摘要:

Summary—The EDAP LT.01 is a second generation shockwave lithotripter which employs ultrasound imaging and piezoelectric shockwave generation. We describe the first 12 months of its use in the treatment of urinary calculi by urologists with no previous practical experience of ultrasonography. A total of 406 calculi (359 renal and 47 ureteric) in 317 patients were treated. Analgesia or sedation was not routinely used and 59% of all treatments were performed as outpatient procedures. The clearance rate of renal calculi smaller than 1 cm was 81%, while that of calculi larger than 3 cm was 80% (mean clearance 77.5%). Lithotripsy of ureteric calculi following retrograde manipulation to a renal site resulted in 94.4% clearance compared with 39% for those treated at a ureteric site; 93% of 684 lithotripsy treatments were either painless or caused only mild pain. Our experience with imaging and treating urinary calculi with the EDAP LT.01 lithotripter has been excellent. Patients are treated effectively and inexpensively as out‐patients without analgesia or sedat

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05512.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—An unselected group of patients with renal stones was treated with extracorporeal piezoelectric lithotripsy (EPL) monotherapy. The results showed that this minimally invasive treatment was very effective for patients with stones smaller than 20 mm. After a minimum follow‐up of 1 month, 65% of these patients were stone‐free and 22% of the remainder had only small fragments. Patients with larger stones (20 mm or larger) required multiple treatment sessions (mean 5.8) and had less favourable results. One month or more after treatment, only 46% of these patients were free of stone and 21% required secondary operative procedures for obstructing ureteric fragments. Most of these patients are better treated initially by percutaneous nephrolith

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05513.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—We present 5 patients with urinary calculi and vesicoureteric reflux (VUR). In 4 patients the VUR was probably primary and in 1 it was secondary to the calculus disease. The incidence of calculi with reflux is approximately 0.5% whereas the incidence of reflux with calculi is approximately 8

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05514.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—In this selective study, 59% of the patients had a renal injury (laceration, rupture or pedicle injury). A normal IVU excluded significant renal injury after blunt trauma. Renal angiography was more accurate than ultrasonography or computed tomography in determining the extent of the injury. A retroperitoneal haematoma found during laparotomy should be explored if significant renal trauma cannot be excluded. Renal salvage after rupture or pedicle injury should be attempted in stable patient

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05515.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—We present a retrospective 10 year analysis of 76 patients with urothelial tumours of the upper urinary tract. Patients older than 65 years, and female patients, presented with more advanced stages and had a worse prognosis. The grade and stage of the tumour has the greatest impact on survival. No conclusions can be drawn on the efficacy of various types of surgery, but simple nephrectomy gave a 5‐year survival of 68%, with a stump recurrence rate of 15%.We observed that patients with urothelial tumours had 4 fold increased chance of developing gastrointestinal can

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05516.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—Tumour cells from 23 renal carcinomas were exposed in vitro to increasing concentrations of medroxyprogesterone acetate (MPA) or one of several cytotoxic agents. Thereafter the uptake of75Selenomethionine (75SeM) was compared to that of tumour cells not exposed to the drug.Using drug concentrations similar to those seen following in vivo administration in patients, MPA produced 50% inhibition of75SeM uptake in 5 of 23 cases. The comparable proportion for doxorubicin was 4 of 5 and for mitozantrone 7 of 12. Methotrexate and Vinblastine were much less effective. In all cases where 2 50% inhibition was obtained with doxorubicin and mitozantrone the carcinoma had spread beyond the kidney. Thus drug sensitivity may be associated with a high mitotic rat

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05517.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The study of voiding in men and women has been handicapped by the lack of a normal reference range covering urinary flow rates over a wide range of voided volumes.Normal volunteers (331 males and 249 females) were studied. Each voided once into a calibrated Dantec Urodyn 1000 mictiograph. On a second occasion 282 men and 46 women voided. The maximum and average urine flow rates of the first voids in both sexes were compared with the respective voided volumes.Nomogram charts, in centile form, for both the maximum and average urine flow rates were constructed using statistical transformations of the data. Males showed a significant decline in both urinary flow rates with age, although there was no statistically significant variation in either urine flow rate with respect to first versus repeated voiding. Females showed no statistically significant variation in either urine flow rate with respect to age, parity or first versus repeated voiding.The maximum and average urine flow rates in both sexes showed an equally strong relationship to voided volume. No artificial restriction of voided volume, erg. minimum 200 ml, appeared appropriate. These nomograms offer reference ranges for both maximum and average urinary flow rates in both sexes covering a wide range of voided volumes (15–600

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05518.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—A study was made of 20 patients fulfilling the criteria customarily used for the diagnosis of interstitial cystitis. A possible infective aetiology was sought by culture of bladder tissue, catheter and midstream specimens of urine, and urethral swabs by methods capable of detecting fastidious bacteria as well as aerobic pathogens. All bladder biopsies showed the histological appearances usually associated with interstitial cystitis, and bacteria were isolated from the catheter specimens and/or bladder biopsies of 12 patients. Eight of these isolates were fastidious bacteria, Gardnerella vaginalis (6) andLactobacillussp. (2). Fastidious bacteria were isolated from the midstream specimen of urine (MSU) and/or urethral swab of 6 other patients. The correlation of the histological and bacteriological findings supports the hypothesis of an infective aetiology and suggests that the so‐called urethral syndrome and interstitial cystitis may be the earlier and later stages of the same disease process. The importance of early diagnosis of infection in these patients is emphasi

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05519.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The mean corpuscular volume (MCV) of urinary erythrocytes was measured by a Coulter Counter in 42 patients with asymptomatic haematuria. All patients had the source of haematuria established by a renal biopsy, cystoscopy or radiology. The mean urine MCV was significantly less in those with glomerular disease (n = 21) than in those with non‐glomerular haematuria (n = 21). In every patient with glomerulonephritis, urinary erythrocytes were smaller than those in their own venous blood. Conversely, urinary red cells larger than venous blood were confined to patients with a non‐glomerular source. Coulter analysis of urine provides a simple and objective aid to the diagnosis of haema

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05520.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The prognostic value of DNA ploidy and blood group (ABH) antigen reactivity was studied in a consecutive retrospective study of 230 patients with primary transitional cell carcinoma of the urinary bladder. In 195 cases the DNA ploidy and ABH reactivity could be assessed in paraffin‐embedded tissue. Early progression (in the first 3 years) occurred in 2% of the patients with diploid ABH positive tumours and in 31% of those with aneuploid ABH negative tumours. The 5‐year survival rates corrected for intercurrent mortality were 95 and 56% respectively. In a Cox multivariate analysis, T category, age at diagnosis and histological grade emerged as significant independent prognostic indicators of bladder cancer death, whereas ABH reactivity and DNA ploidy had no significant independent value. However, if the combination of ABH reactivity and DNA ploidy was included in the Cox model, this and T category were independent predictors. When this Cox model was applied to assess the risk of progression, the only independent prognostic factor was the combination of ABH reactivity and DNA p

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05521.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY