bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ileal T‐pouch as a urinary continent cutaneous diversion: clinical and urodynamic evaluation
Authors: Marino G. , Laudi M. 
Published: March 2003

Objective  To report the functional results of continent cutaneous urinary diversion with ileum, using the serous‐lined extramural valve and Mitrofanoff procedure for the continence mechanism. Patients and methods  From April 1999 to October 2001, 18 patients (mean age 68 years) underwent radical cystectomy for invasive bladder cancer involving the bladder neck, urethra or prostate; they then had an ileal continent cutaneous T pouch constructed. The mean (range) follow‐up was 12 (4–20) months. The first five patients had reconstructions using the original orthotopic T‐pouch configuration, but in subsequent patients the technique was simplified, reducing the ileal segments. The ureteric‐intestinal anastomosis was made using a split‐cuff nipple technique. Results  All patients were continent day and night, and there were no late complications. All cutaneous continent T pouches had a good capacity and low pressure, with no urinary reflux. No catheterization difficulties were reported and the evacuation intervals were ≈ 4 h. Conclusions  This ileal cutaneous continent diversion is a versatile technique; the T‐valve can be used successfully as a continent mechanism, ensuring continence day and night. The simplified technique maintains a reservoir of good capacity and compliance, thus preserving ≈ 13 cm of ileal tract. The ureteric intestinal anastomosis by the split‐cuff nipple technique is suitable in undilated and peristaltic ureters.
Increased urinary nitrite excretion in primary enuresis: effects of indomethacin treatment on urinary and serum osmolality and electrolytes, urinary volumes and nitrite excretion
Authors: Al‐Waili N.S. 
Published: March 2003

Objectives To assess urinary nitrite excretion, a stable end product of nitric oxide (NO), in patients with enuresis and in normal controls, and to evaluate the effects of indomethacin (a potent prostaglandin synthesis inhibitor) on urinary nitrite excretion, other urinary variables and bladder capacity. Patients and methods The study comprised 10 patients with primary enuresis and 10 normal comparable controls (age range 6–14 years). Nitrite was assayed in ‘spot’ morning urine samples in both the enuretics and normal controls. Enuretics were then given 50 mg indomethacin suppositories each night; urine volume, urinary osmolality and electrolytes, serum osmolality and electrolytes and urinary nitrite were assayed before indomethacin treatment and after 15 days of treatment. Results The mean (sd) urinary nitrite excretion was 24.4 (19.6) µmol/L in normal children and 275.9 (111.2) µmol/L in enuretics (P<0.05). With indomethacin, the urinary nitrite concentration was significantly decreased to 141 (45.1) µmol/L (P<0.05) and associated with a significant reduction in bed‐wetting episodes and voiding frequency. The functional bladder capacity was <70% of the predicted value for age in six of the patients; they had significant improvements on indomethacin, to values similar to those in patients with a nearly normal functional bladder capacity. Indomethacin decreased the 24‐h urinary volume by 41%, the night volume by 40%, clearance of free water by 46% and increased the day : night urinary volume ratio by 55%. The absolute amounts of urinary calcium, magnesium, phosphorus, urea, creatinine, and glucose were lower on indomethacin, although not statistically significantly so. Indomethacin decreased the 24‐h urinary and ‘spot’ morning osmolality and osmotic clearance. There were no significant changes in serum osmolality and electrolyte concentrations. Indomethacin also decreased the absolute amount of urinary sodium, chloride and potassium, fractional sodium and potassium excretion, and filtered sodium. Creatinine clearance was decreased by 20% (P>0.05) and normal 24‐h urinary protein was significantly lower, by 47%, after indomethacin treatment (P<0.05). Conclusion Urinary nitrite excretion increased significantly in patients with primary nocturnal enuresis; indomethacin markedly reduced bed‐wetting episodes and decreased the frequency of voiding in enuretics with small or normal functional bladder capacity, which was associated with a significant decrease in urinary nitrite excretion. Indomethacin reduced bed‐wetting by decreasing the urine volume, clearance of free water and urinary electrolytes, and through possible effects on bladder and urethral contraction, by inhibiting NO and prostaglandin synthesis. NO and prostaglandins might be important in the pathogenesis of primary enuresis.
A high easy‐to‐treat complication rate is the price for a continent stoma
Authors: De Ganck J. , Everaert K. , Van Laecke E. , Oosterlinck W. , Hoebeke P. 
Published: March 2003

Objective To evaluate the conduit‐related complications and their treatment in Mitrofanoff continent urinary diversion and antegrade colonic enema (ACE) procedures. Patients and methods The files of 53 patients (18 men and 35 women) in whom 58 continent stomas were created were retrospectively reviewed. Gender, age, age at the time of surgery, underlying disease, concomitant surgery, abdominal position of the stoma, follow‐up, complications and treatment were assessed. The mean (sd) age at the time of surgery was 19 (13) years; 30 patients were aged <15 years and the mean follow‐up was 2.8 (1.9) years. Fifty‐three continent vesicostomy‐type Mitrofanoff stomas were constructed and five ACE procedures performed. Forty‐five stomas were in the umbilicus and 13 on the abdominal wall. For 45 conduits the appendix was used; in the other 13 a transverse tubularized ileal segment according to Monti was created. Results There were stoma‐related complications in 19 patients (36%), with 27 in all and stomal stenosis accounting for more than half. Five patients had urinary leakage. The median time to the first complication was 9 months. Multiple regression analysis showed that gender and stoma location were the only significant determinants of the complication/follow‐up ratio. Women had more complications than men and umbilical stomas fared worse than those on the abdominal wall. Age, underlying disease and type of stoma were not significantly related to the complication/follow‐up ratio. The complication was treated by one procedure in 13 patients; four needed two and two needed three surgical revisions. Most complications were relatively easy to treat, i.e. dilatation in five, endoscopic incision in one, re‐anastomosis in four, Y‐V plasty in seven, a new channel in two, reimplantation in three, a bladder cuff in two for stomal leakage, and abdominoplasty in two. Only one stoma had to be abandoned. Conclusion The complication rate for continent small‐diameter stoma is high. However, most complications are relatively easy to treat. Despite these complications, patient satisfaction remains high.
The presence or absence of an impalpable testis can be predicted from clinical observations alone
Authors: Mesrobian H.‐G.O. , Chassaignac J.M. , Laud P.W. 
Published: March 2003

Objective  To evaluate, in a prospective study, the accuracy of predicting the presence or absence of unilateral or bilateral impalpable testes from a clinical examination, particularly whether the contralateral descended testis (CDT) is hypertrophied. Patients and methods  Whether the ipsilateral scrotal appendages were palpable, and the size of the CDT, were determined before surgery in a series of patients, and compared with age‐matched controls. Between 1992 and 2000, 100 impalpable testes in 86 consecutive patients (mean age at orchidopexy 45 months, range 6–223; 66% <36 months) were evaluated and treated. In addition to the presence or absence of palpable ipsilateral scrotal appendages, the size of the CDT, when present, and the intraoperative findings were recorded. Logistic regression analysis was used to model the probability of the presence or absence of the testis, as determined by the preoperative clinical findings alone. Results  Of the 86 testes that were located at surgery, 50 (58%) were intracanalicular, 28 (32%) intra‐abdominal and the remainder (10%) were in the superficial inguinal pouch. Of 13 patients with the ‘vanishing testis syndrome’, the atrophic testicle was intracanalicular in nine, in the upper scrotum in three and intra‐abdominal in only one. All viable testes were successfully relocated in the scrotum, with one atrophic after surgery. The positive predictive value (PPV, with 95% confidence interval) of a testis being present when the ipsilateral appendages were palpable and the CDT was not hypertrophied was 0.93 (0.83–0.97). Conversely, the PPV of the impalpable testis being absent when the appendages were impalpable and the CDT was hypertrophied was 0.95 (0.64–0.99). Conclusion  When evaluating and surgically treating impalpable testes, the presence of palpable ipsilateral scrotal appendages and a CDT with no hypertrophy is associated with a 93% likelihood of discovering a testis that can be successfully relocated to the scrotum. Conversely, when the ipsilateral scrotal appendages cannot be palpated and the CDT is hypertrophied, there is a 96% probability that the impalpable testis is absent (vanishing testis syndrome). This readily available information may be valuable in preoperative counselling and planning.
Modulation of heat‐induced cell death in PC‐3 prostate cancer cells by the antioxidant inhibitor diethyldithiocarbamate
Authors: Moriyama‐Gonda N. , Igawa M. , Shiina H. , Urakami S. , Shigeno K. , Terashima M. 
Published: March 2003

Objective To examine the relationships between the form of cell death (apoptosis or necrosis), reactive oxygen species (ROS) generation, superoxide dismutase (SOD) activity and the level of heat‐shock protein 70 (hsp 70) expression after thermotherapy of PC‐3 prostate cancer cells; also assessed were the tumoricidal effects of combined treatment with both heat and the antioxidant inhibitor diethyldithiocarbamate (DDC). Materials and methods PC‐3 cells were treated with thermotherapy at 42, 43 or 44°C for 30, 60, 90 or 120 min. Cell proliferation, ROS generation, SOD activity and cellular hsp 70 level were determined using tetrazolium‐based cytotoxicity, fluorescent dichlorofluorescein (DCF) and nitroblue tetrazolium assays, Western blot analysis and flow cytometry, respectively. The apoptotic and necrotic cells were determined by staining with propidium iodide and fluorescein isothiocyanate‐labelled annexin V. These variable were also measured after combined treatment of PC‐3 cells with 1 mmol/L DDC and thermotherapy at 43 or 44°C for 60 min. Results Cell survival was significantly lower after heating cells at 43°C for 60, 90 and 120 min and at 44°C for all periods tested (P<0.05). At 43°C apoptosis increased with the duration of heating and was similarly enhanced after heating at 44°C for 30 min. Necrosis was not increased by heating at 42 or 43°C, but was markedly enhanced after heating at 44°C with both the duration of heating and with time after heating. Significant increases in DCF production were induced by heating at 43°C for 60, 90 and 120 min (P<0.05) and at 44°C at all times (P<0.010–0.005). There was a significant correlation between the level of ROS generation and necrosis (P<0.001) but no correlation between the ROS level and apoptosis. SOD activity increased in cells after heating at 43°C, with significant differences among cells heated for 60, 90 and 120 min (P<0.05). After heating at 44°C, SOD activity was maximal in cells heated for 30 min (P<0.005), by 30 min and then decreased with time after heating. There were significant increases in hsp 70 level in cells heated at 43°C for 90 and 120 min (P<0.05) and at 44°C for 30 and 60 min (P<0.05 and <0.025, respectively). Hsp 70 levels decreased after heating at 44°C for 90 and 120 min. The combination of DDC and heating significantly increased ROS generation and the percentage of cell death, and decreased SOD activity (P<0.05). Conclusions These findings show a qualitative change in the form of cell death induced by thermotherapy of PC‐3 cells, which changed from apoptosis to necrosis according to the degree and duration of heating. Mild thermotherapy induced marginally low occurrence of apoptosis of PC‐3 cells and DDC may represent a useful future strategy for the treatment of prostate carcinoma.
Is microscopic haematuria a urological emergency?
Authors: Khan M.A. , Shaw G. , Paris A.M.I. 
Published: March 2003

Objective  To determine the prevalence of urological pathology in a retrospective and prospective study of patients with microscopic haematuria attending a haematuria clinic. Patients and methods  Between January 1998 and May 2001, 781 patients attended the haematuria clinic; of these, 368 (47%; median age 60 years, range 18–90) had a history of microscopic haematuria, as detected by urine dipstick testing. These patients were investigated by urine culture and cytology, renal ultrasonography, intravenous urography (IVU), flexible cystoscopy, urea and electrolyte analysis, and assay of prostate specific antigen (PSA) where appropriate. Results

Urine cytology showed no malignant cells in any patient with a history of microscopic haematuria. In 143 patients (39%), urine cytology showed no red blood cells and all other investigations were normal. Of the remaining 225 patients, IVU showed a tumour in one (bladder), renal stones in 15 and an enlarged prostate in two. Renal ultrasonography detected no additional pathology. Urine analysis showed one urinary tract infection. Flexible cystoscopy detected five patients with a bladder tumour (all G1pTa), two urethral strictures, five bladder stones and enlarged prostates, six enlarged prostates only, and nine red patches in the bladder, showing one patient with carcinoma
in situ . No PSA levels were suggestive of prostate cancer. Conclusion  Patients with dipstick‐positive haematuria should be re‐assessed by urine microscopy before referral. As only 1.4% of patients had a malignant pathology (all noninvasive), microscopic haematuria should be regarded as a separate entity from macroscopic haematuria, and such patients do not need to be referred urgently.
Efficacy and safety of sildenafil for treating erectile dysfunction in patients on dialysis
Authors: YeniçerioGlu Y. , Kefi A. , Aslan G. , Çavdar C. , Esen A.A. , Çamsari T. , Çelebi I. 
Published: March 2003

Objective  To assess the efficacy of sildenafil for erectile dysfunction (ED) in patients on haemodialysis (HD) or peritoneal dialysis (PD), as men with end‐stage renal disease (ESRD) often have sexual dysfunction (up to 82% among those on chronic dialysis). Patients and methods  Forty‐one patients with ED and in ESRD participated in an open‐label prospective study. Thirty patients on HD and 11 on PD were asked to complete the International Index of Erectile Function (IIEF) and Fugl‐Meyer life‐satisfaction scale before and after sildenafil treatment. A total score in the erectile function domain of ≤ 25 was accepted as indicating ED. All patients were started on a 25‐mg dose, which was increased to 50 mg if there was no response after two trials. In addition, the overall efficacy question was used to evaluate satisfaction, and patients reported any side‐effects during treatment. Results

The erectile function and intercourse satisfaction domains improved significantly in both groups (
P

< 0.01). After sildenafil treatment, two‐thirds of those on HD (20/30) and nine of the 11 on PD recovered their erectile function. The pretreatment scores on the IIEF and four domains (except sexual desire) of those responding were significantly higher than in those not responding (
P  < 0.05). The satisfaction rate on the overall efficacy question was 80% and 82% for the HD and PD groups, respectively. At least one side‐effect was seen in 17 patients (43%); one had severe hypotension in the PD group. Overall, mild headache (seven patients, 18%) and flushing (12, 30%) were reported most often. Conclusions  Sildenafil is a safe and satisfactory drug for improving erectile function in patients with ESRD. Patients were satisfied whether treated by HD or PD. Pretreatment scores on the IIEF may be useful for predicting the success of treatment.
The CAG trinucleotide repeat length in the androgen receptor does not predict the early onset of prostate cancer
Authors: Mir K. , Edwards J. , Paterson P.J. , Hehir M. , Underwood M.A. , Bartlett J.M.S. 
Published: March 2003

Objective  To relate the repeat length of the androgen‐receptor CAG trinucleotide to the age of onset of prostate cancer, stage and grade of disease. Patients and methods  After obtaining ethical approval, 265 patients with locally confined or locally advanced/metastatic prostate cancer were identified and evaluated for age at diagnosis (< 65 years and > 75 years). DNA was extracted from peripheral blood lymphocytes and 1 µg aliquots subjected to polymerase chain reaction using fluorescently labelled primers. Samples were then run on an ABI 377 gene scan analysis gel with an internal molecular weight marker. The length of the CAG repeat was determined by comparing the gene scan product size to samples where the CAG repeat length had been quantified using direct sequencing. The Kruskal–Wallis, Mann–Whitney and Wilcoxon two sample tests were used to analyse the data. Results
The mean (range) length of the CAG repeat in the androgen receptor was 22.2 (10–31) in the younger and 22.5 (16–32) in the older group, and was not statistically different. There was no significant association between the CAG repeat length and the age of onset of prostate cancer (
P
= 0.568) or with stage (
P
= 0.577) and grade (
P  = 0.891) of prostate cancer. Conclusion  These results suggest that there is no correlation between the androgen receptor CAG repeat length and the age of onset, stage and grade of prostate cancer, confirming recent doubts from other similar studies of a suggested correlation between shorter androgen receptor CAG repeat and early onset and aggressiveness of prostate cancer.
Levels of urinary inter‐α‐trypsin inhibitor trimer as a function of age and sex‐hormone status in males and females not forming stones
Authors: Ricchiuti V. , Hartke D.M. , Yang L.Z. , Goldman H.B. , Elder J.S. , Resnick M.I. , Marengo S.R. 
Published: March 2003

Objectives  To determine if levels of inter‐α‐trypsin inhibitor (IαTI)‐trimer differ in normal individuals based on age, gender or hormonal status, as the regulation of calcium oxalate (CaOx) crystallization inhibitors, e.g. by sex steroids, could be a mechanism contributing to the differences in CaOx urolithiasis between the sexes. Subjects and methods
Voided urine samples were collected from normal males and females. In Experiment 1 samples were grouped by gender and age, i.e. paediatric (PED) ≤ 10 years, male (M) 21, female (F) 14; young adult (YGAD) 20–30 years, M 23, F 18; adults (AD), 35–50 year, M 25, F 13; adults aged ≥ 60 years (> 60), M 24, F 16 (totals, M 93, F 61). In Experiment 2 samples were grouped by gender, age and hormonal status, i.e. PED, M 24, F 17;
AD , M 24, F 22; > 60 and not on hormonal therapy, M 23, F 30; M > 60 and on androgen deprivation therapy (ANDEP) 18; and F > 60 on oestrogen supplementation, F+EST, 18 (total M 89, F 85). Levels of urinary IαTI‐trimer were determined by immunoblotting and enhanced chemiluminescence, and relative densities of the bands determined. Results
In both experiments the relative levels of IαTI‐trimer were 2–7 times higher in M‐PED than in all other groups of males (
P
≤ 0.007). Among adult males, IαTI‐trimer levels were similar in all groups, including ANDEP (
P
≥ 0.9). There were no differences in the relative levels of IαTI‐trimer among any of the groups of females, regardless of age or hormonal status (
P  ≥ 0.7). Conclusions  In males a decrease in IαTI‐trimer was associated with the onset of adulthood and entry into the ‘stone‐forming years’. Females did not show this decrease, and neither sex showed an increase in IαTI‐trimer in the > 60 group, when the incidence of CaOx urolithiasis is supposedly declining. While changes in urinary IαTI‐trimer levels in males may reflect maturational changes in the kidney, overall these data do not support the hypothesis that the age‐related changes in the incidence of urolithiasis are paralleled by changes in the expression IαTI‐trimer. Additionally, the sex steroids do not appear to acutely regulate the expression of IαTI‐trimer in adults, making differences in IαTI‐trimer levels unlikely to be the reason for the disparity in the incidence of CaOx urolithiasis between the sexes.
Survival prospects after screen‐detection of prostate cancer
Authors: Nicholson P.W. , Harland S.J. 
Published: March 2003

Objective  To ascertain more realistic survival values for screen‐detected prostate cancer than those in current use which are derived from conventionally presenting, usually symptomatic, populations.Materials and methods  Survival data for conventionally detected cases were derived from the Surveillance, Epidemiology and End Results database for men diagnosed in the years 1983–1988. The incidence of screen‐detected prostate cancer by age and grade was taken from published data.Results  For a cohort of men, initially 55 years old, screen‐detected cases were estimated to outnumber by 2–3‐fold, depending on age, those detected by conventional means. By assuming various survival characteristics for the screen‐detected cases the mean lead time was estimated to be 9 years. Because screen‐detected cases usually have clinically localized disease they are commonly advised on survival times derived from conventionally detected cases. Applying these survival times over‐predicts the number of deaths by factors of at least 3.4, 1.9 and 1.5 at 65, 75 and 85 years old, respectively.Conclusions  Screening detects prostate cancer a mean of 9 years before clinical presentation. The prognosis of screen‐detected prostate cancer is considerably better than that of conventionally presenting localized disease. The advice given to patients with early prostate cancer should take account of this.