摘要:

It is perhaps surprising that despite sophisticated modern technology, basic information about the pattern of disease in communities is remarkably little understood. The concept of examining a community on a random basis in order to determine the pattern of a particular disease and subsequently to repeat the exercise to determine the changing rate of the particular disease process has rarely been attempted. In most countries the information availble on renal stone epidemiology is based on an analysis of significant cases which present at a hospital (Andersen, 1968). The number of cases actually present in a community may be very different from those which present clinically.This review summarises the major surveys undertaken in recent times in several different countries.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05853.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Experiments have been carried out with isolated ring preparations of human ureter. The tissue displayed spontaneous activity and contracted when exposed to barium chloride (0.5‐4 mM) but no responses were obtained with carbachol (0.1 micromolar‐0.1 mM). This raises questions about the value of treating ureteric colic with anti‐muscarini

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05854.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Treatment with phosphates, thiazides and allopurinol was undertaken in 54 idiopathic calcium oxalate stone formers, 38 of whom were recurrent stone formers. The patients were followed up for 1 1/2 to 4 years (mean 2.6). During the same period at the pre‐treatment stage the patients formed 80 stones, but during therapy only one stone was formed.A dynamic scheme of therapy was used. Each patient was tested before the start of drug treatment by the discriminant index (DI) method, which measures the overall inhibitory potential to calcium oxalate crystallisation. About 10 days after the start of treatment the DI was tested again. If the response was positive, therapy was continued; if not, the patient was given another drug. Adjustments were made as required.The stopping of stone formation correlated well with the DI prediction but less well with the hypocalciuric effect of the dr

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05855.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—The relationships between urinary oxalate, calcium and magnesium were investigated in 81 patients with idiopathic calcium oxalate urolithiasis on their regular diets. A significant relationship was established between calcium and oxalate excretion in the analysis of recurrent stone‐formers (n = 44, P<0.01), though there was no significant difference between the two in the analysis of the patients overall or in single stone‐formers. This suggests that recurrent stone‐formers may have some abnormality of oxalate absorption in relation to calcium absorption.The role of calcium‐oxalate interaction in the gut as a cause of mild hyperoxaluria is

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05856.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—The Ames Seralyzer reflectance photometer and disposable reagent strips for the determination of plasma creatinine were evaluated in the laboratory and on a urology ward over a 3‐month period. Principles of the instrument used are described, as are details of the evaluation procedures. Reproducibility of results under optimum conditions gave coefficients of variation<7%. Under routine conditions of use, medical staff and laboratory analysts achieved high correlation with the routine laboratory method of analysis (r = 0.986, N = 108: r = 0.996, N = 102 respectively). Potential sources of inaccuracy were identified. Seralyzer determination of plasma creatinine can be rapidly, simply and reliably performed by medical staff on a urology ward, thereby facilitating assessment of renal function governed by clinical requirement rather than by laboratory convenie

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05857.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Three methods of assessment of upper urinary tract dilatation were compared prospectively. Forty‐eight dilated renal units (35 patients) were studied, the majority being idiopathic pelvic hydronephrosis (69%).Dynamic computed tomography (CT) involves rapid sequence CT after injection of contrast medium. The maximum enhancement of a medullary region of interest (MMR) and its rate of enhancement (SMS) were derived from dynamic CT. Dynamic CT was compared with diuresis probe renography and measurement of parenchymal transit time (PTT) from DTPA imaging.The MMR (70.1±; 10.6 HU) and SMS (2.0±; 0.5 HU/s) in controls were significantly greater than in patients with upper tract dilatation (52.8±; 18.5 and 1.43±; 0.85 HU/s; bothP<0.001). A significant association was observed between impairment of renal function in patients with upper tract dilatation and a low SMS and MMR (P<0.01).Statistically significant agreement was observed between the results of diuresis renography and PTT (P<0.025). However, no significant agreement was found when the results of dynamic CT were compared with either diuresis renography or with PTT.Dynamic CT as performed in the present study has no useful contribution to make in the diagnosis of patients with dilatation of the upper urinar

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05858.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—The purpose of this study was to clarify the role of the conduit in the development of upper tract dilatation after ileal conduit urinary diversion. Twenty‐seven patients with a normal upper tract were compared with 17 who had developed upper tract dilatation. Patients were studied by means of a technique to measure pressure and flow under “steady‐state” conditions.Pressure activity was classified into two types. Type I pressure activity (frequency 6.2± 3/min; amplitude 4.7± 3 cm H2O) resulted in to‐and‐fro movement of contrast and the escape into the appliance of small volumes of contrast. In controls, most of the output from the conduit occurred during type I activity (73± 14%). Type III/IV pressure activity resulted in vigorous aboral peristalsis and occurred infrequently in controls (frequency 5± 4/h). In patients with upper tract dilatation, in contrast, type III/IV peristaltic activity occurred frequently (frequency 37±30/h;P<0.00l: amplitude 72± 34 cm H2O) and was responsible for most of the output (70± 17%;P<0.00l).The findings support the hypothesis that high pressure activity in the conduit is an important factor in the aetiology of upper tract dilatation, and they are compatible with the presence in such patients of functionally important obstructions o

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05859.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—As part of an ongoing study on trabeculation of the human urinary bladder, morphological and morphometric techniques have been employed on biopsy samples of detrusor muscle removed from control and urodynamically obstructed patients. In control material the mean profile area, profile diameter and nucleated profile percentage of bladder smooth muscle cells were determined. The values of the same parameters were obtained for smooth muscle cells in samples from urodynamically obstructed and endoscopically trabeculated patients. Comparison of the results obtained from the two groups showed that smooth muscle cells undergo compensatory hypertrophy in response to outflow obstruction. Furthermore, connective tissue infiltration of detrusor muscle bundles is a characteristic of those bladders which possess cells showing the largest increase in cell siz

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05860.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Fifty‐one patients with predominantly superficial bladder tumours underwent prospective cytological examination at predetermined intervals following surgery in order to evaluate the prognostic reliability of bladder irrigation cytology. The results suggest that positive cytology 3 days after radical transurethral resection is a reliable indicator of incomplete resection or additional occult tumour foci. The implications for post‐operative management and follow‐up are di

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05861.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Summary—Sixty‐five patients had a cystectomy for a solitary bladder tumour (28) or multifocal lesions (37). The histological extent of the disease within the bladder was correlated with mucosal abnormalities within the urethra. The presence of multifocal or solitary bladder disease was not an accurate predictor of the presenceorabsence of urethral dysplasia. Details of mortality and morbidity associated with one‐stage cystourethrectomy are presented and it is concluded that irrespective of whether the bladder contains a solitary or multifocal tumour, complete cystourethrectomy should be considered as the treatment of choice whenever cystectomy for attempted cure is indi

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1985.tb05862.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY