摘要:

Summary—The value of dynamic CT scanning for staging renal carcinoma was studied prospectively in 28 patients and the results compared with those of ultrasonography, arteriography and conventional CT. Arteriography correctly staged 48% of tumours; ultrasonography and conventional CT correctly staged 50% and dynamic CT correctly staged 72%.Dynamic CT staged renal carcinoma more accurately than ultrasonography, conventional CT or arteriography and it is suggested that arteriography should be restricted to specific indications such as the mapping of arterial anatomy and therapeutic renal artery embolisatio

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb05999.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The treatment of metastatic renal carcinoma is still unsatisfactory because of the lack of effective systemic therapy. In 14 patients with metastatic renal carcinoma an attempt was made to influence the course of the disease by administration of recombinant human interferon (rHu‐IFN) gamma; 9 patients were evaluated after treatment.There was partial remission in 3 patients, stable disease in 2 and tumour progression in 4. The cyclic application of rHu‐IFN at a dose of 0.25 mg/day for 8 days, with treatment‐free intervals of 3 to 4 weeks, was tolerated well. Side effects consisted mainly of fever and leucocytopenia. From this small series it seems that cyclic IFN gamma treatment might be helpful in some cases of metastatic renal ca

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06000.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—Despite advances in radiological imaging techniques, the ideal management of antenatally diagnosed hydronephrosis remains controversial. A map, showing diagnostic and management pathways, has been designed in an attempt to provide maximum information from the most appropriate and minimum number of investigation

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06001.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The degree of infection and the urographic picture was correlated to the presence and level of circulating immune complexes (CICs) in 69 patients affected by urinary schistosomiasis. Patients were divided into 2 groups: those eliminating less and those eliminating more than 25 eggs/10 ml of urine. Radiological changes in the urinary tract were present in 67% of patients, the most frequent finding being single or multiple filling defects in the bladder. CICs were present in 39 patients. A positive correlation was found between the presence and level of CICs and the output ofSchistosoma haematobiumeggs, as well as between the presence of CIC and single or multiple filling defects of the bladder.Our findings indicated that CICs were present in patients with urinary schistosomiasis, but the different incidence in patients with a large egg output and radiological filling defects suggests a possible pathogenic role only in the earlier phase of the infectio

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06002.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—Conventional treatment of enteric hyperoxaluria (EHO) consists of dietary restriction of oxalate and fat and correction of its underlying cause whenever possible. Recent work suggests that allopurinol reduces the incidence of urolithiasis and the urinary excretion of both oxalate and uric acid in patients without intestinal disease. We have assessed the effect of allopurinol, 300 mg daily for 2 weeks, on urine biochemistry in patients with EHO due to small bowel Crohn's disease and/or resections. Compliance with treatment was confirmed by a fall in plasma uric acid in every patient. Allopurinol failed to alter 24 h urinary oxalate excretion or oxalate concentration. There were also no significant changes in the urinary excretion of glycollate (like oxalate, a breakdown product of glyoxylate), citrate, magnesium or calcium, each of which was at the lower end of the normal range before and during treatment with allopurinol. It appears unlikely that allopurinol will prove useful in the prevention of urolithiasis in patients with EH

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06003.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—The inhibitory capacity of pyrophosphate, citrate, magnesium and chondroitin sulphate was investigated, using the urine of 21 calcium oxalate stone‐forming patients without metabolic alterations. The inhibitory effect of these substances was assessed by a combination of nephelometry (light scattering) and optical microscopy. The results showed that citrate and magnesium had an inhibitory effect in a significant number of cases. Pyrophosphate and chondroitin sulphate had a less marked effect. The main urinary lithogenic biochemical parameters of the patients were also studied to see if there was a relationship between them and the inhibitory capacity of the compou

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06004.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—A study was made of 16 patients who developed renal failure secondary to ureteric obstruction by tumour. All were managed by percutaneous nephrostomy inserted under local anaesthesia. The results in terms of recovery of renal function, subsequent management and long‐term outcome are descri

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06005.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—Beta human chorionic gonadotrophin (βHCG) was measured in 127 urine and 85 serum samples from 175 untreated patients with urothelial cancer. Serum levels of βHCG were substantially elevated in 16 of 21 patients (76%) with widespread metastases but in only 2 of 64 patients (3%) with disease confined to the pelvis. Urine βJHCG levels were moderately raised in 11 of 25 patients (44%) with locally advanced disease, but greatly elevated in 5 of 7 patients (71%) with metastases. Measurement of serum and/or urine βSHCG appears to be an efficient diagnostic marker for the presence of distant metastases in bladder carc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06006.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—A series of 76 bladder tumours was studied using a panel of 5 anti‐human leucocyte monoclonal antibodies (mAb): anti‐pan‐leucocytes (SLC1), anti‐T lymphocytes (ST1), anti‐B lymphocytes (SB3), anti‐macrophages (PHM2) and anti‐granulocytes (WEMG1). The DNA content and the expression for each mAb were measured in separate samples with flow cytometry. The importance of local inflammatory reaction was measured objectively according to tumour grade. These cells formed 41, 32 and 31% of the total cell count for grade I, II and III tumours respectively. The percentage of each leucocyte population according to grade I, II or III was as follows: 8, 5 and 6% respectively for T‐lymphocytes; 3, 3 and 4% for B‐lymphocytes; 10, 7 and 6% for granulocytes; 17, 18 and 24% for macrophages. No relationship was found between mAb expression and DNA content of tumours. This study demonstrates the importance of the inflammatory reaction in bladder tumours and the preponderance of cells expressing a macrophage phenotype. In a flow cytometry study, leucocytes may mask the presence of a minor group of urothelial tumour cells with an elevated DNA content associated with a poor prognosis; on the other hand, host leucocytes within a tumour could be used as an internal reference for precise measurement of the DNA cont

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06007.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Summary—A series of 71 patients with muscle invasive bladder cancer received a median of 3 cycles (range 1–6) of methotrexate, vinblastine, Adriamycin and cisplatin (M‐VAC). Efficacy assessed by transurethral resection alone showed that 48% of patients were TO, 13% Tis and 54% had normalisation of initially positive urinary cytology after treatment. However, when considering transurethral resection of the bladder (TURB), cytology and non‐invasive procedures (CT scan and/or ultrasound), only 21% had a clinical complete remission (cCR); 48 patients (68%) had pathological evaluation and 13 (27%) were PO after treatment. Non‐responding patients had a poor prognosis: 14/30 (47%) developed metastatic disease and 13 died. In assessing the primary lesions, clinical understaging was significant. Of 15 patients who were TO cystoscopically prior to surgery, 6 (40%) had residual disease in the pathological specimen, including 4 with muscle infiltration; 23 patients (32%) remained clinically staged, only 8 of whom remain disease‐free. With a median follow‐up of 24 months (range 2–42+), 41 patients are alive and disease‐free, including 20 with a functional bladder. The large staging error raises questions concerning studies using clinical rather than pathological endpoints as the sole cri

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1989.tb06008.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY