ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07446.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07447.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07448.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective To determine factors associated with complications in patients undergoing renal transplant biopsy.Patients and methods A total of 210 consecutive renal transplant patients biopsied for acute graft dysfunction or as part of a long term surveillance programme. Biopsies were performed under ultrasound control at two centres (Nottingham City and Leicester General Hospitals).Results Seventeen patients developed macroscopic haematuria following biopsy (8%). There were no graft losses. In cases where at least one biopsy core contained only renal medullary tissue, there was a significantly higher risk of a post‐biopsy bleed (P<0.001).Conclusion This study demonstrates that even with careful ultrasound guidance, renal transplant biopsy has an important complication rate. Every effort must be made to obtain very superficial biopsies which consist largely or exclusively of renal corte

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07449.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective To define the clinical manifestations of echinococcal involvement of the urinary tract and to propose guidelines for treatment.Patients and methods A positive diagnosis of hydatid disease was made in seven patients and in all of these the cyst was located in the kidney only. The patients included four males and three females whose ages ranged from 6 to 56 years (mean 33.3).Results Surgical treatment involved total nephrectomy in six patients and partial nephrectomy in one patient. There was no operative or post‐operative mortality and all patients were cured of the disease.Conclusion Despite its rarity, hydatid disease should be considered in the differential diagnosis of space‐occupying lesions of the urinary tr

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07450.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective To study the properties of lymphokine‐activated killer (LAK) cells and the effect of immunotherapy with a combination of autologous LAK cells and interleukin‐2 (IL‐2) [LAK therapy] in 10 patients with metastatic renal cell carcinoma (RCC).Materials and methods The LAK cells were generated from peripheral blood lymphocytes (PBL) by incubation in a serum‐free medium (AIM‐V) supplemented with IL‐2 for 4 days and killer cells were administered intravenously twice a week. The LAK cells showed cytotoxicity against allogenic RCC cell lines and augmented NK and LAK activities. Their phenotypes were CD25‐, HLA‐DR+, CD3+, and CD16+. Furthermore, LAK cells released IFN‐γ, IL‐1β and TNF‐α. The total number of LAK cells administered ranged from 3.8 × 109to 52.6 × l09cells and the total amount of IL‐2 ranged from 150 times 105to 900 times 105U. The effect on pulmonary metastasis in response to LAK therapy was studied.Results The outcome was complete response (1), partial response (1), minor response (2), no change (4) and disease progression (2). Toxic effects were transient and no serious side‐effects occurred. Evaluation of host immune parameters indicated that a clinical response was expected in patients with increasing proportions of CD16‐, CD25+, CD57+, HLA‐DR+ and CD3+ DR‐cells among PBL and with augmentation of NK and LAK activities. Brain metastases were detected in three patients during or after treatment.Conclusion LAK therapy appears to be effective in treating some patients with RCC and pulmonary metastasis. The potential for inducing brain metastasis, h

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07451.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective To develop a ureteric retrieval net with advantages over existing stone retrieval methods.Materials and methodsIn vitroexperimental trials comparing the ureteric retrieval net with Dormia baskets were performed with porcine ureters and artificial calculi placed in a proximal or distal position.Results For removing a single, large stone (9 times 6 × 5 mm) the net was slightly better than baskets (100% versus 90%) and it was significantly (P<0.001) more effective for removing multiple small stones (2 times 2 × 3 mm to 5 times 4 × 3 mm) in one pass (76% versus 40% with three distal stones; 73% versus 13% with three proximal stones; and 53% versus 3% with six proximal stones).Conclusion This newly developed ureteric retrieval net has a compact design, resulting in minimal resistance during retraction. Its smooth hydrophilic outer surface enhances scooping properties against the luminal wall. The mesh is similar to that in nylon stockings — porous enough to allow flow, yet small enough to capture fragments. It can capture numerous small fragments with one scoop, but can easily disengage them if extraction is not possible. The loop encompasses the entire lumen with the ‘pusher’ offset to a side wall, allowing maximal space and visualization, and the device can dilate the ureter to facilitate extraction. Clinical studies are in progress to evaluate the full potential of this ne

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07452.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective To determine the factors affecting the success of retrograde manipulation (RM) of upper ureteric stones.Patients and methods A total of 601 patients with upper ureteric calculi underwent attempted RM. In 216 patients, RM was performed irrespective of the respiratory phase, stone characteristics and ureteric anatomy (group 1). In the remaining 385 patients RM was performed at the height of expiration (group 2). Patients with large or impacted stones, ureters with a fusiform or funnel shape appearance on urography and grade IV hydronephrosis were not included in group 2.Results The success rate was significantly greater in group 2. The rates of fever and perforation in groups 1 and 2 were 6.9/2.3% and 3.2/0.2% respectively. The incidence of residual fragments was also less in group 2.Conclusion RM at the height of expiration is associated with a higher success rate and lower complication rate.

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07453.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective To study the clinical, histological, and immuno‐histochemical findings of small cell carcinoma (SCC) of the urinary bladder, and also to delineate its behaviour in comparison with transitional cell carcinomas of the bladder.Materials and methods A retrospective review of 552 patients with bladder cancer yielded six cases (1%) of small cell carcinoma which were histologically identical to pulmonary small cell anaplastic carcinoma. Clinical data and follow‐up were collected. Aside from the conventional histological parameters, an immunohistochemical study with AE1–AE3 and Cam 5.2 keratins, epithelial membrane antigen, neuron‐specific enolase, chromogranin, synaptophysin, ACTH, calcitonin, and prostatic specific antigen was performed.Results The clinical presentation did not differ from conventional transitional cell carcinoma, haematuria being the most frequent complaint (four cases). All the cases presented as flat tumours. On light microscopy, there were oat cell (four cases), intermediate (one case) and mixed oat‐cellJintermediate (one case) variants. Three cases were associated with transitional cell carcinoma. Dysplastic changes were observed in the adjacent urothelium in one case only. At the time of diagnosis, all tumours were deeply invasive (pT3). Three cases were Stage III and three Stage IV, with involvement of regional lymph nodes and metastases to the liver (two cases) and lung (one case). Immunohistochemically, epithelial markers were variably expressed as AE1‐AE3 keratin (5J6), Cam 5.2 keratin (2/6) and epithelial membrane antigen (3/6). Neuron specific enolase was demonstrated in every case. Chromogranin, however, was expressed in only one case. Synaptophysin, ACTH, calcitonin, and prostatic specific antigen all gave negative results. All the patients died of the disease and the overall length of survival was very poor (range 5–2 5 months, mean 13.3).Conclusion Small cell carcinomas show the same histological patterns as their pulmonary counterpart. Immunohistochemistry reveals a wide spectrum of activity, enolase and keratins being the most constant. The present study confirms that the overall prognosis of this tumour

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07454.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective To study the results of transverse colon conduit urinary diversion in patients receiving very high dose pelvic irradiation (≥ 65 Gy).Patients and methods Records were reviewed for 30 such patients who underwent transverse colon conduit as a primary form of urinary diversion between January 1986 and June 1992. Most of the conduits were constructed using refluxing ureterocolic anastomoses with stents.Results There was no operative mortality. Although the procedure was associated with a complication rate of 37% and a re‐operation rate of 20%, there were no bowel or urinary anastomotic leaks. The operation could be safely performed on patients with renal failure, with 83% of such patients showing normal or improved serum creatinine levels post‐operatively.Conclusion The advantages of transverse colon conduit urinary diversion are the use of non‐irradiated bowel and ureters for diversion. We recommend it as a primary form of urinary diversion in these high ris

ISSN:0007-1331    

DOI:10.1111/j.1464-410X.1994.tb07455.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY