摘要:

The long‐term survival of children with congenital urological abnormalities is now taken for granted. In general, they have been found to grow up well after many operations and often in the face of considerable handicaps. Their survival carries with it numerous complications, the most frightening of which is the development of cancer. Successful treatment of congenital abnormalities does not excuse the patient from developing cancers to which the general population is prone, but some conditions and some treatments raise specific risk

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15785.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—A number of patients with medullary sponge kidney recurrently form and pass stones with the risk of developing an obstructive nephropathy. These patients may benefit from extracorporeal shock wave lithotripsy to the medullary collections, as this appears to reduce the frequency of symptomatic stone passag

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15786.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—Struvite (MgNH4PO46H2O) crystals were produced byProteus mirabilisgrowth in artificial urine, in the presence and absence of the urease inhibitor, acetohydroxamic acid (AHA). In the absence of AHA, struvite crystals assumed an “X‐shaped”or dendritic crystal habit due to rapid growth along their 100 axis. When AHA was present, crystal growth, as monitored by phase contrast light microscopy, was greatly slowed, and the crystals assumed an octahedral crystal habit. Scanning electron microscopy revealed that crystals grown in the presence of AHA were pitted on their surface. This pitting was absent in control samples. While most of this inhibition by AHA was due to lowered urease activity, some crystal growth inhibition occurred in struvite produced in the absence of urease activity through NH4OH titration of artificial urine. We conclude that while AHA is primarily a urease inhibitor, it may also disrupt struvite growth and formation directly through interference with the molecular growth processes on crystal s

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15787.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—A series of 23 confirmed cases of pyonephrosis initially treated by percutaneous nephrostomy drainage were reviewed. Presentation was extremely variable, ranging from sepsis to asymptomatic bacteriuria. Fever, flank pain and leukocytosis were often absent. Ultrasonography was diagnostic in only 3 of 12 patients. In all, 17 patients had associated nephrolithiasis, and 5 patients ultimately required nephrectomy. Renal urine cultures were positive in 16 of 21 instances, with multiple organisms found in 8 of 21, and added bacteriological data not provided by bladder urine cultures in 11 cases. A pre‐existing history of urinary tract infection, hypertension and malignancy was common. Percutaneous drainage was a safe, quick and effective diagnostic and therapeutic met

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15788.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—DNA ploidy and S‐phase fraction (SPF) were measured by flow cytometry on 381 paraffin blocks from 93 unselected primary renal parenchymal adenocarcinomas (RPA). The results were compared with tumour grade and T category and patient survival, with a mean follow‐up of 87 months. Only 21% of the tumours were uniformly diploid and ploidy was heterogeneous in 49% of cases. DNA ploidy and SPF were significantly associated with grade, but not T category of disease. Both flow cytometric parameters were significantly related to survival in a univariate analysis. However, when tumour grade was taken into account, both DNA ploidy and SPF lost their prognostic significance. Thus, neither of these parameters gave prognostic information additional to that provided by tumour grade in unselected cases of primar

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15789.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—The density of subepithelial, presumptive sensory nerves in the bladder wall was assessed in 21 women with idiopathic detrusor instability and compared with the density of these nerves in 21 asymptomatic women, using a point‐counting technique on sections of bladder biopsies stained for acetylcholinesterase activity. The mean value (± S.E.) for the amount of such nerves in patients with detrusor instability (91 ± 13/mm2) was significantly greater than that from the control group (61 ±7/mm2). This suggests that a relative abundance of subepithelial sensory nerves may serve to increase the appreciation of bladder filling, giving rise to the frequency and urgency of micturition which are characteristic of patients with detrusor insta

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15790.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—This is the first investigation of alterations in the innervation of the obstructed human bladder by nerves containing neuropeptides. The patient groups studied were those with stable detrusor function, those with unstable detrusor function, and those presenting with acute retention of urine. Specimens of bladder tissue were taken from the lateral wall of the bladder below the peritoneal reflection. A total of 23 patients was studied (control, n = 4; acute retention, n = 5; stable obstruction, n = 5; unstable obstruction, n = 9). Substance P, calcitonin gene‐related peptide and vasoactive intestinal polypeptide levels in the bladder were quantified by immunoassay. The density of innervation of the bladder detrusor by nerves containing these neurotransmitters and by those containing neuropeptide Y and somatostatin was assessed using both semiquantitative and quantitative immunohistochemical techniques.A reduction in the density of innervation by vasoactive intestinal polypeptide, calcitonin gene‐related peptide, substance P and somatostatin‐immunoreactive but not neuropeptide Y‐immunoreactive nerve fibres was shown in the obstructed bladder. These findings, combined with the significant reduction in substance P content of the obstructed bladder and in particular of the acute retention bladder, indicate that there may be an afferent nerve dysfunction resulting from prostatic bladder outflow ob

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15791.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—Over a 2‐year period, 31 patients underwent prolonged hydrostatic bladder distension for benign and malignant bladder disease in this unit. Of these, 29 patients had benign functional disorders or bladder contracture, and in 2 patients hydrodistension was performed for complications of treatment for bladder neoplasia. Of the 29 patients with benign disease, 6 observed marked improvement and 8 some improvement in their symptoms, and 12 received no benefit. Patients with detrusor hypersensitivity fared better than those with detrusor instability or interstitial cystitis. A patient with malignant bladder disease died soon after the procedure as a result of a myocardial infarction. Problems attributed to the hydrostatic balloon catheter were responsible for 2 failures. The regional anaesthetic technique failed to provide adequate anaesthesia for hydrodistension in 9 procedures and limited the duration to 2 h in 13 others. Following recall of the perished balloon catheters by the manufacturer, and the introduction of continuous spinal anaesthesia, the number of technical failures has been reduced. This technique still has an important role to play in the relief of severe symptoms unresponsive to medical treatment, but it is important that ideal conditions are provided for hydrodistension in order to ensure maximum success, particularly when the alternative is major surg

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15792.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—Six women were identified as having difficulty in voiding or complete urinary retention due to abnormal myotonic‐like electromyographic (EMG) activity in the striated muscle of the urethral sphincter. An attempt was made to improve voiding by injection of botulinum toxin into the striated sphincter muscle. Although 3 patients then developed transient stress incontinence, demonstrating that sufficient botulinum toxin had been given to cause sphincter weakness, no patient had significant symptomatic bene

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15793.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Summary—Diabetic cystopathy (DCP) is a well known complication in diabetes mellitus (DM). In the present experimental study, DM was induced in rats by streptozotocin and DCP was confirmed on cystometry.In vitrostudies on detrusor strips from diabetic rats showed an increased contractile response to substance P (SP) compared with controls, indicating denervation supersensitivity. A decreased response to capsaicin in diabetic detrusor strips indicated a decreased neuronal content of SP or a diminished number of SP‐containing sensory nerves. This suggests that DM induces alterations in nerves containing SP which may be at least partly responsible for sensory loss and the development of

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1992.tb15794.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY