摘要:

SUMMARY1 The normal upper urinary tract functions as a low‐pressure, low‐resistance urine propulsion system.2 During antidiuresis the pressure in the renal pelvis is zero to a few millimetres of mercury. Phasic contractions of the pelvis occur, but as there is no obstruction to outflow, intraluminal pressure is either unaffected or minimally raised. The contraction wave occludes the lumen of the pelvi‐ureteral junction separating off a “spindle” of urine. This “spindle” is then conveyed along the ureter to the bladder by the complex contraction wave.3 During diuresis there is an increase in the renal tubular excretory pressure. This increase in pressure and the associated high flow rate produces a potential inflow‐outflow imbalance resulting in a gradual increase in pelvic baseline pressure and volume, with a distal movement of the functional pelvi‐ureteric junction. Pelvic contraction waves can be recorded as there is a relative outflow obstruction. As flow rate rises there is pooling of urine in the ureter, and ultimately a confluent column of urine in the upper urinary tract flowing continuously into the bladder. As the ureter increases in diameter with the rising baseline pressure the height of the contraction wave diminishes.4 If the high outflow resistance is sustained due either to polyuria or to organic obstruction, the continuous high baseline pressure leads to a permanent dilatation proximal to the obstruction with urinary stasis. In turn, because of a back pressure effect or secondary vascular occlusion, there is renal parenchymal atrophy with a fall in tubular secretory pressure and pelvic and ureteric intraluminal pressure. This results in the dilated urinary tract with low intraluminal pressure.5 Manometry has contributed to the understanding of the function of the renal pelvis and ureter. Although it is a useful research technique, in clinical practice it provides little information which cannot now be deduced from routine investigations such as infusion pyelography, micturating cystography, a

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09917.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYSixteen cases of communicating cyst of the renal calyx are described. A new technique for surgical treatment of the condition is described.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09918.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYThe well‐known techniques of modification of crystal habit and composition or inhibition (prevention or slowing down) of crystal growth by addition of foreign substances to the crystallising solution have been successfully applied to the crystallisation of calcium oxalate. Several ions, notably A13+, many dyestuffs, including thosepermitted as colouring matter in foods, and some compounds of therapeutic value are particularly effective. It is hoped that some of these may prove to be of use in the control of the formation of calcium oxalate renal calcul

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09919.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYA perfusion technique is described whereby rat kidneys were perfused with solutions containing gradually increasing concentrations of DMSO as they were cooled to‐25d̀ C. They were then frozen and cooled to‐79d̀ C. and after a variable period of time, thawed. As re‐warming took place perfusion was recommenced and the DMSO removed from the kidney. The technique described eliminates weight gain and reduces protein loss to a minimum.This work was supported by a grant from the Medical Research

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09920.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYIsolated rat kidneys were perfused with solutions containing DMSO, cooled to‐25d̀ C. and then stored in the frozen state at‐79d̀ C. for one hour. They were then thawed, rewarmed and the DMSO removed.The experimental kidney was then linked by means of a cannula in the renal artery to the aorta of a second rat and the urine excreted from it collected.The urea‐content of this urine was compared with the urea‐content of the blood of the perfusor rat. Thirteen experiments were performed. In five of these the urine‐urea/blood‐urea ratio was greater than one, thus indicating preservation of tubular function in these kidneys after they had been stored at ‐79d̀

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09921.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYCinefluorograms were obtained of the posterior urethra of the ram visualised by injection of Hypaque into the vas deferens. Three sets of observations were made:1 At rest, the posterior urethra remains empty. Any fluid introduced via the vas deferens is promptly expelled into the bladder, and only sometimes into the distal urethra. This may be due partly to intramural tension of the urethral wall and partly to muscular action.2 Ejaculation was induced by means of electrical stimulation via the rectum and recorded cinefluorographically. During ejaculation the contents of the vas and ampulla are expressed distally through a wide open channel with no reflux into the bladder. Between contractions, fluid remaining in the posterior urethra is expelled into the bladder. There must therefore be a mechanism for preventing reflux during ejaculation, and it is suggested that this is due to a combination of elasticity of the prostatic urethra and prostatic contraction.3 Ejaculation was observed in one ram after separation of the bladder from the prostate. This would confirm the conclusion of (2) above, and also does not disprove the theory of passive continence or the anatomical observations of the “internal sphincter”, which suggests that this is an opening rather than a closing mechanism. The bladder and its internal sphincter play little or no part in the control of ej

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09922.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYThirty‐three patients with severe uræmic upper urinary tract obstruction were treated in Leeds over the past 10 years with the aid of dialysis. The value and indications for dialysis and results are described and discuss

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09923.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYTwenty‐one patients with urinary incontinence were treated with portable electronic stimulators, the stimulus being delivered by a vaginal pessary, a rectal plug or an implantable device. Details are given of the degree of success achieved with each device. The results have proved sufficiently encouraging to warrant extension of the trials. It is suggested that the implantable device should not be regarded as the primary treatment, owing to the danger of electronic failure or lead migration. The investigations used to assess the suitability of patients for the various devices are describe

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09924.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYContinuous pressure profiles would seem to include all possible advantages over other methods of urethral assessment. The method applies equally to electro‐stimulation testing and to the evaluation of stricture. A wide range of variations and refinements to the method may be suggested, for instance, the profile catheter should preferably be withdrawn at a known steady rate, and this could perhaps be achieved by a mechanical device. It might also be useful if subsequent profiles could be superimposed on the initial trace to allow of a more accurate comparison between sequential examinations.Perfectly adequate results may however be obtained with the simple apparatus described abov

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09925.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY

摘要:

SUMMARYA case of survival following rupture of a renal artery aneurysm is presented and is the twelfth on record. Although rupture of such an aneurysm is described quite frequently, death is usually due to delayed diagnosis and treatment. The presenting symptoms and signs of rupture are discussed. If the diagnosis is made early enough the patient will survive after nephrectomy.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1969.tb09926.x

出版商:Blackwell Publishing Ltd    

年代:1969

数据来源: WILEY