ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16015.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—The Yorkshire Lithotriptor Centre acquired a Candela MDL‐2000 Laser Tripter and a 7.2F Miniscope in February 1990. We present the results obtained in the first 200 patients referred for treatment of ureteric stones or stone fragments.Of 175 patients who were evaluable, 58 had upper ureteric stones, 41 mid‐ureteric and 76 lower ureteric stones. Successful laser fragmentation was achieved in 77% of cases and a further 10% were rendered stone‐free by the push‐bang technique. Ureterolithotomy was required in 9% and the major complication rate was 4%. Ureteric dilatation was not used. Maximum laser energy was required to break 19% of the stones, but no stone was encountered which could not be broken.Laser lithotripsy with this system is highly effective at all levels of the ureter; it is safe and it complements ultrasound‐guided extracorporeal

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16016.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—We investigated the influence of ionic strength on both the binding ability of macromolecules onto calcium oxalate crystals and the inhibitory activity of macromolecules related to calcium oxalate crystal growth and aggregationin vitro.The amount of heparin sodium salt adsorbed onto calcium oxalate crystals was studied in both a seed and a non‐seed crystal system at various ionic strengths with the aid of radiolabelled heparin. In both adsorption models, adsorption of heparin was greater in the buffered solutions of lower ionic strength, and significantly so in the range of physiological ionic strength. The inhibitory activity of heparin in the non‐seed crystal system, which was determined using a Coulter Multisizer, increased as the adsorbed dose increased. The naturally existing urinary macromolecules showed a similar change in their inhibitory activity on calcium oxalate crystal growth and/or aggregation in accordance with changes in ionic strength.These results indicate that macromolecular inhibitory activity seems to be enhanced in urine of lower ionic strength as a result of an increased adsorption of macromolecules on the surface of calcium oxalate cry

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16017.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—This study was performed to determine urinary sulphate excretion in patients with renal stone disease. Stone formers showed a significantly higher fractional excretion of sulphate than control subjects; 80% of stone formers had fractional excretions>0.26. No significant relationship was established between increased urinary sulphate excretion and any identifiable metabolic disorder, or the recurrence rate of stone episodes.The increase in fractional excretion of sulphate appears to be a more prevalent tubular defect among stone formers than has hitherto been reporte

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16018.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—Zinc has an important place amongst inhibitors of crystallisation and crystal growth. These views are supported byin vivoandin vitrostudies which suggest that the urinary zinc level is a significant factor in urolithiasis. Some recent studies have given contradictory results.Blood serum and urinary zinc levels were measured in 30 normal healthy controls and 42 stone forming patients (renal, ureteric and vesical). Statistically significant levels were found in all groups, varying according to the number of calculi. Increased urinary zinc levels and decreased serum zinc levels appear to be secondary to the process of stone formation. The role of zinc as an inhibitor of urolithiasis is questionabl

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16019.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—If renal colic is suspected in the patient presenting with acute flank or lower abdominal pain it must be established whether or not the affected kidney is obstructed and whether there is functional impairment that may require urological intervention.The radionuclide renal study developed in this hospital and used routinely for over 10 years can reveal obstruction when the results of commonly used tests are negative. It also provides information on renal function, morphology and blood flow. It is a cost‐effective, safe and reliable procedure for the initial investigation of patients presenting with suspected renal co

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16020.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—Extensive ureteric strictures due to bilharziasis can be managed satisfactorily by reimplantation of the ureters using a Boari flap technique. A series of 150 patients with extensive ureteric strictures underwent ureteric reimplantation using this technique.Contrary to the conventional belief that patients with bilharziasis have a contracted bladder, our patients maintained a good capacity and sufficient supple tissue was available to replace even very extensive ureteric stricture

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16021.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—Videourodynamic studies were performed on 57 wet children, 35 of whom were assessed retrospectively and 22 prospectively. Thirty‐two studies (56%) were abnormal; detrusor instability or reduced compliance was found in 26, increased bladder sensitivity in 3, detrusor sphincter dyssynergia in 2 and sphincter weakness incontinence in 1. A detailed micturition history sheet and the results of routine preliminary investigations (mid‐stream urine and ultrasonography) were used in an attempt to predict the outcome of urodynamics. Since only 5 of the 25 normal studies and 18 of the 32 abnormal studies were correctly predicted, it was concluded that accurate prediction was not possible. Urodynamic investigations are therefore required to identify the underlying cause of wetting and to guide appropriate trea

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16022.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—Bladder outflow tract obstruction was produced in immature female guinea‐pigs. Obstruction caused an increase in voiding pressure and bladder weight and a decrease in bladder compliance. No change occurred in the sensitivity of obstructed detrusor strips to exogenous agonists, but the force of contraction and response to electrical stimulation of the intrinsic nerves were less than in the strips from controls. The response of strips from sham‐operated animals to exogenous agonists and to electrical stimulation was greater than that from obstructed animals. The effects of length and tension could not account for thein vitroresponses from obstructed animals. Histology after obstruction showed muscle hypertrophy, connective tissue infiltration and decrease in nerve density. Many of the changes resembled those seen in the obstructed human bl

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16023.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Summary—Forty‐seven patients with primary total incontinence underwent bladder neck reconstruction (BNR) between 1978 and 1988. This included 31 patients with exstrophy/epispadias, 14 with myelomeningocele and 2 with caecoureteroceles. The patients were divided into 5 groups based on the type of BNR: Group 1—standard Young‐Dees‐Leadbetter (YDL.) BNR; Group 2—YDL. + Silastic sheath; Group 3—modified YDL.; Group 4—Kropp BNR; Group 5—other BNRs; Group 1 included 18 patients with a 45% primary continence failure rate, a 44% reoperation rate and only a fair ability to void spontaneously after BNR. There were 11 patients in Group 3 with a 9% primary continence failure rate, a 27% reoperation rate and excellent post‐operative emptying. None of the 3 patients in Group 4 was incontinent post‐operatively, but they all required reoperation and had poor post‐operative emptying. We feel that the modified YDL BNR provides better overall voiding and continence with less morbidity than the other bladder neck/urethral re

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1993.tb16024.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY