ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00412.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00413.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectivesTo study the effects of citrate on urease‐induced crystallization in human urine.Materials and methodsUrine samples were collected from seven healthy volunteers with no history of urinary tract infection or stone disease. Citrate was removed from the urine samples by decomposition with citrate lyase. Citrate was then added to the urine in increasing concentrations. Oral potassium citrate was given to the volunteers and their urine was collected. The samples were incubated with urease and the crystallization induced was observed by the Coulter counter technique, by using an optical microscope and by precipitated material analysis.ResultsThe initiation of crystallization was markedly delayed by both the addition of citrate to the urine and after the ingestion of citrate. Crystal growth and the resulting precipitation of both calcium and magnesium showed a concentration‐dependent reduction when citrate was added up to a concentration of 4 mM. Crystal growth and precipitation of calcium and magnesium were also significantly decreased by oral citrate intake.ConclusionCitrate added to the urine or taken orally markedly delays urease‐induced crystallization in human

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00414.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo evaluate the antitumour effect of an angio‐inhibitory drug, a synthetic analogue of fumagillin (TNP‐470), on murine renal carcinoma (Renca) invivoandin vitro.Materials and methodsThe effect of TNP‐470 on the growth of Renca cellsin vitrowas measured by angio‐genesis assay and cell counting with dye exclusion. In the angiogenesis assay, Renca cells were injected intra‐dermally and the number of blood vessels orientated towards the tumours was counted 3 days after tumour inoculation. To examine the effect of TNP‐470 on the subcutaneous tumour growth and lung metastasis of Renca, Renca cells were injected subcutaneously or intravenously in BALB/c mice and they were treated with a subcutaneous injection every 3 days.ResultsDose‐dependent growth inhibitionin vitrowas observed with 50% inhibition occurring at 600 ng/ml. Angiogenesis assay revealed that administration of TNP‐470 inhibited the angiogenesis induced by Renca in a dose‐dependent manner. In the subcutaneous experiment, TNP‐470 decreased the growth rate of established subcutaneous tumours rather than reduced the size of the tumour. The administration of TNP‐470 in mice with lung metastasis inhibited the development of metastasis of Renca without weight loss or diarrhoea.ConclusionThe present study demonstrated that TNP‐470 had an inhibitory effect on tumour‐induced angiogenesis and a significant anti‐tumour effect on Renca. This suggests that TNP‐470 could be useful in the treatment of renal cell carcinoma. Further studies are needed to clarify whether TNP‐470 is more effective when combined with

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00415.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective To evaluate the role of parenchyma‐sparing surgery in patients with renal cell carcinoma (RCC).Patients and methodsBetween 1965 and 1990, 34 patients with RCC underwent renal parenchyma‐sparing surgery. There were 22 men and 12 women with a mean age of 62 years (range 40–89). Ten patients underwent enucleation (Group A), 15 partial nephrectomy (Group B), and nine a combination of procedures (Group C). Conservative surgery was performed in the presence of a normal contralateral unit in four patients (12%).ResultsFive patients developed local recurrence. Metastases appeared in six patients (18%) from 12 to 58 months post‐operatively. Adequate renal function was obtained in 32 of the 34 patients. The mean follow‐up for all patients was 64.6 months overall, 75.6 months for group A, 64.1 months for group B and 53.4 months for group C. The 3 and 5 year probabilities of survival for all patients were 77.8% and 69.5% respectively. The probabilities of 3 and 5 year survival were 80% for group A, 80% for group B and 71.4% and 57.1% for group C.ConclusionEnucleation and partial nephrectomy are both viable options in the management of solitary or bilateral RCC, as there is no decline in effective tumour control and prognosis. Larger groups and longer follow‐ups are needed to assess the role of renal parenchyma‐sparing surgery more

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00416.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo evaluate the role of nephron‐sparing surgery in patients with incidental renal cell carcinoma and a normal contralateral kidney.Patients and methodsA total of 230 patients underwent curative surgery for unilateral renal cancer between 1979 and 1991. Of these, 41 had a partial nephrectomy. The numbers of patients who underwent partial or radical nephrectomy over the course of the study are compared.ResultsThe number of partial compared to total nephrectomies increased from 8% in 1979‐84, to 20% in 1984‐88 and 30% in 1989‐91. This reflected increased detection of incidental renal tumours by radiological imaging. The local recurrence rate in those patients who underwent partial nephrectomy was 2% and survival was 95%, with an average follow‐up of 3 years (range, 2–13).ConclusionNephron‐sparing excision of small, incidental renal tumours achieved comparable early results to radica

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00417.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo determine the pathophysiological changes in upper urinary tract motility and calculus transit which may occur following JJ stent insertion.Materials and methodsThe acute and chronic effects of JJ stent placement were studied in 24 canine renal units. Intrarenal and intraureteric pressures and motility were measured, in addition to transit times for complete passage of synthetic calculi from the upper ureter into the bladder.ResultsAcute effects included raised renal intrapelvic pressure, reduced pelvic and ureteric motility and delayed calculus transit time. Prolonged JJ stent placement was associated with return of intrapelvic pressure to normal but persistent changes in both renal and ureteric motility and also calculus transit time.ConclusionInsituJJ stents impair upper urinary tract motility and experimental calculus transit time and may delay passage of ureteric calculi or calculus fragments following extracorporeal shock wave lithotripsy.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00418.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo determine whether indwelling JJ stents significantly alter renal pelvic pressure and consequently have deleterious effects on renal function.Materials and methodsThirteen piglets were used totalling 26 renal units. Using an open, sterile surgical procedure, 23 renal units were stented with 6F JJ catheters of eight different types; three renal units were not stented and served as controls. Intra‐pelvic pressure values during diuretic stress were measured before and after 6 weeks of intubation. The kidneys were then removed and sent for pathological evaluation of renal parenchymal thickness.ResultsA marked increase in intra‐pelvic pressure values was found in two of the 19 stented renal units suitable for this measurement. A significant reduction (more than one third with respect to the control values) in renal parenchymal thickness was found in six of the 21 stented renal units suitable for this measurement, three of which had been intubated with a Cook polyurethane stent and three with an Angiomed Puroflex stent.ConclusionIn the present experimental study some JJ stents seemed to cause long‐lasting changes in renal pelvic pressure and consequently to have deleterious effects on renal function. Although experimental findings are not always fully related to clinical practice, a knowledge of the potential effects of these prostheses is essential to minimize complications related to thei

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00419.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo describe the clinical and laboratory findings in patients with Group A streptococci (GAS) bacteriuria.PatientsPatients with GAS bacteriuria seen in a tertiary care hospital in southern India between 1988 and 1993 were identified. Data were collected from the hospital records.ResultGAS were isolated from 15 women and 11 men. Clinical data were available for 24 of these. The condition presented as asymptomatic bacteriuria (nine patients), dysuria or frequency (12), and fever without localizing signs (three). All infections occurred in individuals with systemic or local conditions predisposing to urinary tract infection. All patients responded well to antimicrobial therapy.ConclusionGAS bacteriuria is rare and occurs only in individuals with other predisposing conditions. Patients with this infection respond well to therapy.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00420.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo illustrate how the original principle of an appendicovesicostomy can be expanded upon and applied successfully to numerous urological conditions utilizing a variety of surgical techniques.Materials and methodsOver the 8‐year period 1985‐1993 the Mitrofanoff principle was utilized 105 times in 100 consecutive patients. Seven different types of catheterizing conduit were constructed in conjunction with six varieties of urinary reservoir for patients falling into one of seven different categories of uropathy.ResultsAt a median follow‐up of 30 months, the continence rate for patients was 91%. The re‐operation rate for conduit complications was 33%. Neither continence rates nor complications specific to the Mitrofanoff were related to the underlying uropathy, the type of conduit constructed, the urinary reservoir employed, and the patient's age at surgery.ConclusionThe Mitrofanoff principle of continent urinary diversion is a versatile technique with a predictable success rate applicable to a wide variety of urological conditions. Patients and surgeons should be aware of the significant rates of revision required on the catheterizing conduit to enable continence to be ultimately a

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb00421.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY