ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07182.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Ten urological complications (2.9%) were found in 350 kidney transplants performed in this centre. These included obstructive uropathy (20%), urinary leaks (40%), distal uretic fistulas (necrosis) (30%) and renal calculi (10%). Two grafts were lost due to chronic rejection 9 and 30 months post‐operatively. The remaining 8 patients have stable renal function (mean creatinine 1.5 mg%). It was concluded that meticulous surgical technique may reduce the number of urological complications and early diagnosis and prompt surgical treatment may help to save the gra

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07183.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Emphysematous pyelonephritis in patients with diabetes mellitus is increasingly recognised as a disease requiring urgent and aggressive treatment. We present 3 cases of emphysematous pyelonephritis; 1 patient required percutaneous nephrostomy followed by nephroureterectomy but the other 2 were successfully managed with antibiotics and control of diabetes. Diagnosis was confirmed by sequential imaging techniques which demonstrated an inflammatory renal mass associated with gas and flui

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07184.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—An investigation was carried out into renal injury caused by extracorporeal piezoelectric lithotripsy (EPL) using an EDAP lithotriptor. Four urinary proteins, with a molecular weight range of 160000‐14500, immunoglobulin G (lgG), N‐acetyl‐beta‐glucosaminidase (NAG), albumin and lysozyme, were monitored in 27 patients 1 day before and 1, 7, 30, 90 and 180 days after unilateral EPL treatment. All patients had non‐obstructive renal stones, previously untreated. Apart from 5 patients with stablised hypertension and 6 with persistent urinary infections due to the infected stones, all patients appeared healthy, as confirmed by clinical, haematological and biochemical investigations. Only albumin levels increased significantly 1 day after treatment; statistically nonsignificant increases and decreases were recorded in the levels of NAG and lysozome respectively. IgG was beyond the limit of detection (<0.5 mg%) in all patients. The albumin level returned to normal 7 days after treatment. The EPL‐induced increase in albumin was recorded in 88% of patients, compared with increased levels of NAG in 46% and lysozyme in 64%, mainly in those with infected stones. These findings indicated a transient glomerular injury after

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07185.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—A comparison of urinary fibrinolytic activity between 31 stone formers and 50 controls failed to demonstrate any significant difference and so failed to confirm an earlier independent observation. This may be due to methodological and design differences between the 2 studies, but does suggest reservations about the significance of lowered urinary fibrinolytic activity as a risk factor for renal stone disease.Dietary information from those taking part in the study suggests that a reduction of meat intake by stone formers might be associated with increased urinary fibrinolytic activity. This might account for the discrepancy between the 2 studies, in which case this observation could be of significanc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07186.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—A series of 24 patients with renal angiomyolipoma was reviewed. Their ages ranged from 10 to 70 years (average 41). Four cases were associated with tuberous sclerosis, 1 with spinal neurilemmoma, 1 with transitional cell carcinoma and another with renal tuberculosis.The presenting symptoms in decreasing frequencies were flank pain, mass, haematuria, fever, syncope and respiratory distress. Although it has often been said that angiomyolipomas associated with tuberous sclerosis are small and asymptomatic, all 4 such patients in this study had large symptomatic tumours. Before the advent of CT scan and ultrasonography, the pre‐operative diagnostic rate for cases unassociatedwith tuberous sclerosis was 10% (1/10). With the combined use of these 2 modalities, the diagnostic rate increased to 60% (6/10).Most patients in this series were treated with nephrectomy. However, equally good outcomes occurred in 2 patients who received partial nephrectomies. Pre‐operative diagnosis now makes it possible to consider more conservative manag

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07187.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Small cell carcinomas of the urinary tract are rare, but lethal. We report 3 cases of primary small cell carcinoma of the kidney, urinary bladder and prostate with light microscopic, immunohistochemical and electron microscopic findings. One patient with small cell carcinoma of the prostate died of disseminated disease 2 years after diagnosis and another patient with small cell carcinoma of the urinary bladder was free of tumour after 6 months. A partial remission was induced in the third patient with distant metastases of small cell carcinoma of the kidney by using chemotherapy protocols similar to the drug regimens for small cell carcinomas of the lung; the patient survived for 5 months. Immunohistochemical studies revealed the absence of argyrophilic immunostaining of tumour cells in all 3 cases, positive staining for keratin in 2 and staining for neuron‐specific enolase in all 3. In the third patient, reactivity for prostate‐specific antigen was negative. Dense‐core, membrane‐bound granules were identified in the cytoplasm of 2 patients. The paraneoplastic syndrome was not found, indicating that in considering the occurrence of ectopic hormones, specific cytoplasmic granules of origin need not be implicated. Recognition of this distinct entity requires full consideration of morphological, immunohistological, ultrastructural and biological features. In order to define the origin of this tumour more clearly and to evaluate the effectiveness of chemotherapy, larger series of patients a

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07188.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—Ten renal carcinomas were established in culture and their sensitivity to mitozantrone ± verapamil, as measured by (75 Se) selenomethionine incorporation, was studied. The 5 tumours with spread beyond the kidney were those in which sensitivity to mitozantrone was enhanced by verapamil. With 4 of the 10 tumours and 1 further carcinoma, similar experiments were performed using doxorubicin. This drug was more active, its anti‐tumour action being related to concentration. Verapamil was more effective in potentiation of doxorubicin and this action increased in proportion to the concentration of verapamil a

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07189.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—In a study of the pain‐relieving effect of 3 drugs commonly used to treat acute renal colic in this hospital, intravenous indomethacin and intramuscular diclofenac (prostaglandin synthetase inhibitors) were compared with intravenous Avafortan (analgesic antispasmodic). As first‐line analgesics, prostaglandin synthetase inhibitors, if given intravenously, offer an effective alternative to Avafortan. Of 145 patients studied, 32 required a second injection for complete relief of pain. Administering a second dose of prostaglandin synthetase inhibitors resulted in equally significant pain relief rate even though the route was intramus

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07190.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Summary—A bladder advancement extension technique was developed to proviae a reliable method for creating an extra length of bladder in continuity, so that Boari flap and psoas hitch procedures, with or without the extension grafts, would reach sufficiently high routinely to permit these procedures to become the preferred practical options for accomodating significant proximal ureteric deficiencies or for replacing the whole of the ureter. In addition, an omentally supported bladder graft was established separately for use in a “retrieval” procedure should extension graft stenosis develop subsequently.Of 10 dogs studied for 6 months, 2 required “retrieval” pedicled island patch grafts for stenoses al extension graft/upper ureteric junctions. Healthy urothelium with muscle in the walls was seen in grafts resting on their supporting omental beds. At the time of sacrificing, none of the operated upper tracts was o

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1990.tb07191.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY