摘要:

The calciuric response and the changes of plasma glucose and insulin produced by a 75-gram oral glucose tolerance test were determined in 27 male patients with idiopathic calcium renal stones (6 with dietary hypercalciuria, 5 with nondietary hypercalciuria and 16 with normocalciuria) and 22 healthy male subjects. The subjects were classified as obese (≧ 120% ideal weight) and nonobese. The incidence of an abnormal response to glucose loading was similar in the stone patients and the healthy subjects. In addition, the plasma glucose and insulin levels after oral glucose load did not differ between the stone patients and control subjects and were affected by the individual degree of obesity. Urinary calcium excretion increased significantly after glucose ingestion in both the stone patients and the control subjects. Urinary calcium excretion was greater in the stone patients than in the control subjects due to the presence of patients with nondietary hypercalciuria, and the increment in urinary calcium excretion in the dietary hypercalciuric and normocalciuric stone patients was indistinguishable from that in the control subjects. The degree of obesity did not affect the increment in urinary calcium excretion. These results suggest that overconsumption of refined carbohydrates such as sugar-sweetened soft drinks, soda and cakes may be a risk factor for stone formation, especially in the patients with nondietary hypercalciuri

ISSN:0042-1138    

DOI:10.1159/000282542

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In the period of 1983–1990, a total of 691 ureteroscopies were performed in 480 patients. The main indications for ureteroscopy were stones, stenoses or making a diagnosis. In one third of the cases, pathology was suspected in the renal pelvis or at the ureteropelvic junction, in one third in the distal third of the ureter, and in the remaining cases, in either the upper or the middle part of the ureter. The most frequent ureteroscopic procedures were diagnostic examination or surveillance and procedures involving treatment of stones. In the 1st attempt, the ureteroscope was introduced to the suspected pathology in 79.9% of all cases, and the main objective was achieved in 76.6%. The success of stone manipulation has increased from 74% in the 1st to 92% in the last part of the period. More than half the procedures involving a ureteral stenosis were not completed satisfactorily. The location of suspected pathology did not influence the results. Complications occurred in 23% of the ureteroscopies, and the relative number of major complications decreased continuously. We conclude that ureteroscopy is appropriate at any location of pathology and that efforts must be made to minimize both major and minor complication

ISSN:0042-1138    

DOI:10.1159/000282543

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Sex-dependent stone formation following portacaval shunt (PCS) was investigated in 82 male and 71 female Sprague-Dawley rats. 72.6% of male PCS rats and none of the female PCS rats developed urolithiasis, in 90.2%, potassium-hydrogen-urate stones formed. Hormonal analysis revealed significant alterations in steroid hormones and glucagon postoperatively. Male PCS rats showed a significant decrease in total and free testosterone and an increase in estradiol and glucagon levels. Female PCS rats showed a marked rise in testosterone and glucagon levels as well as a decrease in estradiol plasma levels. Male PCS rats had higher urinary and plasma uric acid concentrations compared to female PCS and sham-operated rats. Loss of testosterone and rise of glucagon in males was correlated with urolithiasis in so far as stone-forming rats had higher concentrations than non-stone-forming PCS rats. Our findings suggest that hormonal alterations might contribute to sex-dependent stone formation in PCS rats.

ISSN:0042-1138    

DOI:10.1159/000282544

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In a cross-section study the levels of urine laminin P1 expressed as a laminin P1:creatinine ratio were determined in 25 patients with superficial (noninvasive) transitional cell carcinoma (TCC) of the bladder, 12 patients with invasive TCC, 15 patients with inflammatory bladder diseases and 50 healthy controls. The mean of laminin P1·creatinine ratios in invasive TCC patients (4.83 ± 3.05 U/mol creatinine) significantly differed from those of superficial TCC (2.60 ± 1.07 U/mol creatinine), inflammatory bladder disorders (2.38 ± 1.74 U/mol creatinine) and controls (2.47 ± 0.86 U/mol creatinine) (p < 0.03). At the individual patient level 7 out of 12 patients with invasive TCC, but only 1 out of 25 patients with superficial TCC, showed laminin P1 urine levels above the normal range (0.75–4.18 U/mol creatinine), thus giving a 58% sensitivity and a 96% specificity of laminin P1 urine assessment in the discrimination between noninvasive and invasive disease. Given a 20–24% prior chance of invasive disease at initial diagnosis detection of elevated urine laminin P1 in TCC patients raises the posttest chance of invasive disease

ISSN:0042-1138    

DOI:10.1159/000282545

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A new technique using the pedicled island flap of penile skin for total urethral reconstruction is described. The technique consists of using a long, modified flap of more than 15 cm in length and was utilized in 6 cases of total urethral stricture. Four cases resulted in an excellent outcome, while 2 had fistula with anastomotic stricture. The technique is useful in reconstruction of the total urethra, but the utmost care is needed in the dissection to preserve the viability of the pedicle.

ISSN:0042-1138    

DOI:10.1159/000282546

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In distal hypospadias without chordee, surgical correction has a purely cosmetic character. In contrast to standard techniques focusing on meatal position, parents often regard the redundant dorsal prepuce and its missing ventral fusion as the essential constituent of this malformation. The operative technique, presented in detail, emphasizes on foreskin reconstruction. The ventral adaption of the prepuce (VAP procedure) results in a penis with normal appearance. Complications presented reveal the importance of proper patient selection.

ISSN:0042-1138    

DOI:10.1159/000282547

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Conventional varicocelectomy is complicated by a postoperative recurrence rate of 5–20% in patients with varicocele [1, 2]. On the other hand, the exact location and relationship of the internal, external and gubernacular veins, arteries and lymphatics within the inguinoscrotal portion of the spermatic cord have not been well described. The results of detailed intraoperative observations and surgical dissection of the spermatic cord and gubernaculum are presented in 32 patients with clinically palpable varicocele. Following the identification of all veins within and around the spermatic cord and gubernaculum, dilated veins originating from the testis and traversing the gubernaculum were observed in 31 % of the patients. External spermatic veins were present in 70% of all spermatic cords evaluated. The majority of patients ( > 65%) had more than 3 internal spermatic veins. An average of 3.1 lymphathics per spermatic cord was identified and preserved during dissection of the cord. A solitary testicular artery was observed in 55% of the patients treated. In 3 patients with recurrent varicocele, by using intraoperative venography, we tried to demonstrate the relationship between the gubernacular, external spermatic veins and the plexus pampiniformis. Our results indicate that by giving a precise attention to varicocele anatomy and performing an extended vein ligation, better results together with decreased recurrence rates may be obtaine

ISSN:0042-1138    

DOI:10.1159/000282548

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The microsurgical method of varicocelectomy was performed in 56 patients. In 25 cases the procedure was done because of scrotal symptoms and in 31 cases as a treatment for infertility. Complete regression of varicosities was observed in all the cases including 2 recurrent ones. The conception rate was 56% in the infertility patients excluding azoospermic and severe oligozoospermic ones. This microsurgical method has a good success rate and is also quite satisfactory in terms of its pregnancy rate.

ISSN:0042-1138    

DOI:10.1159/000282549

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The effect of adenine-induced chronic renal failure on the male reproductive system was studied using male Wistar rats. On the 30th experimental day, serum creatinine and urea nitrogen were elevated in adenine-treated rats. Body weight ratio of the testes and serum levels of gonadotropins (luteinizing hormone and follicle-stimulating hormone) in adenine-treated rats were similar to those in the controls. Serum testosterone level was reduced in adenine-induced uremic rats, but serum concentrations of 17α-hydroxyprogesterone and androstenedione were increased in the uremic group. These results suggest that adenine-induced chronic renal failure reduces testicular function by suppressing 17β-hydroxysteroid oxydoreductase which converts androstenedione to testosteron

ISSN:0042-1138    

DOI:10.1159/000282550

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

We report an anorchic patient with normal male phenotype and 46, XY karyotype. Plasma levels of gonadotropins and testosterone were abnormally low. Administration of human chorionic gonadotropin caused no increase in plasma testosterone, and injection of luteinizing hormone-releasing hormone resulted in a lack of plasma gonadotropin response. Sex-determining region Y was detected by DNA studies of peripheral white blood cells. Laparoscopy revealed absence of testis, Wolffian and Müllerian derivatives. We discuss the embryology and hormone condition in an anorchic patient

ISSN:0042-1138    

DOI:10.1159/000282551

出版商:S. Karger AG    

年代:1993

数据来源: Karger