopic de‐roofing of the cyst.RESULTSOf the 17 patients referred, one failed to respond to aspiration and was excluded from further analysis. Three patients had sustained pain relief from simple aspiration alone, 13 required further treatment for symptom relapse, of whom six had aspiration and sclerotherapy, and seven had laparoscopic de‐roofing. After a mean follow‐up of 17 months, pain had recurred in all five patients originally presenting with pain and managed by sclerotherapy, and the patient who presented with a painless mass from a large cyst also developed pain after sclerotherapy. In contrast, the subsequent seven patients managed by laparoscopic treatment are pain‐free at a mean follow‐up of 17.7 months.CONCLUSIONEvaluation including a diagnostic aspiration is essential to diagnose a symptomatic cyst. When treatment is indicated, laparoscopic de‐roofing appears to be more effective than sclerotherapy.
National and international variation in the registration of bladder cancer
Authors: Crow P. , Ritchie A.W.S. 
Published: September 2003

OBJECTIVETo determine whether variations exist in the methods by which different cancer registries record information on bladder cancers.METHODSThe registration practices of the various cancer registries within the UK, Europe and the USA were investigated by consulting the available publications and by correspondence with registry staff. In addition, a telephone survey was carried out within the UK to determine whether the national guidelines on bladder cancer coding were being followed.RESULTSThere is variation in the registration of bladder cancers both among regions within the UK and between the UK and other regions. The telephone survey showed that only four of the 11 UK regional registries were correctly following the national bladder cancer coding guidelines. Bladder cancer registration also varies between the cancer registries within mainland Europe. When comparing registration practices in the UK and the USA the major difference is that cases of bladder carcinoma in situ and pTa transitional cell carcinoma are included in the North American cancer statistics but not in the British cancer statistics.CONCLUSIONMuch needs to be done before it can be claimed that the registration of bladder cancers has been standardized either nationally or internationally. In particular, the differences in registration practices between the UK and the USA will tend to give a falsely low impression of British incidence and survival rates compared with the equivalent North American figures. This confounding factor must be considered if these incidence and survival values are to be compared.
The catheterized patient undergoing transurethral resection of the prostate: a survey of the current practice of British urologists
Authors: Wilson J.R. , Puri R. , Prescott S. , Urwin G.H. 
Published: September 2003

OBJECTIVETo determine, using a postal questionnaire survey of practising British consultant urologists, the duration and type of antibiotic deemed most effective in patients with an existing indwelling catheter before transurethral resection of the prostate (TURP), as the value of prophylactic antibiotics before TURP is well recognized, but no data are available.METHODSA questionnaire was posted to each of the 321 practising consultant urologists listed in the handbook of the British Association of Urological Surgeons (1998). A hypothetical situation in the opening statement proposed ‘a patient with an indwelling catheter is to undergo TURP’. The type, timing and duration of prophylactic antibiotic usage were elicited by circling the appropriate response from a choice of several possibilities.RESULTSIn all, 250 questionnaires were returned; 98% of respondents recognized the importance of the prophylactic use of antibiotics in catheterized patients undergoing TURP, and routinely use them. Most urologists (53%) use more than one dose, with most of these preferring a second dose on catheter removal (60%).CONCLUSIONThe magnitude and diversity of response suggests uncertainty about the appropriate prophylaxis in such patients, and the need for further studies to clarify this situation.
Impalpable testis cancer
Authors: Hindley R.G. , Chandra A. , Saunders A. , O'Brien T.S. 
Published: September 2003

OBJECTIVETo assess the significance of ultrasonographically detected hypoechoic lesions of the testis when the clinical examination is normal, and to highlight the management difficulties thereafter.PATIENTS AND METHODSOver a 2‐year period four patients underwent radical orchidectomy where the sole indication for surgery was a hypoechoic lesion detected on ultrasonography (US). The indications for US were persistent scrotal discomfort in two men, contralateral orchitis, and the follow‐up of testicular microlithiasis. The lesions were 4–11 mm in size and one man had several. None of the lesions were palpable; the tumour markers were normal in all patients.RESULTSThree of the testes contained seminoma; in one there were two foci of seminoma and in all intratubular germ cell neoplasia was also identified. The remaining case was a Leydig‐cell tumour. All tumours were staged as pT1 after radical inguinal orchidectomy.CONCLUSIONImpalpable lesions of the testis are likely to be malignant if they are hypoechoic on US and should be considered as seminoma until proved otherwise. The management thereafter is not straightforward, but must ensure an adequate histological diagnosis if the US appearances do not resolve.
Neuroanatomy of the male urethra and perineum
Authors: Yucel S. , Baskin L.S. 
Published: September 2003

OBJECTIVETo describe the topography of the perineal nerves from their pudendal origin to their course into the male genitalia, with specific attention on the course of the perineal nerve along the ventral penis, including branches into bulbospongiosus muscle and corpus spongiosum.MATERIALS AND METHODSThe study comprised 18 normal human fetal penile specimens at 17.5–38 weeks of gestation (determined by fetal heel‐to‐toe length). Specimens were fixed in formalin, embedded in paraffin wax and serially sectioned at 6 µm. The penile specimens contained the whole penis from the glans to the crural bodies, beneath the pubic arch and the perineum up to the anal verge. Immunocytochemistry was assessed on selected sections with antibodies against the neuronal markers S‐100 and nitric oxide synthase (nNOS). Three‐dimensional computer reconstruction of serial sections allowed an in‐depth analysis of the neuroanatomy of the fetal penis, perineum and surrounding structures.RESULTSAfter the pudendal nerve leaves the pudendal canal it gives rise to the perineal nerve branches in the ischiorectal fossa. Perineal nerves travel alongside the ischiocavernous and bulbospongiosus muscles and before reaching the latter, nerve branches course into the bulbospongiosus muscle. During its pathway within this muscle, fine nerve fibres course into the corpus spongiosum by piercing through the junction of the muscle. At the penoscrotal area, the perineal nerves give branches to the scrotum, funnelling into the interscrotal septum. Perineal nerves continue their pathway over the ventral side of penis covering the ventral surface of corpus spongiosum. Branches of the dorsal nerve of the penis at the junction of corpus cavernosum and corpus spongiosum assemble into a network with the perineal nerves. All perineal nerves from their main trunk at the ischiorectal fossa until their interaction with dorsal nerve of penis at the base of penis were nNOS negative. After the interaction with the dorsal nerve of penis, they become nNOS positive.CONCLUSIONIntegrating neuroanatomical knowledge about the perineal nerves and their communication with the dorsal nerve of penis should facilitate a strategic approach to reconstructive procedures on the penis. Special care should be taken at the junction between the corpora cavernosa and spongiosa, where the dorsal nerve joins the perineal nerve, and at the proximal bulbospongiosus muscle, thereby protecting the fine nerves piercing into the cavernosa spongiosa.
Individual patient variation and inter‐rater reliability of lower calyceal infundibular width on routine intravenous pyelography
Authors: Pace K.T. , Weir M.J. , Harju M. , Tariq N. , D’A.Honey R.J. 
Published: September 2003

Three papers in this section all relate, directly or indirectly, to minimally invasive procedures. When John Wickham coined this phrase several years ago, it was not possible to predict how widely used it would become, and how relevant to the future not only of urology, but of surgery in general. Obviously, minimally invasive techniques are not only used in the upper urinary tract, but also in most other parts of the urinary tract. There have been many advances in recent years, but we acknowledge John Wickham as a very important founding father.OBJECTIVETo standardise infundibular width (IFW) measurement, to determine patient variability, and to determine inter‐rater variability on intravenous pyelography (IVP).PATIENTS AND METHODSFifty outpatient IVP films were randomly drawn from two hospitals between 1 July 1998 and 31 August 1999, and examined to measure the lower calyceal IFW on the 5, 10 and 20 min films with compression, and after voiding. Kidneys with previous renal surgery, hydronephrosis or renal anatomical anomalies were excluded; in all, 81 kidneys from 50 patients were examined. The IFW was measured at the narrowest point along the infundibulum. All 50 films were then reviewed by two urologists unaware of their origin, to determine the inter‐rater reliability of the infundibular measurements.RESULTSAnalysis of variance (anova) with posthoc analysis showed a significant difference in IFW at each phase of the IVP (repeated measures anova, P < 0.001). The mean (95% confidence interval) IFW was greatest on the compression film, at 4.4 (2.6) mm, and least on the postvoid film, at 1.6 (2.1) mm. Overall inter‐rater reliability was 0.9780 (intraclass correlation coefficient), and the Pearson correlation between each rater for the IFW at each phase of the IVP was ≥ 0.886.CONCLUSIONSThere is wide variability in lower calyceal IFW among the various IVP films in a given study. Thus any predictive value of the IFW must be standardized for the timing and IVP film type (compression, postvoid, etc.). The inter‐rater reliability of IFW is high, suggesting that if used correctly it may be more useful in predicting the outcome after shock wave lithotripsy.
Does overnight normalization of plasma glucose by insulin infusion affect assessment of glucose metabolism in Type 2 diabetes?
Authors: Staehr P. , Hojlund K. , Hother‐Nielsen O. , Holst J. J. , Beck‐Nielsen H. 
Published: September 2003

AbstractAims  In order to perform euglycaemic clamp studies in Type 2 diabetic patients, plasma glucose must be reduced to normal levels. This can be done either (i) acutely during the clamp study using high‐dose insulin infusion, or (ii) slowly overnight preceding the clamp study using a low‐dose insulin infusion. We assessed whether the choice of either of these methods to obtain euglycaemia biases subsequent assessment of glucose metabolism and insulin action.Methods  We studied seven obese Type 2 diabetic patients twice: once with (+ ON) and once without (– ON) prior overnight insulin infusion. Glucose turnover rates were quantified by adjusted primed‐constant 3‐3H‐glucose infusions, and insulin action was assessed in 4‐h euglycaemic, hyperinsulinaemic (40 mU m−2 min−1) clamp studies using labelled glucose infusates (Hot‐GINF).Results  Basal plasma glucose levels (mean ± sd) were 5.5 ± 0.5 and 10.7 ± 2.9 mmol/l in the + ON and – ON studies, respectively, and were clamped at −5.5 mmol/l. Basal rates of glucose production (GP) were similar in the + ON and – ON studies, 83 ± 13 vs. 85 ± 14 mg m−2 min−1 (NS), whereas basal rates of glucose disappearance (Rd) were lower in the + ON than in the – ON study, 84 ± 8 vs. 91 ± 11 mg m−2 min−1 (P = 0.02). During insulin infusion in the clamp period, rates of GP, 23 ± 11 vs. 25 ± 10 mg m−2 min−1, as well as rates of Rd, 133 ± 32 vs. 139 ± 37 mg m−2 min−1, were similar in the + ON and – ON studies, respectively (NS).Conclusions  Apart from basal rates of Rd, assessment of glucose turnover rates in euglycaemic clamp studies of Type 2 diabetic patients is not dependent on the method by which plasma glucose levels are lowered.
Are analogue insulins better than soluble in continuous subcutaneous insulin infusion? Results of a meta‐analysis
Authors: Colquitt J. , Royle P. , Waugh N. 
Published: September 2003

AbstractAims  The properties of rapid‐acting insulin analogues are thought to be particularly appropriate for use in continuous subcutaneous insulin infusion (CSII) or insulin pump therapy. We conducted a systematic review and meta‐analysis of trials comparing rapid‐acting insulin analogues with soluble insulin in CSII.Methods  The following databases were searched (last search June 2002): MEDLINE 1985–2002; Embase 1980–2002; PubMed internet version, records added June 2001 to June 2002; Science Citation Index 1990–2002; BIOSIS 1999–2002; Web of Science Proceedings 1990–2002; and the Cochrane Library, including DARE and the HTA databases. Randomized controlled trials and crossover studies with at least 10 weeks on each treatment were included. Data extraction and quality assessment were undertaken by one reviewer and checked by a second. A meta‐analysis was undertaken using a random effects model.Results  A significant improvement of 0.26% (95% confidence interval −0.47, −0.06%) in glycated haemoglobin was demonstrated with lispro. Some studies reported fewer hypoglycaemic episodes with analogue insulin but this varied according to the definitions used. No differences in insulin dosage or weight were seen. Two studies reported patient preference, with analogues preferred in both. The extra cost per annum ranges from £72 (at 40 units per day) to £150 (at 84 units per day).Conclusions  Insulin analogues result in a modest but significant reduction in HbA1c compared with soluble insulin when used in CSII, and are preferred by patients.
Characteristics of Type 1 diabetes of over 50 years duration (the Golden Years Cohort)
Authors: Bain S. C. , Gill G. V. , Dyer P. H. , Jones A. F. , Murphy M. , Jones K. E. , Smyth C. , Barnett A. H. 
Published: September 2003

AbstractBackground  Type 1 diabetes mellitus is associated with high levels of premature morbidity and mortality. Prolonged survival is possible, however, and some patients appear to be protected from the long‐term complications of this condition.Methods  Diabetes UK awards medals to patients who have had Type 1 diabetes for 50 years or more. By examining medal‐holders, we have established the clinical and biochemical features of a group of 400 subjects (54% male) with Type 1 diabetes of long duration.Results  Mean age of the subjects was 68.9 years and mean age‐at‐onset of diabetes 13.7 years. Features of long duration diabetes in this cohort include normal body mass (mean BMI 25.0 kg m−2), low insulin dose (mean 0.52 units kg−2) and greatly elevated HDL‐cholesterol (mean 1.84 mmol/l). Mean HbA1c was 7.6% (normal range 3.8–5.0%) and no patient had a normal HbA1c at the time of venesection. As a group, they have long‐lived parents and consume moderate amounts of alcohol. Medical contact has often been sporadic. A significant proportion (29%) were taking anti‐hypertensive medication. Screening for micro‐ and macroalbuminuria was positive in 35.7%.Conclusions  Patients with long‐duration (> 50 years) Type 1 diabetes are relatively protected from clinical diabetic nephropathy and large vessel disease; our data are consistent with protection possibly being genetically determined in part via elevated HDL‐cholesterol levels. An abnormal urinary albumin/creatinine ratio is common in these patients, despite their low risk of significant renal deterioration; this may have implications for microalbuminuria screening programmes.
Response to treatment with rosiglitazone in familial partial lipodystrophy due to a mutation in the LMNA gene
Authors: Owen Katharine R. , Donohoe Mollie , Ellard Sian , Hattersley Andrew T. 
Published: September 2003

AbstractBackground  Familial partial lipodystrophy (FPLD) is a monogenic form of diabetes characterised by a dominantly inherited disorder of adipose tissue associated with the loss of subcutaneous fat from the limbs and trunk, with excess fat deposited around the face and neck. The lipodystrophy causes severe insulin resistance, resulting in acanthosis nigricans, diabetes, dyslipidaemia, and increased risk of cardiovascular disease. Preliminary results from animals and man suggest that increasing subcutaneous fat by treatment with thiazolidinediones should improve insulin resistance and the associated features of this syndrome.Case report  We report a 24‐year‐old patient with FPLD caused by a mutation in the LMNA gene (R482W) treated with 12 months of rosiglitazone. Subcutaneous fat increased following rosiglitazone treatment as demonstrated by a 29% generalised increase in skin‐fold thickness. Leptin levels increased from 5.8 to 11.2 ng/ml. Compared with treatment on Metformin, there was an increase in insulin sensitivity (HOMA S% 17.2–31.6) but no change in glycaemic control. The lipid profile worsened during the follow‐up period.Conclusion  This initial case suggests that, for modification of cardiovascular risk factors, there are no clear advantages in treating patients with FPLD with rosiglitazone despite increases in subcutaneous adipose tissue. Larger series will be needed to identify moderate beneficial effects and treatment may be more effective in patients with generalised forms of lipodystrophy.
Brain‐derived neurotrophic factor shows a protective effect and improves recovery of the ERG b‐wave response in light‐damage
Authors: Ikeda Kazuhito , Tanihara Hidenobu , Tatsuno Tohru , Noguchi Hiroshi , Nakayama Chikao 
Published: September 2003

AbstractWe investigated the neuroprotective effects of brain‐derived neurotrophic factor (BDNF) and its influence on the functional recovery of the retina following light‐induced retinal damage by electroretinogram (ERG). Rats were exposed to constant fluorescent light for 2, 5, 7, or 14 days, then returned to a cyclic light environment for 14 days. The result indicated that BDNF had few effects on the a‐wave amplitude, but there was a statistically significant difference in the b‐wave amplitudes between BDNF‐treated and control eyes from day 0–14 of the recovery period following 2 days of light exposure (p < 0.05). Our findings suggest that BDNF not only protects the retinal neuronal function but also enhances the recovery from retinal light damage.
Nitric oxide and Fenton/Haber–Weiss chemistry: nitric oxide is a potent antioxidant at physiological concentrations
Authors: Sharpe Martyn A. , Robb Sarah J. , Clark John B. 
Published: September 2003

AbstractWe have examined the action of nitric oxide (NO) on the ability of Fenton's reagent (ferrous iron and hydrogen peroxide), to oxidize a number of organic optical probes. We found that NO is able to arrest the oxidation of organic compounds at concentrations of NO found in brain, in vivo. We present evidence that Fenton's reagent proceeds via a ferryl intermediate ([Fe=O]2+), before the generation of hydroxyl radical ·(OH). NO reacts rapidly with this ferryl, blocking the production of ·OH. We propose that NO has an important role in protecting biological tissues, and the brain in particular, from Fenton chemistry.
Uncoupling protein 2 influences dopamine secretion in PC12h cells
Authors: Yamada Shigeru , Isojima Yasushi , Yamatodani Atsushi , Nagai Katsuya 
Published: September 2003

AbstractUncoupling protein 2 (UCP2) belongs to the UCP family, and is distributed in many organs including the brain. Although UCP2 is known to be related to many functions such as the regulation of insulin secretion or the scavenging of the radicals, the role of UCP2 in the central nervous system remains unclear. In this report, rat UCP2 (rUCP2) and its mutants were overexpressed in the PC12h cells to determine the physiological roles played by UCP2 in neural cells and to elucidate the mechanisms that regulate these functions. It was found that rUCP2 was activated by the stimulation of the cAMP‐protein kinase A (PKA) cascade. Moreover, the activation of rUCP2 suppressed intracellular ATP levels and inhibited the cAMP‐dependent increase of dopamine secretion. Thus, UCP2 appears to be regulated by the excitatory stimulus via the cAMP‐PKA cascade and serves to negatively control the synaptic output by reducing intracellular ATP levels.
Increased dopamine and its metabolites in SH‐SY5Y neuroblastoma cells that express tyrosinase
Authors: Hasegawa Takafumi , Matsuzaki Michiko , Takeda Atsushi , Kikuchi Akio , Furukawa Katsutoshi , Shibahara Shigeki , Itoyama Yasuto 
Published: September 2003

AbstractOxidized metabolites of dopamine, known as dopamine quinone derivatives, are thought to play a pivotal role in the degeneration of dopaminergic neurons. Although such quinone derivatives are usually produced via the autoxidation of catecholamines, tyrosinase, which is a key enzyme in melanin biosynthesis via the production of DOPA and subsequent molecules, may potentially accelerate the induction of catecholamine quinone derivatives by its oxidase activity. In the present study, we developed neuronal cell lines in which the expression of human tyrosinase was inducible. Overexpression of tyrosinase in cultured cell lines resulted in (i) increased intracellular dopamine content; (ii) induction of oxidase activity not only for DOPA but also for dopamine; (iii) formation of melanin pigments in cell soma; and (iv) increased intracellular reactive oxygen species. Interestingly, the expressed tyrosinase protein was initially distributed in the entire cytoplasm and then accumulated to form catecholamine‐positive granular structures by 3 days after the induction. The granular structures consisted of numerous rounded, dark bodies of melanin pigments and were largely coincident with the distribution of lysosomes. This cellular model that exhibits increased dopamine production will provide a useful tool for detailed analyses of the potentially noxious effects of oxidized catecholamine metabolites.