ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07592.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Sir Henry Thompson was a gifted Victorian. As a surgeon he achieved early recognition by successfully removing King Leopold of Belgium's bladder stone where two other eminent surgeons had failed. He was undoubtedly the most famous surgeon of his age, a position he was to occupy for some 30 years. As well as professional eminence he achieved success in an extraordinarily wide range of endeavours. He was an accomplished artist, exhibiting 1 2 times at the Royal Academy, a connoisseur and collector of china, a keen astronomer, an authority on diet and cooking and a pioneer advocate of cremation. He was interested in poultry‐farming, market‐gardening and photography. He published two novels sandwiched between a book on tumours of the bladder and another on the prevention of calculous disease, He was a celebrated host and his dinners ‐ called ‘Octaves’ ‐ at which he served eight courses to eight guests were legendary. To be invited meant one had ‘arrived’. He was friendly with artists, scientists and men of letters ‐ Huxley. Browning, Ray Lankester and Thackeray. At the age of 80 he bought himself a motor‐car and 2 years later wrote a book on the anatomy of the motor‐car engine. Sir Zachary Cope described him as a versatile Victorian, a fitting description of an extra‐ordinarily gifted man. A commanding and slightly intimidating figure with little sense of humour, he achieved distinction in professional, artistic and social circles. Not only did he leave his mark on urology he left his ma

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07593.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo review the records of patients with suspected urinary tract trauma to determine whethe reliminating imaging studies would have missed any significant injuries.Patients and methodsThe records of 1103 consecutive patients who underwent radiographic evaluation of the urinary tract because of suspected renal trauma were evaluated retrospectively. A comprehensive review was made of the group of patients who were normotensive and had only microscopic haematuria.ResultsAbnormal intravenous pyelograms (IVP) were found in 10% of patients with normotension and microscopic haematuria. In patients with injuries due to penetrating trauma, five of 16 with an abnormal IVP required operative intervention, while in patients with injuries due to blunt trauma, only one of 60 had a significant renal injury. None of the 605 patients with a blunt injury, microscopic haematuria, no his‐ tory of hypotension, and no significant associated injuries required operative intervention solely for the renal injury. Conclusion Radiographic evaluation of the urinary tract is recommended for all patients with penetrating trauma and any degree of haematuria, but only for patients with blunt trauma if associated with gross haematuria, microscopic haematuria and hypotension, or microscopic haematuria and significant associated injurie

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07594.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo assess the significance of immunosuppressive acidic protein (IAP) for detection of renal cell carcinoma in patients undergoing haemodialysis.Patients and methodsThe serum concentration of both IAP and creatinine was measured in 74 patients undergoing haemodialysis, 10 of whom had renal cell carcinoma and 64 of whom had no renal cell carcinoma. Control data was obtained from 13 healthy blood donors.ResultsThe serum IAP level of patients undergoing haemodialysis was significantly elevated compared with that of the controls. The serum level of IAP inpatients with renal cell carcinoma who were undergoing haemodialysis was also considerably higher than that of patients with no renal cell carcinoma. The serum creatinine levels were not significantly different between patients with and without renal cell carcinoma but were significantly elevated when compared with the controls.ConclusionThe measurement of serum IAP concentration is of value in the detection of renal cell carcinoma in patients undergoing haemodialysis.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07595.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo produce an index of lithogenic risk which identifies patients at risk of stone recurrence and facilitates the monitoring of prophylactic treatments.Patients and methodsThe EQUIL2, program provides an evaluation of the state of urinary saturation, particularly of calcium oxalate, based on the pH and total concentrations (mmol/l) of sodium, potassium, calcium, magnesium, uric acid, chloride, ammonium, citrate, phosphate, sulphate, oxalate, pyrophosphate and carbon dioxide. The morning urinary calcium oxalate saturation coefficient was thus calculated for 30 stone‐formers (Group 1) and 30 normal control subjects (Group 2).ResultsUrine from the majority of individuals was saturated, with no significant difference between the two groups. There appeared to be a correlation between the state of saturation and the urinary calcium oxalate molar product in both stone‐formers (r =0.931) and controls (r=0.914).ConclusionIn future studies on urinary calcium oxalate saturation, it should be possible to supplement the sophisticated coefficient determined by the EQUIL, program with the molar product, except in cases where monitoring therapies have little or no effect on urinary oxalate or urinary calcium lev

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07596.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo assess the efficacy of alkali citrate therapy in patients suffering from recurrent idiopathic calcium oxalate stone formation.Patients and methodsFifty patients suffering from active stone formation who had had at least one stone annually over the previous 3 years were recruited and randomly divided into two groups. They were given either general prophylactic instructions, i.e. abundant liquid intake and dietary restrictions (group I, n = 25) ‐ or were additionally treated with alkali citrate (group 11, n=25).ResultsIn group I, the rate of stone formation was reduced from 1.8 to 0.7 stones per patient per year. Similar results were obtained for group 11, the corresponding figures being 2.1 and 0.9. There was a statistically significant higher urinary citrate excretion in group I1 than in group I. No difference was seen between the two groups regarding recurrent stone formation (Student's t‐test). Stone formation decreased in both groups (group I 27% group I1 31%). Subjectively, 56% of group I1 patients, all of whom had previously experienced severe colic, reported spontaneous stone elimination to be painless, whereas in group I all but one patient suffered pain.ConclusionAn objective benefit of alkali citrate could not be establis

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07597.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo assess the efficacy of radiographer performed ultrasound examination as a routine investigative procedure in a urological out‐patient clinic.Patients and methodsA total of 151 patients attending a District General Hospital Urological Out‐patient Department underwent an ultrasound examination in the clinic.ResultsDiagnosis by ultrasound was achieved in 93% of patients. The remaining patients underwent further investigations. Two (1%) patients with normal scans had small bladder tumours. Subsequent intravenousurography in these individuals showed normal upper tracts.ConclusionAbdominal and pelvic ultrasound examination performed in the urological out‐patient clinic on unprepared patients was the only investigation necessary for evaluation of common problems such as non‐specilk urinary symptoms, recurrent urinary tract infections and bladder outlet obst

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07598.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo study, using a rat model, the tissue reaction in response to the migration of particulate plastics injected into the lungs and subcutaneous sites.Materialsand methods A total of 50 rats were included in the study. Histological examination of 30 rats was carried out up to 6 months after the subcutaneous injection of 0.1 ml of either Polytef or Bioplastique. Specimens from a further 18 rats underwent histologi‐ cal examination up to 3 months after the intravenous injection of 0.01 ml of either Polytef or Bioplastique. Two rats were injected with normal saline to act as controls. Representative sections of multiple organs were taken from each animal.ResultsNo systemic migration from the site of initial implantation was detected. This may have been due either to the animal used or to the limited number of sections taken. However, the intravenously injected plastics were found adjacent to the pulmonary arterioles 3 months after injection. The histological reaction at the local injection and lung sites was similar, with the giant cells being larger and the degree of fibrosis greater for Bioplastique than for Polytef.ConclusionThe histological reaction to Polytef and Bioplastique was similar in both the subcutaneous and lung sites. No migration or malignant change was see

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07599.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo describe trends in deaths from prostate cancer between 1970 and 1990, and trends in registrations of prostate cancer between 1971 and 1986.MethodsData on prostate cancer deaths and registrations were obtained from the Office of Population Censuses and Surveys, and age specific rates were calculated.ResultsThe number of deaths from prostate cancer rose by 107% between 1970 and 1990, from 3906 to 8098. The number of registrations of prostate cancer rose by 75% between 1971 and 1986, from 5819 to 10 180. Age‐specific death rates and registration rates also increased but by a smaller amount than the rise in absolute numbers.ConclusionsA component of the increase seen in both the number of prostate cancer deaths and registrations can be explained by a concomitant increase in the elderly male population, the group at highest risk, but the rises seen in rates are more difficult to explain, The rises are likely to have had considerable implications for the workload of urologists and should be taken into account when planning future health services. With further increases expected over the next decade in the elderly male population, deaths and registrations from prostate cancer will continue to rise. Research will be required to determine possible reasons for the increase seen in prostate cancer rates over the last 20 years, to determine the true incidence and prevalence of prostate cancer in the general population and to identify possible aetiological factor

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07600.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ObjectiveTo evaluate the role of tobacco and alcohol consumption in the aetiology of prostate cancer.Patients and methodsIn a case‐control study conducted in the Netherlands, information on smoking and drinking habits was obtained from questionnaires completed by 345 patients exhibiting primary prostate cancer and by 1346 controls with benign prostate hyperplasia. The response rate was 79%.ResultsNo association was observed between drinking habits and the risk of prostate cancer (324 cases versus 123‐7 controls; odds ratio 1.36; 95%CI 0.84‐2.22). A significantly elevated odds ratio was found for individuals who had smoked at any time during their lives (329 cases versus 1212 controls: odds ratio 2.12; 95%CI 1.24‐3.62). However, no relationship was observed between the number of cigarettes smoked, the duration of smoking, the age at which the subjects started smoking or with the calendar period in which they were born. Odds ratios calculated for individuals who smoked in consecutive 5‐year periods between 1940 and 1989 did not show any trend. Furthermore, the risk of prostate cancer among ex‐smokers did not differ significantly from the risk among current smokers, even when smoking was stopped more than 25 years previously.ConclusionFrom these findings, which do not point to the causative agent, it would appear that neither smoking nor alcohol consumption seriously increases the risk of pros

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07601.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY