ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04253.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Repeated measurements of serum calcium and immunoreactive parathyroid hormone were performed in 1433 renal stone formers systematically referred from Accident and Emergency Departments and from Departments of Urology and Nephrology, irrespective of their serum calcium. Primary hyperparathyroidism was found in 23 patients and confirmed in 19/20 patients who underwent neck surgery, including 8 with intermittent hypercalcaemia. Our data suggest that when selection bias is minimised, primary hyperparathyroidism is found in about 2% of renal stone formers in a western country such as Belgiu

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04254.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Fungal pyelonephritis caused byCandidaspecies andTorulopsiswithout evidence of systemic organ involvement is uncommon. Most reported cases have been in diabetic females or in patients on immunosuppressive drugs. We report 3 cases of elderly men who had fungal pyelonephritis presumed secondary to obstructive uropathy. All subsequently developed fungaemia. Two were managed successfully with percutaneous or ureteric stents and systemic antifungal therapy; the third died despite systemic amphotericin

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04255.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—The early treatment of patients with bladder cancer reduces mortality. By arranging a pre‐clinic intravenous urogram we reduced the time from receipt of the General Practitioner's referral letter to making a diagnosis from 85 to 67 days and saved on clinic time and resources. A further reduction to 52 days was made by not using any out‐patient time at all. Significant saving of time and resources is possible without any disadvantage to the pa

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04256.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Either transurethral ureteroscopy (URS) or extracorporeal Shockwave lithotripsy (ESWL) was the primary method of intervention in two series of patients presenting consecutively with stones located in the ureter distal to the radiological marking of the sacroiliac joint. Of 65 patients treated by URS, successful evacuation of the major part of the stone was achieved in 97% in one or two sessions. Of those subsequently attending for review, 93% proved stone‐free but 3% required surgery for serious complications. In the ESWL series of 53 patients, successful stone fragmentation was recorded in 94%, with 2 patients requiring a supplementary endourological or surgical procedure. No significant complications were related to ESWL and 90% of those followed up after successful ESWL proved stone‐free at 6 weeks. In uncomplicated cases, the mean procedure time for ESWL was one‐third of that required for URS and the hospital stay one‐half. It is suggested that ESWL should be the primary method of intervention in patients with distal ureteric stone, with URS reserved for the small number that prove refractory to such

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04257.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Evidence of a leaky urothelial barrier in bilharzial uropathy is presented. The ultrastructural basis of this concept is demonstrated together with its functional consequences. The study was conducted on 4 ureters obtained at surgery from patients with non‐functioning kidneys due to chronic bilharzial infections. Six normal ureters from kidney donors served as controls. Light and electron microscopic studies showed a reduced thickness of the transitional epithelium together with localised disruption of intercellular junctions and infiltration of red blood cells. The functional studies involvedin vitrodemonstration of stable phasic peristaltic contractions which were fundamentally altered by the addition of urine. The changes in motility included increase in contractile frequency and elevation of basal tone, inducing a state of hypermotility which could be equated with ureteric spasm. These changes were partly reversible upon administration of the histamine I‐blocker, mepyramine. Evidence is presented to show that these changes might be inducedin vivoby histamine released from mast cells triggered by urine leaking through a damaged urothelial barrier. The functional consequences (pain, spasm) are disc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04258.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—The evolution of a collagen/vicryl composite membrane designed as a prosthetic material for use in urinary tract surgery is described. The early experiments in which collagen film alone was used to repair experimental ureterotomies are reviewed together with our first experiments with the collagen/vicryl prosthesis in the repair of partial nephrectomies and of full thickness defects created in the urinary bladder of experimental rabbits.These early results led to the preparation of a composite using a more highly purified collagen and employing a method of sterilisation (gamma irradiation) which would be acceptable for regular use in medical products. The results of a further series of partial nephrectomy and full thickness bladder repairs show that irradiation does not compromise the efficacy of the collagen/vicryl compositein viv

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04259.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—A multidisciplinary diagnostic approach to a case of bladder carcinoma in a 19‐year‐old male smoker is presented. The transitional cell carcinoma was submitted to conventional histological examination, flow cytometry and cytogenetic analysis. Serum and urine tumour markers were also investigated. The tumour was diploid, with an increased proliferative phase, and a chromosome marker was found. A net decrease in serum and urine ferritin concentrations was noted after transurethral resection of the neoplasm and its low malignancy was confirmed at foll

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04260.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—We report a case of bladder cancer developing in a patient after renal transplantation in whom it was possible to demonstrate DNA evidence for infection of the tumour with HPV Type 11.The significance of the observation is discussed in relation to the hypothesis that immunosurveillance can control the development of malignanc

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04261.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Summary—Thirty‐six females with genuine stress incontinence (GSI) were treated by bladder neck teflon injection. Urethral pressure profilometry (UPP) and uroflowmetry were performed both pre‐and post‐operatively on 18 patients. In 24 patients who were either completely cured or improved by this procedure, the mean urine flow rate was reduced by 23% and the mean functional profile length increased by 9% compared with pre‐operative values. Although these findings appear to explain the mechanism by which teflon improves continence, these differences were not statistically significant.Fourteen of the 18 patients who had not responded to previous anti‐incontinence procedures were successfully treated by teflon injection. The improved response rate in these patients was not statistically significant. It was not possible to predict with certainty those patients most likely to respond to teflon injection. However, in women with normal or near normal pelvic floor anatomy the procedure had an acceptable success rate. In view of the simplicity, lack of morbidity and the ease with which it can be performed and repeated, bladder neck teflon injection deserves consideration as an alternative, particularly where open surgery

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1988.tb04262.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY