ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09805.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09806.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

摘要:

SUMMARYCanine kidneys were removed and cooled by perfusion and then stored in a hyperbaric oxygen chamber at 0° C. After given periods of storage the kidney was retransplanted into the original animal. Opposite nephrectomy was performed either immediately or some weeks after the transplantation. Twenty–three kidneys were perfused with autologous arterial blood or Ringer's solution containing canine albumin and preserved for 24 hours under 2 or 3 ATA of oxygen. Nine kidneys were perfused with autologous blood and stored for 48 hours under hyperbaric oxygen between 2 and 8 ATA.The kidneys perfused with Ringer's solution containing albumin showed severe damage==and did not function. Kidneys preserved 24 hours after perfusion with autologous arterial blood had much less damage and some of these supported life after delayed opposite nephrectomy.Forty–eight hours of preservation was constantly unsuccessful when 2 to 3 atmospheres of hyperbaric oxygen were used. At 8 atmospheres histological damage was less severe but the kidneys did not support life.It would appear that if hyperbaric oxygen affords any benefit, in the context of our experiments, the effect must be s

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09807.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

摘要:

SUMMARYUsing a special twin–channel catheter, bladder and urethral pressures have been recorded in three normal patients and in 46 patients with recurrent urinary infection. A majority of the patients showed a disturbance of the pressure gradient as between bladder and urethra and this upset may produce a functional situation resembling a concealed bladder–neck stenosis. More work is needed to show whether surgery might benefit such patients.This work was made possible by a generous grant (ACMR 507 E–62) from the Secretary of State for Scotland for the necessary equipment and for part–time technical help. Mr Roy Drummond, Mr D. Hardy, Mr W. Kay and Miss Jane Tapley have given invaluable technical help in building parts of the apparatus and in its running and maintenance. The London Rubber Company Limited kindly supplied through Mr R. W. Larkin, their Laboratory Manager, the fine latex sleeves for the urethral

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09808.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

摘要:

SUMMARYThe normal range of values for urinary alkaline phosphatase by a partially automated method and for urine lactic–acid dehydrogenase activity by a colorimetric method was established and was compared with values obtained in association with neoplasms of the urinary tract, extra–urinary neoplasms, and with other disorders of the genito–urinary tract. The findings do not indicate that such assays constitute an important addition to conventional methods for the diagnosis of kidney or bladder neoplasms, although urinary enzyme activity was increased in the presence of normal urine analysis in some patients. Urinary alkaline phosphatase activity may be increased in cases of malignant disease not involving the urinary tract and also in association with a major elevation of activity in the serum. Problems associated with the assay of urinary enzymes and the interpretation of the values obtained are discussed.We are indebted to Miss A. Illing for technical assis

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09809.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

摘要:

SUMMARYAn assessment of the value of prophylactic antimicrobial therapy in patients undergoing retropubic prostatectomy is presented.A series of 463 patients was studied. The management of the indwelling catheter was similar in all cases.Prophylactic antimicrobial therapy did not appear to be of advantage when the patient's urine was sterile at the time of operation.In the presence of infected urine at operation appropriate prophylactic antimicrobial therapy caused a significant reduction in the incidence of pyelonephritis and septicaemia after operation. Mortality from these causes was also significantly reduced. The giving of appropriate antimicrobial prophylactic therapy did not reduce post–operative morbidity or mortality from any other cause in these infected cases.I am grateful to Mr Arthur Jacobs and to Mr W. Barr Stirling for allowing me access to many of their cases during the course of this investigation. These surgeons also offered much helpful advice and criticis

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09810.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

摘要:

SUMMARYEvidence has been put forward in recent years that urinary continence depends on urethral length. There are theoretical objections to this hypothesis which are discussed.Nine dogs were investigated under anaesthesia. Six dogs were found to be continent when the urethra was divided at the bladder neck. Three dogs were incontinent and these were found to be suffering from marked prostatic hyperplasia. In four dogs it was possible to remove the full bladder completely after dividing the urethra at the bladder neck and it was shown that the primary sphincter could withstand a pressure of up to 15 cm. of water. It is concluded that the primary sphincter of the bladder is at the internal meatus. We have been unable to show that the posterior urethra is necessary to maintain continence in the normal dog and it is likely that the broad aspects of function at the bladder neck are similar in man.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09811.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

摘要:

SUMMARYObservations have been made of voiding in 10 dogs in response to direct bladder filling, and intravenous injection of carbachol or bethanechol before and after section of the urethra at the bladder neck.The isolated bladder is seen to be continent, and similar emptying pressures before and after urethral section at the bladder neck indicate that the primary functional sphincter of the bladder is in this region, and the urethra is unnecessary to maintain continence in the normal dog.The effects of carbachol and bethanechol are compared and it was found that in high doses carbachol causes distension of the posterior urethra with retention of urine due apparently to spasm of the external sphincter. When increasing doses of bethanechol were administered, the bladder emptied normally. This difference of action is probably due to the marked nicotinic effect possessed by carbachol.After division of the neck of the bladder both carbachol and bethanechol caused a vigorous detrusor contraction with a large rise in intravesical pressure, and complete urinary retention in five dogs. This observation is believed to be significant and is in accordance with Woodburne's (1960) hypothesis that longitudinal muscle fibres passing through the internal meatus into the urethra are responsible for opening the neck of the bladder.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09812.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

摘要:

SUMMARYA one–stage retroperitoneal method of producing acute transient experimental uræia is described. After defects in the peritoneum have been fashioned, the uræmic state delays the formation of new peritoneum and depresses the production of collagen. It would be advisable to include uræmia amongst other general factors when future studies of wound disruption are contemplated.The majority of this work was performed in the Surgical Unit Laboratories, Westminster Hospital. We would like to thank Professor D. Slome for providing additional facilities at the Department of Physiology, Royal College of Surgeons. We are grateful to Dr Klaus Lewin for assistance with the histology and photogr

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09813.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY

摘要:

SUMMARYThe author analyses his experience of reconstruction of the external genitalia in ten females and one male pseudohermaphrodite who were operated on by labioplasty and clitoridoplasty in one session.The submerged vaginal introitus is enlarged after cutting of a skin flap from the perineum. The corpora cavernosa of the hypertrophied clitoris are stitched and obliterated by mattress sutures, the glans being diminished by resection and overlapped by skin. The operation can be carried out before the age of 5 years. The advantages of this method over those previously described are discussed.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1967.tb09814.x

出版商:Blackwell Publishing Ltd    

年代:1967

数据来源: WILEY