摘要:

Summary—We report our experience with 107 percutaneous antegrade pyelograms in 79 children aged between 3 days and 14 years. The main indications for the procedure are outlined, together with a note on the technique. Puncture of the pelvicaliceal system failed in 10% of cases. The procedure is simple to perform and is preferred to retrograde urography, which carries significant morbidity and is impracticable in the male infant. Antegrade pyelography provides the definitive anatomical diagnosis of obstruction of the upper urinary tract. It is particularly useful in megaureters after reimplantation and in grossly dilated and/or poorly functioning systems where diagnosis of obstruction by radionuclide renal scan could be difficult. The procedure has been found to be safe and complications are minima

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05380.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—The occurrence of bacteria and Ureaplasma urealyticum in the upper urinary tract was studied in 50 patients operated on for renal stones. Cultures were performed on voided urine, pelvic urine obtained during surgery and the stone. The chemical composition of the stones was analysed.Twenty‐six stones were of metabolic origin and 24 infection‐induced, i.e. composed of struvite and/or carbonate‐apatite. Ureaplasma urealyticum was cultured from the upper urinary tract in 1 patient with metabolic stones, and in 7 with infection stones. In 4 of these 7 patients no other urease‐producing micro‐organism was detected, suggesting that Ureaplasma urealyticum may have been associated with stone formation in the

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05381.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—The composition of encrustations precipitated on long‐term indwelling urethral catheters was analysed using a newly developed wet chemical method that allows determination of small sample volumes. In contrast to earlier studies, the major portion of the encrusted material could be identified; ammonium magnesium phosphate and calcium phosphates (brushite and apatite) were the major components. The effect of allopurinol was also investigated and it was found to decrease significantly the amounts of urate and calcium phosphate but not to lower significantly the total amount of material precipitated on the cathet

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05382.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—Bendroflumethiazide was administered to 85 patients (62 men, 23 women) with recurrent calcium oxalate stone disease. Side effects leading to interrupted treatment were observed in 26 (31%) of the patients. Fifty‐nine (40 men, 19 women) remained on treatment for a mean (± SD) period of 3.7 ±1.0 years, and 21 reported late side effects. Twenty patients were given 2.5 mg bendroflumethiazide daily (Group A), 27 were given 2.5 mg twice daily (Group B), and 12 were given 5 mg once daily (Group C). Eight patients (14%) formed new stones and another two demonstrated stone growth during treatment. A beneficial effect on stone formation was observed in Groups B and C but not in Group A. Patients who failed to respond to treatment had a pre‐treatment stone formation rate of 0.74 stones per year compared with 0.22 in those who did not form new stones. Those with recurrence during treatment had a lower citrate excretion than other patients. No effect on urinary citrate was recorded during treatment, and long‐term treatment with bendroflumethiazide did not affect oxalate

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05383.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—The metabolic effects of a high protein diet (HPD) were studied in eight patients with idiopathic recurrent calcium oxalate stones.On the HPD there was a 35% increase in urinary calcium concomitant with increased excretion of cyclic AMP and hydroxyproline. These findings point to an enhanced resorption of bone, possibly secondary to increased renal loss of calcium. The urinary citrate decreased by 25% along with reduced serum standard bicarbonate and urinary pH. The high formation of acid metabolites might also have adverse effects on calcium balance and bone.Urinary oxalate excretion was not affected nor were there any significant changes in the calculated urinary supersaturation of calcium oxalate, if changes in urinary citrate, pH, sulphate, sodium, phosphate and volume were also considered.This study suggests that the possible negative influence on the propensity to form renal stones of a diet rich in animal protein is probably due to reduced urinary inhibitory activit

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05384.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—A consecutive series of 257 patients with renal carcinoma treated by radical nephrectomy is presented. The crude 5–year and 10–year survival rates for all patients were 47 and 31% respectively and for patients without distant metastases 62 and 50%. The importance of factors relating to prognosis was investigated with multivariate survival analysis. Metastases, nodal involvement and histological grade were strongly and independently associated with survival, but the influence of venous invasion was less important. When these factors are taken into consideration, direct extension, size and cell type of the tumour or sex and age of the patient give no significant additional prognostic inform

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05385.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—Surgery has often been performed for presumed obstruction in dilated bilharzial ureters but with unrewarding results. In this report 55 non‐refluxing dilated bilharzial ureters were studied. Perfusion pressure flow studies and diuresis renography with washout technique were used to diagnose the presence or absence of obstruction. Surgery was performed only when obstruction was proven by PPFS and diuresis renography; thus patients were spared an operation when the obstruction could not be confirmed. Antegrade ureteropyelographic findings, evaluation of peristalsis and transport of urine were the basis for the selection of operation performed. The various surgical procedures are discus

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05386.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—Nine children underwent urinary diversion for lower urinary tract obstruction and were followed for periods of 2.5 to 15 years (median 10 years). Eight had cutaneous ureterostomies and the ninth had an ileal conduit. Undiversion was performed because of the return of normal function, the possibility of renal transplantation and ileal conduit stomal obstruction.The patients have been followed for periods ranging from 6 months to 9 years (median 2.5 years) after undiversion. To date, eight have moderate to good renal function. The remaining child has progressive renal failure. Eight are continent and one has mild stress incontinenc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05387.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—Treatment of idiopathic detrusor instability with drugs and prolonged distension of the bladder is often unsatisfactory. Some amelioration of symptoms has previously been described by using the Cystomat. The present study showed that 1 week's treatment with the Cystomat produced convincing subjective improvement as well as an increase in bladder capacity. The improvements were statistically significant and persisted for 3 months. Although the mechanism by which bladder distension exerts its effect is poorly understood, the technique of repeated distension offers an alternative in the treatment of patients with idiopathic detrusor instabilit

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05388.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary—In this prospective study, primary urothelial bladder tumour specimens from 64 patients were investigated by means of DNA Feulgen cytophotometry. The patients were followed clinically for at least 7 years. The objective cytophotometric parameters correlated well with the histopathological grading and the cytochemical data were of considerable prognostic value. They were closely correlated with the stage of the tumour, 5‐ and 7‐year survival rates and the probability of tumour recurrence.It is concluded that DNA cytophotometry can serve as a method for the standardisation of histological grading and can give more objective and more detailed prognostic information than conventional histopath

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1984.tb05389.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY