bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of bicarbonate buffered dialysate on human peritoneal mesothelial cell intracellular calcium homeostasis
Authors: BIRD STEPHEN D , WALKER ROBERT J 
Published: May 2003

SUMMARY: This study compares the biocompatibility of two bicarbonate‐based peritoneal dialysis (PD) solutions using the measurement of intracellular free calcium (Cai2+) as a sensitive parameter of cell function in human peritoneal mesothelial cells (hPMC). Fura‐2‐loaded hPMC suspensions were exposed to bicarbonate (38 mmol/L) and bicarbonate (25 mmol/L), lactate‐buffered PD (15 mmol/L) solutions at pH 7.4 and compared with Krebs–Ringer physiological saline (KRS; pH = 7.4). Resting Cai2+ values and 4br‐A23187 (1.0 µmol/L) induced transients were compared in treatment and control groups. In separate studies, the effect that low saline pH had on Cai2+ homeostasis was examined. Suspended cells or cells attached to coverslips were bathed in citric acid‐phosphate (McIllvaine’s) buffered saline (MBS, pH = 7.4). Cells were acidified (pH = 5.3) with citric acid and then challenged with ionophore. Ionophore challenge produced a significantly reduced Cai2+ transient response in cells exposed to the bicarbonate/lactate fluid compared with bicarbonate or KRS. Acidified cell suspensions produced a small monophasic Cai2+ transient rise that was short lived. Gradual recovery of MBS to pH 7.4 produced no changes to Cai2+ homeostasis of cell monolayers. Ionophore treatment produced a biphasic response identical to cells bathed in KRS. This study has demonstrated that short‐term exposure to bicarbonate did not alter Cai2+ homeostasis directly, or subsequent modulation of intracellular pH. The MBS system provided a reliable method of modifying the external pH during continuous Cai2+ measurement.
Urinary aquaporin‐2 levels in healthy volunteers
Authors: AL‐DAMEH ALI , BEDFORD JENNIFER J , LEADER JOHN P , WALKER ROBERT J 
Published: May 2003

SUMMARY:  Renal water handling is regulated by the release of arginine vasopressin (AVP) and the subsequent insertion of aquaporin 2 (AQP2) in the apical membrane of collecting duct cells. This in turn increases the membrane permeability to water and the passive reabsorption of water down the concentration gradient present in the medulla. Aquaporin 2 can be detected in the urine under conditions of antidiuresis. We wish to validate an assay for urinary AQP2. Fourteen volunteers participated in studies of water loading and water deprivation followed by the administration of 1‐deamino‐8‐d‐arginine vasopressin (dDAVP). Urine osmolality was measured by vapour pressure osmometry. Urinary AQP2 was measured by using a chemiluminescent assay. Baseline correlations between serum AVP levels, urinary osmolality and urinary AQP2 levels were not significant. Following the administration of dDAVP, a positive correlation between urine osmolality and urinary AQP2 was evident (r = 0.762). For specific conditions where renal water retention is stimulated via AVP, urinary AQP2 measurements provide a reproducible measurement of the renal actions of AVP.
Spontaneous regeneration of the seriously injured sympathetic pathway projecting to the prostate over a long period in the dog
Authors: Kobayashi T. , Kihara K. , Hyochi N. , Masuda H. , Sato K. 
Published: May 2003

OBJECTIVESTo explore the spontaneous regeneration, over a long period, of the seriously injured sympathetic pathway controlling the prostate.MATERIALS AND METHODSThe hypogastric nerve (HGN), which is part of the sympathetic pathway from the spinal cord to the prostate, was partly removed over half of its length on both sides in six dogs. Four years after surgery the responses of the prostate to electrical stimulation of the lumbar splanchnic nerve (LSN) or the HGN proximal to the site removed, were assessed.RESULTSIn six dogs, 10 of the 17 LSNs (second to fourth) and four of the 10 HGNs stimulated elicited prostatic contraction. The pathways via the ipsilateral HGN and/or the contralateral HGN from the LSNs to the prostate were identified as having regenerated in four of six dogs.CONCLUSIONThese results indicate that the sympathetic pathways via the HGN to the canine prostate can regenerate spontaneously over a long period after serious injury, and that their cross‐innervation system can also be repaired.
Detection of vesico‐ureteric reflux in children by colour‐flow Doppler ultrasonography
Authors: Koşar A. , Yeşi̇ldağ A. , Oyar O. , Perk H. , Gülsoy U. 
Published: May 2003

OBJECTIVESTo assess the findings of colour‐flow Doppler ultrasonography (DUS) in the diagnosis of vesico‐ureteric reflux (VUR), as an alternative to the primary diagnostic tool, voiding cysto‐urethrography (VCUG).PATIENTS AND METHODSThirty‐five children (aged 2–15 years) were examined for VUR by DUS and standard VCUG. All patients underwent DUS and VCUG within 48 h but the findings of the latter were not reported to the ultrasonographer. The DUS was undertaken using a colour Doppler real‐time system; a positive ultrasonogram was defined by visualizing Doppler signals from the bladder to the ureter during the course of bladder filling.RESULTSOf the 70 ureters assessed, 28 were refluxing on DUS and 29 on VCUG; there were two false‐positive and three false‐negative results. Comparing the two methods showed DUS to be 90% sensitive with a specificity of 93% for detecting VUR. Four patients underwent reimplantation during their treatment. DUS findings correlated well with standard VCUG in these patient as a method of follow‐up.CONCLUSIONDUS can be used as an alternative to standard VCUG for screening and following VUR. In addition, DUS avoids the danger of exposure to ionizing radiation and the unpleasant catheterization that many of these children fear.
Structural and ultrastructural studies of the urinary tract of mice inoculated with Lactobacillus fermentum
Authors: Silva de Ruiz C. , Del R. Rey M. , Nader‐Macías M.E. 
Published: May 2003

OBJECTIVETo assess, using structural and ultrastructural studies of the urinary tract, the effects of the intraurethral inoculation of lactobacilli (probiotic treatment) as lactobacilli are the predominant micro‐organisms of the urogenital tract of humans, monkeys and mice.MATERIALS AND METHODSPrevious work showed the protective effect of Lactobacillus fermentum CRL 1058 intraurethrally inoculated against the challenge of uropathogenic Escherichia coli. There was also an effect of oestrogens and antibiotics in the kinetics of colonization of both micro‐organisms in mice. In the present study L. fermentum was inoculated with agarose beads (107 colony‐forming units) and the number of micro‐organisms determined by plating in selective media, giving a high degree of colonization in all the organs studied. The urinary tract organs were processed by histological and electron microscopy techniques standardized in our laboratory.RESULTSThe intraurethral inoculation of lactobacilli produced no adverse effects or significant changes in any of the organs assessed (kidney, ureter, bladder or urethra), when evaluated by histological and ultrastructural techniques.CONCLUSIONThe use of lactobacilli as a probiotic treatment is probably safe.
Improvement in urinary symptoms after radical prostatectomy: a prospective evaluation of flow rates and symptom scores
Authors: Masters J.G. , Rice M.L. 
Published: May 2003

OBJECTIVETo evaluate the change in flow patterns and urinary symptoms before and after radical retropubic prostatectomy (RRP).PATIENTS AND METHODSBetween 1994 and 1998 one surgeon undertook RRP in 125 men. Urinary flow rates and the International Prostate Symptom Score (IPSS) were recorded before and at each visit after RRP; only voids of> 150 mL were included. Strictures and bladder neck stenoses requiring surgical intervention were noted. Statistical significance was determined using Student's t or the chi‐squared test.RESULTSBefore RRP 38% men had a flow rate of ≤ 10 mL/s, suggesting obstruction. At the first review (median 2 months) there was an increase in flow rate (median 16.8 vs 11.6 mL/s, P < 0.001) and at the 6‐, 14‐ and 20‐month visits this improved further, to 20, 21 and 24 mL/s, respectively. Before RRP 56% of men had moderate or severe symptoms, with an IPSS of ≥ 8. At 2, 6, 14 and 20 months the proportion of men with an IPSS of ≥ 8 decreased to 26%, 14.5%, 18% and 14% (P < 0.001); 20% developed stricture/stenosis and initially these men had a decrease in flow rate and a higher IPSS. Their symptoms improved when the stricture was treated.CONCLUSIONSTwo‐fifths of men with prostate cancer undergoing RRP have bladder outlet obstruction, as defined by a flow rate of < 10 mL/s and bothersome symptoms. This study showed that there is a very significant increase in flow rate and decrease in IPSS after surgery. RRP offers improved voiding function and urinary symptoms, and the possibility of curing the cancer.
A systematic review and meta‐analysis of familial prostate cancer risk
Authors: Johns L.E. , Houlston R.S. 
Published: May 2003

OBJECTIVETo identify published studies quantifying familial prostate cancer risks in relatives of prostate cancer cases and, by meta‐analysis, obtain more precise estimates of familial risk according to the family history.METHODSThirteen case‐control and cohort studies were identified which have reported risks of prostate cancer in relatives of prostate cancer cases. Pooled estimates of risk for various categories of family history were obtained by calculating the weighted average of the log relative risk (RR) estimates from studies.RESULTSThe pooled RR (95% confidence interval) in first‐degree relatives was 2.5 (2.2–2.8). There was evidence that this was highest in relatives of cases diagnosed before age 60 years and that RRs declined with age. The risk for the few men with two affected relatives was increased 3.5‐fold (2.6–4.8). RRs to sons of cases appeared to be lower than in brothers; a complete explanation of this observation is uncertain.CONCLUSIONMen with a family history of prostate cancer have a significantly greater risk of developing prostate cancer than those with no such history. Risks are greatest for relatives of cases diagnosed when young and those with more than one relative affected.
The acute effect of magnetic stimulation of the pelvic floor on involuntary detrusor activity during natural filling and overactive bladder symptoms
Authors: Bradshaw H.D. , Barker A.T. , Radley S.C. , Chapple C.R. 
Published: May 2003

OBJECTIVETo evaluate the effect of magnetic stimulation of the pelvic floor (MSPF) on involuntary detrusor activity observed during natural filling, and on the overactive bladder symptom complex.PATIENTS AND METHODSEighteen women with detrusor overactivity on conventional cystometry underwent ambulatory urodynamic monitoring over two filling cycles. Fluid intake was standardized, provocative manoeuvres applied at regular intervals and symptoms documented contemporaneously. During the second filling cycle MSPF was delivered whenever the detrusor pressure increased by> 5 cmH2O. The women were subsequently treated with MSPF for 6 weeks; their lower urinary tract symptoms were assessed before and after treatment.RESULTSComparing the second (stimulated) cycle with the first (unstimulated) cycle, cystometric capacity was higher (373 vs 224 mL, P < 0.03). and involuntary detrusor activity of shorter duration (370 vs 427 s, P < 0.82) and lower amplitude (53 vs 63 cmH2O, P ≤ 0.05). All women tolerated the procedure comfortably, but nine found it too time‐consuming and withdrew. In the nine women who completed treatment there was no consistent change in overactive bladder symptoms.CONCLUSIONSIn this pilot study, MSPF during natural filling was associated with a decrease in the amplitude of involuntary detrusor contractions and a significant increase in cystometric capacity. However, MSPF had a variable effect on sensations of urgency, both acutely and after treatment, and currently there is no evidence to suggest that MSPF has an enduring effect on symptoms of the overactive bladder.
Morbidity of transrectal ultrasonography‐guided prostate biopsies in patients after the continued use of low‐dose aspirin
Authors: Maan Z. , Cutting C.W. , Patel U. , Kerry S. , Pietrzak P. , Perry M.J.A. , Kirby R.S. 
Published: May 2003

OBJECTIVETo determine whether low‐dose aspirin increases morbidity after transrectal ultrasonography‐guided sextant prostate biopsy.PATIENTS AND METHODSIn a single‐centre prospective cohort study of 200 patients who underwent sextant prostate biopsies, those routinely taking low‐dose aspirin were encouraged to continue to do so before and after biopsy. The morbidity in each case was assessed using a standardized questionnaire that patients completed in the 7 days after biopsy. The presence of haematuria, rectal bleeding and haematospermia were recorded. The questionnaire also directed the patient to record fevers, use of analgesia and any further treatment received.RESULTSIn all, 36 patients took aspirin whilst the other 141 did not. There were no major complications in either group. Of the patients on aspirin, 20 (56%) had haematuria, compared with 83 (59%) of those not taking aspirin (difference 3%, 95% confidence interval, CI, −15 to 21). Overall bleeding (haematuria, rectal bleeding and haematospermia) occurred in 22 patients (61%) of the aspirin group and 105 (74%) of the other group (difference 13%, 95% CI −4 to 31). Comparisons of other morbidities between the groups are also discussed.CONCLUSIONSThere was no statistically significant difference in the incidence of haematuria or overall bleeding after biopsy between the groups. There is no evidence that aspirin needs to be discontinued before sextant prostate biopsy.
Problems with prostate specific antigen screening for prostate cancer in the primary healthcare setting in South Africa
Authors: Heyns C.F. , Mathee S. , Isaacs A. , Kharwa A. , De Beer P.M. , Pretorius M.A. 
Published: May 2003

OBJECTIVESTo assess the feasibility of detecting early‐stage prostate cancer in the primary healthcare setting, and to investigate whether there is a higher incidence of prostate cancer in Black African men.PATIENTS AND METHODSThe study was a collaboration with registrars in the authors’ institutions and primary healthcare centres serving mainly a Black African or mixed ancestry (Coloured) population in the semi‐urban Cape Town metropolitan area of South Africa. Men aged 50–70 years attending the clinics were counselled about prostate cancer and invited to have a digital rectal examination (DRE), serum prostate‐specific antigen (PSA) assay and transrectal ultrasonography‐guided sextant prostate biopsy if the DRE was clinically suspicious of malignancy or the serum PSA was ≥ 4.0 ng/mL. An American Urological Association Symptom Index (AUA‐SI) was obtained, and urine analysed using dipsticks.RESULTSFrom May 2000 to November 2001, 660 men were assessed (mean age 59.4 years, range 30–82); 60.6% were Black African, 37.3% mixed (Coloured), 1.8% White (Caucasian) and 0.2% Asian (Indian). The mean (range) AUA‐SI was 5.98 (0–35) in the whole group; the DRE was recorded as clinically suspicious of malignancy in 3.2%. The mean PSA was 20.39 (0.04–10 000) ng/mL in the whole group, but when two outliers (1865 and 10 000 ng/mL) were disregarded, it was 2.4 ng/mL. In Black patients the mean PSA was 31.8 (0.04–10 000) ng/mL, and without the outliers, 2.1 ng/mL; in Coloured patients it was 2.94 (0.05–50) ng/mL. The PSA was ≥ 4.0 ng/mL in 9.6% of the whole group, in 7.8% of Black and in 13% of Coloured patients. Prostate biopsies were taken in 21 patients (3.2% of the whole group and a third of those with a PSA of ≥ 4.0 ng/mL); in Black patients, biopsies were taken in 1.5% and 19.4%, respectively, and in Coloured patients in 6.1% and 46.9%, respectively. The prostate biopsy showed cancer in 43% of the whole group, in a third of Black and in 47% of Coloured patients; prostate cancer was detected in 1.4%, 0.5% and 2.8%, respectively.CONCLUSIONSThat prostate biopsies were obtained in only 19% of Black and in only 47% of Coloured men with a serum PSA of ≥ 4.0 ng/mL is of concern. This indicates that there is a significant problem in getting men with an elevated serum PSA level to undergo a prostate biopsy in the primary healthcare setting in South Africa.
Transdermal electromotive administration of verapamil and dexamethasone for Peyronie's disease
Authors: Di Stasi S.M. , Giannantoni A. , Capelli G. , Jannini E.A. , Virgili G. , Storti L. , Vespasiani G. 
Published: May 2003

Peyronie's disease continues to be a fascinating topic for urologists, and two papers in this section, one from Rome and one from Los Angeles, describe new insights into this disease. Authors from the UK write about the current practice of vasectomy reversal and the management of unobstructive azoospermia in a region of that country. Although this is a questionnaire‐based survey, a 74% response rate justifies the authors’ conclusions and their comments, which will be of value to the reader. OBJECTIVETo evaluate the effects of the transdermal electromotive administration of verapamil and dexamethasone on plaque size, penile deviation, pain, erectile function and capacity for vaginal penetration in patients with Peyronie's disease.PATIENTS AND METHODSForty‐nine patients were treated four times weekly for six consecutive weeks. During each session the drug mixture was administered from a receptacle fixed to the skin overlying the plaques, using 2.4 mA pulsed current for 20 min. Plaque size and penile deviation were evaluated by dynamic penile duplex ultrasonography, X‐ray and photographs; pain, erectile function and capacity for vaginal penetration were assessed using a questionnaire. Vital signs and side‐effects were recorded. Differences before and after treatment were assessed.RESULTSThe plaque disappeared in 8% of patients, with a measurable reduction in volume in 74% and no change in 18% (P < 0.001). Penile deviation resolved in 10% of the men, decreased in 74% and remained unchanged in 16% (P < 0.001). The plaque volume was halved in two‐thirds of the men, to a mean (sd) of 515 (301) mm3, and the penile deviation halved in 45% of patients, to 24 (5)°; pain was completely eliminated in 88% (P < 0.001). Erectile function was completely restored in 42% of patients with initial erectile dysfunction and improved in 17% (P < 0.001); vaginal penetration improved in 73%. No toxicity was noted, except for a transient skin erythema at the site of the penile and dispersive electrodes.CONCLUSIONThe transdermal electromotive administration of verapamil and dexamethasone is clinically safe and appears to be an effective treatment in patients with Peyronie's disease.
Myths and marital discord in a family with a child with profound physical and intellectual disabilities
Authors: Withers Paul , Bennett Lara 
Published: May 2003

SummaryThe pressures involved in caring for a child with profound physical and intellectual disabilities are well documented in the literature. The present article offers a brief overview of this literature, followed by a description of an intervention with a family caring for their young daughter with profound physical and intellectual deficits. At the time of the intervention, the parents had been experiencing considerable intramarital difficulties and were considering a separation. They had also encountered difficulties in coping with the practical demands of caring for their daughter and in obtaining appropriate respite services. Following the intervention, the emotional climate of the parents' marriage was reportedly much improved and the parents felt more able to cope with the strains of caring for their daughter.
An assessment tool for investigating paedophile sexual interest using viewing time: an application of single case methodology
Authors: Glasgow David V. , Osborne Andrew , Croxen Justine 
Published: May 2003

SummaryThe present paper describes the development and piloting of a computer‐based single case methodology for the assessment of paedophile sexual interest in people with learning disabilities. Clinical, methodological and ethical issues with respect to the assessment of sexual interest are raised. Data from a series of assesments is presented graphically and the implications of the findings are discussed.
Setting up participatory research: a discussion of the initial stages
Authors: Burke Anne , McMillan Jane , Cummins Lorraine , Thompson Agnes , Forsyth Watson , McLellan James , Snow Linda , Fraser Anne , Fraser Mary , Fulton Charity , McCrindle Elizabeth , Gillies Lorraine , LeFort Shelley , Miller Gail , Whitehall John , Wilson John , Smith Janet , Wright David 
Published: May 2003

SummaryParticipatory research is becoming a very popular way of helping to empower people with learning disabilities. All stages of this kind of research are conducted in partnership with non‐disabled researchers. Furthermore, the research agenda in learning disability is moving towards increasing participation in all forms of research. As a group undertaking participatory research, the present authors wish to share their experience of setting up a project over a period of 9 months to examine ‘keeping fit’. The authors include adults with learning disabilities, clinicians and a researcher from a primary care NHS trust, and support workers who work directly with the adults with learning disabilities in various community settings. An understanding of what is involved in participatory research is important as a first stage, and so the present authors invited speakers undertaking a similar project investigating direct payments to a one‐day conference that was set up locally. At the end of the conference, the present authors requested volunteers for the local project to investigate health. This approach enabled well‐informed agreement to participate. The present paper discusses the initial 9 months of the project, including a description of the volunteers and the major issues which all the participants learned during these early stages.
About leaving: making sense of moving on
Authors: Banham Ken , Garrett Malcolm , McClean Arlene , Strydom Andre , Hassiotis Angela 
Published: May 2003

SummaryThis article is written by two people with learning disabilities and their health care team. It is about our wish to move into homes in the community after years in hospitals. In it we explain the experiences we had of services in the past and what we are looking forward to for the future. We felt that preparing to move on was very exciting. We also thought about what we would be leaving behind and tried to make sense of it all.
Challenging behaviour and communication difficulties
Authors: Kevan Fiona 
Published: May 2003

SummaryOver the last 10 years as a speech and language therapist, working with adults with learning disabilities and challenging behaviour, the author has noted the tendency of services to focus their attention on the observable behaviours of the people with learning disabilities. Such observable behaviours include expressive communication behaviours. However, the ‘hidden’ phenomenon of receptive communication skill tends to be neglected. The present paper highlights the fact that to date, emphasis has been upon promotion of the expressive communication skills of the person with a learning disability and challenging behaviour: whether by direct skills teaching or via modification of the communication environment. It is suggested that we need to pay closer and express attention to the neglected and largely unmet need of receptive communication (comprehension) difficulties.