ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05274.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—Calcium oxalate crystal concentrations were assayed by a new highly specific enzymatic method in 1200 urine samples from normal subjects and stone formers. Examination of the crystals was also carried out by light microscopy and urines were analysed for oxalate, calcium, magnesium, citrate, urate, pH and osmolality.A striking positive correlation was established between urinary oxalate concentration and calcium oxalate crystal concentration as well as incidence of calcium oxalate crystals and aggregates seen by microscopy. A less striking relationship, also supported by light microscopy, was found between calcium oxalate crystal concentration and urinary calcium concentration. A small rise in calcium oxalate crystalluria was seen with increasing osmolality, but no relationship found between concentration or urinary urate, citrate or magnesium and that of calcium oxalate crystals. Higher levels of calcium oxalate crystal concentration appeared in alkaline urines in association with calcium phosphate.The dominance of urinary oxalate as a risk factor for calcium oxalate crystalluria is confirme

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05275.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—Calcium phosphate and calcium oxalate urinary crystal concentrations in normal and stone‐forming subjects were measured. The urinary crystals were examined by light microscopy and urine samples were analysed for oxalate, pH and osmolality.Calcium phosphate crystal concentrations were clearly related to urine pH but unrelated to urine osmolality. An unexpected finding was co‐precipitation of oxalate with calcium phosphate. Consequently, precipitated invariable oxalate increased with rising urinary pH. Possible explanations and implications are disc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05276.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The role of Tamm‐Horsfall glycoprotein (THGP) in the crystallisation of calcium oxalate was investigated. The results showed THGP to have a weak inhibitory effect on crystal growth. In contrast, urinary macromolecules showed a strong inhibitory effect. THGP should, therefore, not be considered the main component of urinary macromolecules which have a strong inhibitory effect on crystal growth. However, THGP did enhance crystal production in the early phase of crystallisation. It appears that THGP should be viewed as a promoter rather than an inhibitor of calcium oxalate crystallisation at physiological concentrati

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05277.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—In a randomised phase II study, 5 of 24 patients with metastatic renal carcinoma responded to treatment with interferon (IFN) (Roferon A, Roche, Basle, Switzerland) (18 times 106u i.m. 3 times/week). The combination of IFN with vinblastine (0.1 mg/kg every third week) yielded a response rate of 16% (4 of 25 patients). Three patients continue to show a response (2 complete, 1 partial) more than 20 months after cessation of treatment.Flu‐like symptoms represented the major side effect and often led to modification or discontinuation of treatment.It was concluded that IFN is the treatment of choice in patients with metastatic renal carcinoma who are candidates for medical treatment. The significance of additional vinblastine is uncert

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05278.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The present investigation provides a histological and fine structural description of pseudomembranous trigonitis, an ill‐understood metaplastic condition affecting particularly the female trigone. Normal trigonal urothelium consists of 3 cell layers (basal, intermediate and superficial), whereas pseudomembranous trigonitis constitutes many layers of stratified squamous epithelium. The basal cells contain prominent nuclei with condensed chromatin, nucleoli and nuclear bodies. The cytoplasm of these cells is rich in mitochondria. The profiles of the urothelial cells become progressively elongated, their nuclei increasingly smaller and their content of cell organelles gradually reduced as the luminal surface is approached. The squamous surface cells, linked by desmosomes, retain many longitudinally arranged fine filaments, together with an occasional degenerate nucleus. The mitotic index of pseudomembranous trigonitis is 0.17% (SD 0.09%),i.e.significantly higher than normal (

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05279.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The treatment and symptomatic outcome were reviewed in 50 women who had presented with urgency incontinence as their main symptom 5 years previously. All had idiopathic urgency incontinence and, on the basis of urodynamic investigation, 40 were considered to have detrusor instability and 10 sensory urge incontinence. The results indicate that the natural history of sensory urgency is one of spontaneous resolution; all treatments of detrusor instability (including surgery) produced an unsustained short‐term symptomatic response. This pattern of response to therapy may be interpreted as being largely of a placebo nature and this emphasises the need for long‐term follow‐up in the assessment of new treatment mod

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05280.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—Endoscopic bladder neck suspension has become one of the more popular methods of surgical treatment of stress incontinence. The Pereyra technique was first described in 1959 and modified by Razin 1981. Stamey first described his technique in 1973 and this has been modified in a number of ways. The reported cure rates are 54 to 94% for the Pereyra‐Raz procedure and 61 to 92% for the Stamey procedure.We present a comparative review of the technical results of treatment of 30 patients with a modified Stamey procedure and 17 patients with a modified Pereyra‐Raz technique. The age range of the 2 groups was comparable. A successful result, with either complete continence or only minor occasional leaks after surgery, was achieved in 80% with the Stamey techniques and 76% with the Pereyra technique. Those patients not helped by the procedure had nearly all undergone previous surgery for incontinence. The Pereyra technique was used more frequently in patients who had failed previous incontinence surgery (including the Stamey technique). Complications were minor; 5 buffer infections occurred (3 buffers were removed).Both techniques offer a significant improvement in continence, but previous surgery is associated with a higher failure

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05281.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—We examined the possibility that use of a section of the terminal ileum for ileal conduit construction may impair bile acid absorption and cause choloretic diarrhoea. Nineteen normal subjects (mean age 41 years) and 16 patients with conduits (mean age 47 years) were investigated using the SeHCAT retention test. Conduit patients showed significant impairment of SeHCAT retention compared with normal subjects; 82% of patients had a retention below the lower limit of normal. The mean bowel frequency of patients during the test was 3 motions/day this being significantly different from their pre‐operative bowel habit. It was concluded that the use of the terminal ileum in conduit construction may impair bile acid absorption, as measured by the SeHCAT retention test, and may cause an increase in bowel freque

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05282.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The study group comprised 34 patients with either an ileal augmentation cystoplasty or a colonic substitution cystoplasty. The histological appearance of the intestinal segment, suture line, bladder remnant and bacterial colonisation of the urine and urinary nitrosamine levels were recorded.There was a high incidence of histological abnormalities, the more significant of which correlated with heavy mixed bacterial growth on urine culture and with high levels of urinary N‐nitrosamines. This group of compounds is thought to act as carcinogens in both bladder and bowel under certain circumstances.It was concluded that patients undergoing lower urinary tract reconstruction using intestinal segments should be considered at risk of developing malignant change either in the intestinal segment or in the bladder remnant. Close long‐term follow‐up of these patients is es

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05283.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY