摘要:

The management of urethral injury continues to be controversial and no one policy has received universal acceptance. This review describes the current three‐step approach which we use for the investigation and management of this serious injury. This approach has evolved during the management of a large number of these injuries over the past 22 years. It is relatively simple and can be expected to give a high success and low complication rate. We believe that many of the complications encountered following the management of this injury are avoidabl

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06578.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Magnesium and tartrate each reduce calcium oxalate crystal formation in urine. Since the effects are additive, a palatable mixture of magnesium and tartrate salts was devised and fed to 6 healthy volunteers. There were no side effects. There was a moderate fall in urinary calcium, moderate rises in urinary magnesium, tartrate and citrate, and no change in urinary oxalate. Hence there are good grounds for supposing that this mixture could be used to prevent urinary stone recurrenc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06579.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Calcium loading tests were performed in 21 children with hypercalciuria, haematuria and/or nephrolithiasis and 10 control subjects. Comparisons of 24‐h calcium excretion before and after loading were evaluated rather than fasting urinary calcium to urinary creatinine ratio. The differences in calcium excretion before and after loading clearly distinguished absorptive from renal hypercalciuria. A difference higher than 0.035 mmol/kg indicated absorptive hypercalciuria in 6 of 21 patients, whereas in the remaining 15 much lower differences indicated renal hypercalciuria. Resorptive hypercalciuria caused by low serum values of 25‐hydroxyvitamin D was considered in 6 of the 15 patients with renal hypercalciuria. These patients had low values of phosphate reabsorption (TmP/GFR) and could be clearly separated by high values of calcium reabsorption (TmCa/GFR), in contrast to patients with renal hypercalciuria who had normal values of TmP/GFR and low values of TmCa/GFR. The correct treatment and prevention of nephrolithiasis caused by hypercalciuria in children should be based on accurate diagnosis; this can be achieved by using the calcium loading test described in this r

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06580.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Thirteen patients with medullary sponge kidney underwent a short ammonium chloride loading test to investigate their renal acidification capacity. All but 1 presented with a history of recurrent renal calculi and showed bilateral widespread renal medullary calcification on X‐ray examination. Nine patients had some form of renal acidification defect; 8 had the distal type of renal tubular acidosis, 2 the complete and 6 the incomplete form. One patient had proximal renal tubular acidosis. These findings, which suggest that renal acidification defects play an important role in the pathogenesis of renal calculi in medullary sponge kidney, have considerable therapeutic implicati

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06581.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—One hundred and thirteen children with non‐metabolic urinary tract calculi were operated on between 1960 and 1983. One hundred were followed up for 3 to 17 years (mean 8.2). Seventeen children (15%) developed recurrent calculi after complete clearance at the initial operation and in 13 of these the stones recurred within 5 years.Proteusurinary infection was a constant feature of stone recurrence. Five patients required re‐operation for removal of the recurrent calculus. Small residual caliceal fragments were left behind in 17 children but only 3 required surgical re

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06582.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—A review of 15 cases of unilateral renal dysplasia is presented. Seven patients came to medical attention with urinary tract infection. Only 4 presented with an abdominal mass. Eight patients were found to have ipsilateral ureteric anomalies and 4 of these also had contralateral ureteric problems. Five patients had extra‐renal anomalies and these included Turner's syndrome, scoliosis and congenital dislocation of the hip. Histological examination, in all cases, revealed the presence of primitive ducts surrounded by concentric layers of cellular mesenchyme. Metaplastic cartilage was noted in only 7 of the 15 ca

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06583.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—A new technique is described which facilitates the surgical removal of renal carcinoma from the inferior vena cava. The use of cardiopulmonary bypass with or without cardiac arrest has been advocated but with this procedure only the inferior vena cava is bypassed, using femoral and right atrial cannulation, assisted by a closed system electromagnetic centrifugal pump. In appropriate cases this less complex technique allows prolonged access to the inferior vena cava whilst providing equal protection from pulmonary embolisation and tumour dissemination; it also reduces morbidity, operating time, difficulty and cost when compared with cardiopulmonary bypas

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06584.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—The surgical management of 6 male patients with pelvic kidneys with pelviureteric junction obstruction is discussed. Two patients presented in advanced renal failure and 1 had peritonitis and septicaemia due to rupture of the renal pelvis. Vesicopyelostomy was preferred to pyeloplasty in 5 patients because of adhesions, multiple aberrant vessels, multiple stones, malrotation and the low pelvic position, but pyeloplasty was done in 1 case. Though vesicoureteric reflux was observed during voiding cystourethrography in all patients, no deleterious effect on the kidney was seen during the 3‐ to 5‐year follow‐up

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06585.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Eighty‐one99mTc DTPA renograms were performed in 31 children who had previously undergone pyeloplasty for pelviureteric junction obstruction (PUJ). A post‐micturition image following a diuretic stimulus excluded obstruction in 50% of the patients in whom the frusemide T75 was abnormally prolonged beyond 10 min. Evaluating the99mTc DTPA renogram and the response to a diuretic without both changing the patient's position and ensuring an empty bladder may lead to incorrect diagnosis of PUJ obstru

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06586.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Moderate and even severe dilatation of the urinary tract in the absence of vesicoureteric reflux may remain stable or show spontaneous resolution. Two such cases are described. Twenty‐five children with dilated urinary systems were studied to correlate the radiological, isotope, pressure perfusion and surgical findings. A positive Whitaker test correlated well with the surgical findings and post‐operative improvement in renal function in all patients with pelviureteric junction (PUJ) and vesicoureteric junction (VUJ) obstruction. High flow rates of 8.6 and 12 ml are required even in neonates and infants in order to demonstrate obstruction by Whitaker te

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb06587.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY