摘要:

Complete obstruction of one ureter was created in 3-week-old weanling rats. The endothelin concentration in the renal tissue was measured by radioimmunoassay. In the obstructed kidney, a substantial increase was observed, after 1 week +90%, after 2 weeks +55%, and after 4 weeks + 145% compared to the control rat kidneys. The endothelin-l/endothelin-3 ratio was found to be considerably raised, indicating a predominance of the vasoconstrictor effects of the – with reference to vasoactivity – bi-potential endothelin. Its contribution to vasoconstriction and to glomerular destruction in obstructive nephropathy is discus

ISSN:0042-1138    

DOI:10.1159/000282636

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In order to study the segmental difference in the density of autonomic receptors of the vas deferens, we measured the amount of adrenergic α1-, α2- and β-receptors and muscarinic cholinergic receptors in the three portions (prostatic, intermediate and epididymal) of dog vas deferens using radioligand binding techniques. Saturation experiments with 3H-prazosin, 3H-yohimbine, 3H-dihydroxyalprenolol and 3H-quinuclidinyl benzilate demonstrated that three were significant amounts of adrenergic α1-, α2- and β-receptors and muscarinic cholinergic receptors in the three portions of dog vas deferens. Of the three portions examined, the prostatic portion was found to have a larger amount of α1-, α2-receptors and muscarinic receptors, while the intermediate portion was found to have a larger amount of β-receptors. The epididymal portion was found to have a smaller amount of autonomic receptors. These data suggest that the prostatic portion plays a more important role in the function of the dog vas deferens. It is thought that the different segments of the vas deferens have a different functional role according to the distribution of autonomic r

ISSN:0042-1138    

DOI:10.1159/000282637

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Preoperative evaluation of voiding patterns and detailed urodynamic evaluation before radical retropubic prostatectomy was carried out in an attempt to identify patients at higher risk of developing urinary incontinence postoperatively. Ninety-two men, mean age 64 years (range 54–72), who completed 1 year of follow-up after radical retropubic prostatectomy for clinically localized adenocarcinoma of the prostate were included in the study. According to the preoperative urodynamic findings, patients were divided into two main groups: group 1 (n = 64) patients with normal urodynamic findings, and group 2 (n = 28) patients with abnormal urodynamic findings. The latter group was further subdivided according to the abnormality: detrusor instability (n = 12), weak sphincter mechanism (n = 9), and detrusor and sphincter instability (n = 7). The degree and incidence of urinary incontinence were evaluated in both groups at the 1-year follow-up visit. There was a substantial difference in the incidence of urinary incontinence between the two main groups with only 2 patients with incontinence in group 1 (3%) versus 11 patients in group 2 (39%). In addition, the incidence of incontinence in group 2 differed depending on the type of abnormality: the lower incidence occurred in patients with detrusor instability (17%) and the higher incidence in patients with both detrusor and sphincter instability (71 %). Identification of sphincteric and bladder dysfunction preoperatively may indicate a high risk of urinary incontinence after radical prostatectom

ISSN:0042-1138    

DOI:10.1159/000282638

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Patients with prostatic carcinoma were randomised to treatment with surgical castration (n = 47) or oral oestrogen therapy (n = 53). The oestrogen-treated patients received oral ethinyl oestradiol daily, 1 mg for the first 2 weeks followed by 150 µg. In addition, oestrogen was given intramuscularly as polyoestradiol phosphate monthly 160 mg for 3 months, continued by 80 mg. Before and 1 year after therapy systolic arm and toe blood pressures were measured. Eleven percent of the patients in the oestrogen group had a pathological pressure difference between the arm and toe before treatment versus 34% in the orchidectomy group. Despite the greater proportion of subclinical atherosclerotic disease in the legs of the patients in the orchidectomy group, the patients in the oestrogen group only had signs and symptoms of a deterioration of the arterial system. Thus, in the oestrogen group the arm-toe blood pressure difference increased from 20 ± 3 to 32 ± 4 mm Hg (p < 0.001) and the proportion of pathological toe pressures increased from 11 to 29% (p = 0.0014). Two of the patients in this group had to be referred for reconstructive surgery due to severe intermittent claudication. In addition, 5 more patients in this group suffered arterial ischemic events in the coronary and cerebral vasculatures. In contrast, there were no clinical ischemic events in the orchidectomy group and no change in the blood pressure difference between the arm and the toe 1 year after orchidectomy. In conclusion, oral oestrogen therapy, in contrast to orchidectomy, induces a deterioration of the arterial supply to the lower limbs during the 1st year of therapy. These results constitute a further argument against oral oestrogen therapy in patients with prostatic carcino

ISSN:0042-1138    

DOI:10.1159/000282639

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Histopathological studies were performed in 18 dialysis patients with renal cell carcinoma. All patients were classified as stage I according to the criteria in the protocol of Robson. The 2 main cell types in these patients were granular (50%) and clear (44%) cell tumors. Thirty-nine percent of the carcinomas exhibited a predominantly acinar growth pattern, 27% had a papillary, and 17% exhibited a cystic growth pattern. In 28 nondialysis patients, the commonest cell type was clear cell carcinoma (67%) and acinar growth pattern was the predominant one (67%). The incidence of papillary renal cell tumors in dialysis patients was significantly higher than in nondialysis patients (p < 0.05). Patients with papillary renal cell tumors had received longer duration of dialysis therapy than those with nonpapillary renal cell carcinomas (p < 0.05). Seven (39%) showed grade 1 carcinoma and 11 (61%) showed grade 2, but grade 3 carcinoma was not observed. In these patients, 8 had associated acquired cystic disease of the kidney (ACDK). The duration of dialysis in the patients with ACDK was significantly longer (p < 0.001). The most frequent cell type was granular-cell carcinoma (63%) in the patients with ACDK. Six patients without ACDK (60%) showed clear-cell carcinoma and 4 (40%) had granular cell tumors. Seventy-four percent of carcinomas exhibited a predominantly either papillary or cystic growth pattern in the patients with ACDK. However, renal cell carcinomas in dialysis patients with or without ACDK did not show significant differences in growth pattern. In the patients without ACDK, 60% of the tumors showed an acinar growth pattern. Grade 2 carcinomas were observed in 5 (62%) of the ACDK patients and in 6 (60%) of the non-ACDK patients. Grade 1 was seen in 3 (38%) of the ACDK patients and in 4 (40%) of the non-ACDK patients. These facts suggest that pathogenesis of renal cell carcinoma is different between dialysis and nondialysis patients, but that the presence of ACDK does not influence the histopathological findings of renal cell carcinoma.

ISSN:0042-1138    

DOI:10.1159/000282640

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The Victorian Lithotripsy Service is geographically unique, representing the only Australian lithotripter for a 900-km radius and serving a patient population of over 3 million, and 26 accredited operator urologists. Because of distance and health service constraints few patients treated for renal calculi on this machine have the opportunity to seek additional treatment by extracorporeal Shockwave lithotripsy (ESWL) elsewhere. The treatment histories of all patients who underwent ESWL at this center over a 4-year period were examined, with those patients who required ESWL on more than one occasion being identified and their treatment details reviewed. The retreatment rate was approximately 6%. In patients who required three or more ESWL treatments multiple calculi were present significantly more often than in the overall cohort (p < 0.05), and ESWL alone was ultimately successful in obtaining satisfactory stone fragmentation in only 62% of this group. In view of the high cost of repeated treatments by ESWL the applicability of this treatment method in cases of multiple calculi should be questioned. Initial undertreatment of calculi may also represent a significant factor in the retreatment of some radiopaque calculi.

ISSN:0042-1138    

DOI:10.1159/000282641

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Between January and December 1989, 123 patients with distal ureteral stones were treated with in situ extracorporeal Shockwave lithotripsy (ESWL) using a modified HM3 Dornier lithotriptor. One hundred and three patients (83.7%) were stone-free, 20 patients (16.3%) had small residual stones ( < 1 mm2) that passed spontaneously. In situ ESWL treatment alone was successful in 88 of the 103 stone-free patients (85.4%). Fifty-six (54.4%) needed 1 ESWL session, 26 (25.2%) needed 2 ESWL sessions. Nineteen of the 123 patients (15.4%) needed auxiliary endourological measures. The results of ESWL treatment were correlated to pretherapeutically identified parameters such as stone size, radiopacity, outer contour, shape, inner structure, biochemical analysis of the stones and grade of dilatation of the upper urinary tract. The results prove that size ( 75 mm2), radiopacity and grade of dilatation have a direct correlation to the difficulty to disintegrate ureteral stones.

ISSN:0042-1138    

DOI:10.1159/000282642

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The explosive increase of violence in our society has imposed hazards of gunshot injuries on the civilian population. The genitourinary system is no longer exempted from such assaults. Although male external genitalia are amongst less commonly involved organs, in a span of 14 months, 4 such cases were managed at our institute. Our experience of such injuries is being highlighted so as to draw attention to their increasing incidence and association with injuries of other organs. Three patients had haemorrhagic shock at initial presentation. They were managed by resuscitation, debridement and repair of wounds. Urethral injuries were dealt initially by diversion and subsequently urethroplasty was performed. In a follow-up of 6–12 months, all the patients were reported to be having normal erections and none of them have developed urethral strictur

ISSN:0042-1138    

DOI:10.1159/000282643

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We report the first case of upper lumbar ureteral replacement with the vermiform appendix, in a blunt traumatic ureter rupture with important urinoma. In selected cases, in which the appendix has a required caliber and length, the vermiform appendix is a very good autograft for ureteral substitution. The vermiform appendix must be preserved if possible in the abdominal surgery.

ISSN:0042-1138    

DOI:10.1159/000282644

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A rare case of postnephrectomy arteriovenous fistula of the right renal pedicle of a 6-year-old boy is reported. The diagnosis was made by clinical signs and confirmed by colored duplex sonography and angiography. Successful treatment was achieved by percutaneous transcatheter embolization using coils.

ISSN:0042-1138    

DOI:10.1159/000282645

出版商:S. Karger AG    

年代:1994

数据来源: Karger