bluuebunny/crossref_metadata_2025 huggingface dataset:
The real‐life practice of acute inpatient mental health nurses: an analysis of ‘eight interrelated bundles of activity’
Authors: Deacon Maureen , Fairhurst Eileen
Published: November 2008

This study focuses on nursing in an inpatient mental health setting. Its analytic structure follows from a previous review of nursing studies by Allen, which did not include studies of mental health nursing. Allen's review concluded that the nurses’ role could be understood as that of healthcare intermediary and that nurses’ work could be analysed as eight interrelated bundles of activity. These bundles include such matters as managing the work of others. This study aims to assess the fit of this model to mental health nursing and to add to the body of work concerning the social organisation of nursing. The research materials discussed are derived from an ethnography of a psychiatric unit. The analytic framework employed leads us to conclude that the work of mental health nurses can be understood, too, as that of the healthcare intermediary. However, one bundle is found to fit less well and this is attributed to the fragile uncertainty of knowledge in psychiatry. The use of an additional bundle to describe in‐context nursing interventions is suggested. It is argued that getting to grips with the reflexive relationship between individual patient care and the social organisation in which this is practised is essential for any practice development efforts.
Sensitivity of rapid immunoassay for influenza A and B in the early phase of the disease
Authors: Watanabe Masahiro , Nakagawa Naoko , Ito Masahiro , Ihara Toshiaki
Published: November 2008

Background:  Immunochromatography (IC) tests are often used for the rapid diagnosis of influenza. Once influenza is diagnosed, an anti‐influenza drug can be administered. Physicians claim, however, that they are not sufficiently sensitive, especially in the early phase of the disease. The aim of the present study was therefore to analyze the sensitivity of the IC test from the standpoint of virology.

Methods:  To evaluate the sensitivity of the IC test statistically, 736 nasopharyngeal specimens were subjected to the IC test and virus isolation (VI). The IC test (+) specimens were compared with VI (+) specimens in the early phase after fever onset. Amounts of the virus in IC(–)VI(+) specimens were compared with those in IC(+)VI(+) specimens on real‐time reverse transcriptase–polymerase chain reaction. The isolated viruses from these specimens were subjected to the IC test at the same dose. The nucleotide sequences of NP genes were compared.

Results:  The IC test was less sensitive for diagnosis in the early phase of the disease. Amounts of virus were significantly lower in IC(–)VI(+) specimens than in IC(+)VI(+) specimens. No variations were observed in the isolated viruses.

Conclusions:  The IC test is not sufficiently sensitive owing to the low amount of virus in the nasopharyngeal tract in the early phase of the disease. Influenza should be diagnosed on the basis of clinical symptoms within 1 day after the fever onset.
Changes in salivary and fecal secretory IgA in infants under different feeding regimens
Authors: Maruyama Kazuo , Hida Masatoshi , Kohgo Toshiaki , Fukunaga Yoshitaka
Published: November 2008

Background:  One of the causes of food allergy in infancy is assumed to be immunological immaturity of the intestinal tract. The purpose of the present study was to examine changes in salivary and fecal secretory IgA (sIgA) levels in infants under different feeding regimens to evaluate the immunological maturity of the intestinal tract.

Methods:  Thirty‐four infants were enrolled at the beginning of the study, and 28 of them were followed up to 12 months of age. sIgA was measured on enzyme‐linked immunosorbent assay. Changes in the levels of salivary and fecal sIgA during the first 12 months of life were compared among formula‐fed infants (F group), breast–formula‐fed infants (BF group) and breast‐fed infants (B group).

Results:  Salivary sIgA was detected in almost all neonates on the day of birth. Salivary sIgA was significantly higher in the F group than in the BF group at the age of 2 months (P < 0.05). Fecal sIgA appeared from day 2 and rapidly increased at 1 month of age in all groups. B group infants had significantly higher level of fecal sIgA than F group infants at 1 month of age (P < 0.05).

Conclusions:  The level of salivary sIgA hardly changed, whereas fecal sIgA was significantly influenced by intake of breast milk.
Involvement of the human thalamus in relational and non‐relational memory
Authors: Soei Eleonore , Koch Benno , Schwarz Michael , Daum Irene
Published: November 2008

Damage to the human thalamus has been associated with selective anterograde recognition memory impairments. Recently, recognition memory has been subdivided into relational and non‐relational memory. The aim of the present study was to assess the potentially differential involvement of the human thalamus in relational and non‐relational memory. Ten patients with focal ischemic thalamic lesions were compared to individualized control groups of healthy subjects matched to each individual patient on age and IQ. Six patients showed poorer relational memory than their respective control samples. None of the 10 patients showed a significant deficit on the non‐relational memory task. These observations suggest an involvement of the thalamus in relational memory, and are discussed in terms of disruption of mediotemporal‐thalamic and thalamic‐fronto‐striatal circuits.
Impact of anesthetic agents on cerebrovascular physiology in children
Authors: SZABÓ ELÖD Z. , LUGINBUEHL IGOR , BISSONNETTE BRUNO
Published: November 2008

The role of the pediatric neuroanesthetist is to provide comprehensive care to children with neurologic pathologies. The cerebral physiology is influenced by the developmental stage of the child. The understanding of the effects of anesthetic agents on the physiology of cerebral vasculature in the pediatric population has significantly increased in the past decade allowing a more rationale decision making in anesthesia management. Although no single anesthetic technique can be recommended, sound knowledge of the principles of cerebral physiology and anesthetic neuropharmacology will facilitate the care of pediatric neurosurgical patients.
Double Bladder with Complete Sagittal Septum: Diagnosis and Treatment
Authors: TACCIUOLI M. , LAURENTI C. , RACHELI T.
Published: November 2008

A case of double bladder with complete sagittal septum in which the excluded bladder and septum were removed (together with the silent kidney and ureter) is described.

Long‐term follow‐up has confirmed the success of the operation.

Cases of this rare malformation reported in the literature are reviewed and diagnosis and therapy are discussed.
Instructions to Authors The Role of Angiography in Diagnosis and Management of Blunt Renal Trauma
Authors: LIPSKY H. , PETRITSCH P. , SCHREYER H.
Published: November 2008

In a series of 223 patients with blunt renal injury, 40 patients underwent angiography. From this experience the following conclusions have been drawn:

If a renal injury is suspected the IVP must be done as soon as possible. In most cases the diagnosis can be confirmed.

Mild injuries should be managed conservatively and therefore need no angiography.

In life endangering injury there is no time for angiography. The operation should be done preferably by a transperitoneal approach to allow good control of the renal pedicle.

Patients with severe injuries should undergo angiography. If there is no function on the IVP, angiography should be done immediately to diagnose possible arterial thrombosis. In most cases angiography can be carried out some days after the trauma. This investigation provides an exact diagnosis and helps in deciding about further treatment.

If a major part of the kidney has no blood supply, or there is a rupture with a large perirenal extravasation of urine, we recommend conservative surgery to avoid early and late complications. All operations should be done some days after the trauma.

All patients with renal injuries, either operated or conservatively managed, should be carefully followed up.

Angiography should be done in all cases of post‐traumatic hypertension.
The Place of Partial Nephrectomy in the Management of Renal Calyceal Calculi
Authors: MARSHALL V. R. , SINGH M. , TRESIDDER G. C. , BLANDY J. P.
Published: November 2008

In 416 patients with renal and ureteric calculi other than large staghorns we found that when it was possible to identify the calyx of origin of the stones, the lower poles were involved in 36·6% of males and 40·4% of females.

In the follow up of the 115 lower poles originally containing stones the recurrence rate was 17 % in those who were merely observed, 56% in those treated by pyelo‐ or nephrolithotomy, and zero in those treated by partial nephrectomy. But when these cases were looked at more closely it was found that recurrences were virtually confined to lower poles which had originally harboured more than one stone, while in those with single stones to start with, the recurrence rate was not significantly different in either of these three groups.

Partial nephrectomy should therefore be reserved for selected cases where the stones are originally multiple, or where the lower pole has been severely damaged. It is not necessary for small and single calyceal calculi.
A Simple Classification of Wide Ureters
Authors: WHITAKER ROBERT H. , JOHNSTON J. H.
Published: November 2008

A simple classification of abnormal ureters is presented which categorises the ureters according to the presence or absence of 3 factors, namely reflux, bladder outlet obstruction and ureteric obstruction. It has been devised to try to rid the literature of many confusing and obsolete terms and it is hoped that this new classification may become internationally accepted.
The Actions of Prostaglandins on the smooth muscle of the Human Urinary Tract in vitro
Authors: ABRAMS P. H. , FENELEY R. C. L.
Published: November 2008

14 experiments, 10 on bladder muscle strips and 4 on samples of ureteric muscle, were performed to examine the actions of 4 prostaglandins (PGE, PGE2, PGF1α and PGF2α) on these tissues. Each of the prostaglandins caused bladder muscle to contract and prostaglandin F2α was the most potent in this respect. The F series prostaglandins also caused increased ureteric muscle contraction whilst those of the E series inhibited contractions. It is likely that contraction is produced by the direct action of prostaglandins on urinary smooth muscle. The suggestion is made that prostaglandins may have a function in the maintenance of vesical tone.
Ureteric Obstruction due to Uterine Prolapse
Authors: CHAPMAN R. H.
Published: November 2008

2 cases of ureteric obstruction due to uterine prolapse are reported, one of whom was uraemic. Both were cured by repair of the prolapse.
The Effects of Drugs and Anaesthetic Agents on the Urinary Bladder and Sphincters
Authors: DOYLE P. T. , BRISCOE C. E.
Published: November 2008

Many patients undergoing urodynamic investigations have pressure studies performed under sedation or general anaesthesia. Some of the agents used are known to have effects on smooth muscle (Curreri and Gale, 1950; Burn and Epstein, 1959) and could, therefore, invalidate the results obtained. The purpose of this investigation was to determine the effect of these agents on urethral resistance and bladder capacity.

The influence of sedative, anaesthetic and neuromuscular blocking drugs on diagnostic urethral pressure profiles and cystometrograms has been investigated.

These agents have marked effects on the results obtained; in particular, the urethral pressure profile was raised by opiates and lowered by anaesthetic induction agents. Bladder capacity as measured by the cystometrogram was greatly increased by halothane.

These findings indicate that urodynainic studies should be performed only on conscious unsedated patients.
The Testes After Torsion
Authors: KRARUP TORBEN
Published: November 2008

Summary— In torsion of the testis a large proportion of testes saved by surgery develop secondary atrophy.

External manual reduction may be used as a first treatment, but surgical fixation is mandatory before the patient leaves the hospital.

Prophylactic fixation of the contralateral testis should always be performed as 30% of the patients will otherwise develop symptoms. The preventive operation causes no discomfort to the patient and no harm to the testis.

The fertility of the torsion patients is reduced. Patients treated for unilateral testicular torsion seem to have bilateral testicular abnormality resulting in decreased spermatogenesis.
An Objective Assessment of the Unstable Bladder of Psychosomatic Origin
Authors: FREWEN W. K.
Published: November 2008

Summary— An objective assessment of 40 female patients with an unstable bladder was made. An organic or structural cause had previously been eliminated. In all patients an emotive or psychogenic origin for their urinary symptoms was discovered. The diagnosis of detrusor instability was confirmed by cystometry and bladder drill retraining was employed for 3 months. Cystometric investigation was then repeated and the patient was reassessed from the symptomatic point of view. The cure rate was 82.5%.
Ultrasonic Lithotriptor for Urethral and Bladder Stones
Authors: FAHIQ SALAH EL , WALLACE D. M.
Published: November 2008

Summary— Bladder or urethral calculi in 50 patients were effectively fragmented and removed per‐urethrally using an ultrasonic lithotriptor with the probe vibrating at 30,000 impulses/s. In adults, local anaesthesia was employed and the operation performed as an out‐patient procedure. The method has the advantages over others discussed in that a small (23 F) sheath is used and that damage to the bladder or urethra by the probe is avoided. Using a newer, modified sheath resembling that for punch prostatectomy, larger stones can be fragmented by engaging the stone in the fenestrum of the sheath.
Bladder Neck Incision—A Treatment for Retention with Overflow in the Absence of Adenoma
Authors: JENKINS J. D. , ALLEN N. H.
Published: November 2008

Summary— Twenty‐five cases of outlet obstruction with decompensated bladders and minimal adenomatous enlargement were treated by transurethral bladder neck incision.

The results showed that bladder neck incision was as effective as transurethral resection of bladder neck and prostate and was a useful operation, especially for the elderly uraemic patient. There were no complications and operating time was considerably less than that required for a formal transurethral resection.

The operation should be reserved for cases of outflow obstruction with no or minimal adenomatous hyperplasia.
The Effect on the Bladder Pressure of Sudden Entry of Fluid into the Posterior Urethra
Authors: SUTHERST J. R. , BROWN M.
Published: November 2008

Summary— The posterior urethra was stimulated by the rapid injection of saline against the urethral wall. The effect was studied in 50 female patients attending a urodynamic clinic. The injection was made via a double lumen catheter, and bladder, urethral and rectal pressures were observed during and after the ingress of fluid.

The results indicate that sudden entry of fluid into the posterior urethra does not initiate a detrusor contraction even in those patients in whom the injection of fluid is painful.

The relevance of these results in relation to the unstable bladder and urodynamic tests is discussed.
The Influence of Refined Carbohydrate on Urinary Calcium Excretion
Authors: THOM J. A. , MORRIS J. E. , BISHOP A. , BLACKLOCK N. J.
Published: November 2008

Summary— In the course of study of the influence of varying the amount of refined carbohydrate (sugar and sugar products) in an otherwise standardised diet in 18 normal subjects it was evident that the analysis of 24‐h urine collections failed to show the profound diurnal variation in urinary electrolyte excretion and, in particular in this instance, calcium excretion.

The analysis of individually voided specimens showed some normal subjects to have spontaneously high peaks of urinary calcium concentration throughout the day even whilst on a diet with low refined carbohydrate content. Increase in the refined carbohydrate content of the otherwise standardised diet caused significant increase in the number of urines with a calcium concentration above 9 mmol/l.

Refined carbohydrate, a common constituent in Western diets, can therefore influence urinary electorlyte excretion in such a way that there may be an increased risk of over‐saturation with calcium oxalate.
The Clinical Course in Patients with Renal Carcinoma Subjected to Extracorporeal lmmunoadsorption
Authors: WOLF H. , LANGVAD E. , HYDÉ H.
Published: November 2008

SUMMARY— The clinical course in 4 patients with renal carcinoma stages II, Ill or IV subjected to periods of extracorporeal immunoadsorption is reported. By this technique we have previously demonstrated that it is possible to isolate and remove circulating tumour associated antigens from the blood stream. The removal of these antigens should, according to present‐day concepts, make it possible to control “antigenic inhibition” and/or “blocking”, thus facilitating the immune mediated destruction of residual tumour cells in advanced disease. The clinical course in these patients, however, did not differ from the expected clinical course in other such patients. The failure of extracorporeal immunoadsorption to alter the natural course of the disease may be due either to too large a tumour burden or to the possibility that spontaneous tumours during evolution and progression become independent of immune restrictions.
Sequestration of Ureteric Segments in Dogs
Authors: PRINGLE K. C.
Published: November 2008

SUMMARY— In 2 separate series of dogs a segment of ureter was isolated from both bladder and kidney and left in situwith an intact blood supply. Tense cysts formed in these sequestered segments regardless of whether the ends were occluded or the segments were split longitudinally and left open. The formation of these cysts can be prevented by the removal of the urothelium. The cyst contents were found consistently to have a sodium concentration below that of the simultaneously obtained serum concentration and urea concentration higher than the simultaneously obtained serum urea. Osmolalities and protein levels within the cysts were virtually identical to the serum levels.
Biofeedback Treatment of Intermittent Urinary Retention
Authors: HAFNER R. J.
Published: November 2008

SUMMARY— The treatment of a 29‐year‐old woman with intermittent urinary retention using biofeedback is described and discussed in the context of the pathophysiology of reflux urethral instability and related disorders of micturition. During attempts to train the patient to raise the pitch of an auditory biofeedback signal, which varied directly with intrinsic bladder pressure, evidence appeared for the involvement of sensory neuronal pathways in the disorder. This and other evidence are incorporated within an explanatory hypothesis.
The Management of Acute Retention of Urine
Authors: HIGGINS P. M. , KARIA S. J. , MEHTA K.
Published: November 2008

Summary— In a one year study period, 134 men presenting with retention of urine due to prostatic hypertrophy were catheterised and sent home, subsequently to be readmitted for prostatectomy. Their progress is compared with that of 176 men who underwent “cold” prostatectomy during the same period.
Urethral Diverticula in the Adult Female
Authors: STEWART M. , BRETLAND P. M. , STIDOLPH N. E.
Published: November 2008

Summary— Forty female patients with persisting urinary symptoms were investigated using positive pressure urethrography. Sixteen patients were found to have urethral diverticula; 14 of these underwent diverticulectomy. In addition, 17 patients were found to have a markedly distensible urethra on X‐ray and only the remaining 7 were deemed normal. The clinical and radiological features and surgical management of these patients are presented.
Abnormalities of the Immune System in Patients with ChyIuria
Authors: DATE A. , JOHN T. J. , CHANDY K. G. , RAJAGOPALAN M. S. , VASKA P. H. , PANDEY A. P. , SHASTRY J. C. M.
Published: November 2008

Summary— A study of the immune system in 11 patients with chyluria showed lymphocytopenia, decrease in T cells, a low serum IgA concentration and suppression of delayed hypersensitivity responses to intradermally injected antigens. The similarity of chyluria to intestinal lymphangiectasia and thoracic duct fistula suggests that the immune deficiency may be due to loss of lymph in the urine.
The Urological Complications of 1000 Renal Transplants
Authors: MUNDY A. R. , PODESTA M. L. , BEWlCK M. , RUDGE C. J. , ELLIS F. G.
Published: November 2008

Summary— Two hundred and one urological complications have been diagnosed and treated in 123 transplant recipients in a series of 1000 consecutive renal transplant operations (overall incidence 12.5%). Obstructive uropathies and urinary fistulae accounted for 95% of these complications and all of the mortality (22%). Details of management and patient and graft survival are given. A relationship between mortality from a urological complication and steroid dosage was found. A 30% incidence of recurrent or secondary urological complications was also noted with correspondingly worsened prognosis. Early diagnosis followed by early aggressive surgical treatment is advocated.
Ureteric Obstruction of Solitary Kidneys by Aneurysms of the Iliac Artery
Authors: Thompson P. M. , Packham D. A. , Yates‐Bell A. J.
Published: November 2008

Summary— Two rare cases are reported, both known to have solitary kidneys, that had ureteric obstruction caused by iliac artery aneurysms. Iliac aneurysms have a high mortality and may present to the urologist as an uncommon cause of ureteric obstruction. When the ureter of a solitary kidney is obstructed it is recommended that both ureterolysis and a temporary proximal diversion be performed. A common iliac aneurysm should be excised and grafted where possible; an internal iliac aneurysm is best treated by simple ligation or partial excision only.
Ureterocele in Bilharziasis of the Urinary Tract
Authors: Elem B. , Sinha S. N.
Published: November 2008

Summary— Five cases of ureterocele secondary to bilharziasis of the urinary tract are presented and discussed. It is important to be aware of this complication in an area where bilharziasis is endemic.
Conservative Surgery of Renal Carcinoma: The EIRSS Experience
Authors: MARBERGRE M. , PUGH R. C. B. , AUVERT J. , BERTERMANN H. , COSTANTINI A. , GAMMELGAARD P. A. , PETTERSON S. , WICKHAM J. E. A.
Published: November 2008

Summary— Seventy‐two patients with renal carcinoma (RC) in a solitary kidney or bilateral synchronous tumours underwent parenchyma‐sparing excision of their neoplasms. This was performed in situin 51 and extracorporeally in 21 kidneys, with a complication rate respectively of 1 7 and 43%. The 5‐year survival rates were 78% for unilateral disease, 48% for bilateral synchronous and 38% for bilateral asynchronous disease.

Survival correlated with Pcategory, grade and diameter of the tumour. Vascular invasion and spindle cells indicated a poor prognosis; the position of the tumour, oncocytic elements, calcification, lymphocytic infiltration or the predominance of clear cell or granular cells did not influence survival.
Improvement in Renal Function Following Ureteric Reimplantation for Vesicoureteric Reflux
Authors: MUNDY A. R. , KINDER C. H. , JOYCE M. R. L. , CHANTLER C. , HAYCOCK G. B.
Published: November 2008

Summary— Ten children with vesicoureteric reflux who had moderate impairment of renal function before corrective surgery have been analysed retrospectively. A significant improvement in renal function occurred after successful anti‐reflux surgery. The possible reasons for this improvement are discussed with emphasis on the functional rather than the morphological effects of reflux.
Cardiovascular Complications in the Treatment of Prostatic Carcinoma
Authors: GLASHAN R. W. , ROBINSON M. R. G.
Published: November 2008

Summary— Cardiovascular complications in patients with carcinoma of the prostate have been studied in relation to 3 methods of treatment, namely stilboestrol, estramustine phosphate (Estracyt) and bilateral orchiectomy. One hundred and sixteen patients were studied over a 4‐year period on a prospective basis, 48 being treated with stilboestrol, 31 with estramustine and 37 with bilateral orchiectomy. The incidence of the cardiovascular side effects of these 3 treatment regimes in the first year of treatment was recorded after the patients had been divided into those with localised (MO) disease and advanced disease with metastases (Ml).

In patients treated with stilboestrol 29% had cardiovascular complications with a mortality rate of 1 6%. With estramustine 25% had complications with a 1 6% mortality rate, but with orchiectomy the complication rate was only 8% with a 3% mortality rate. It is recommended that stilboestrol and estramustine phosphate should not be used in the presence of cardiovascular disease and that the primary form of treatment in prostatic carcinoma should be bilateral orchiectomy, especially in patients with localised disease.
Urinary Stone Composition in North‐East Thailand
Authors: PRASONGWATANA V. , SRIBOONLUE P. , SUNTARAPA S.
Published: November 2008

Summary— Stones removed from 120 adults and 22 children were analysed for chemical composition. Calcium oxalate was the main component of both adult (49%) and childhood (44%) stones. Calcium stones formed the major type in adults and were slightly more common in males, whereas urate/uric acid stones were predominant in children and were more common in girls. In adults, the stones were usually found in the upper urinary tract (UUT) and were mainly of calcium type (72%), while all three types were found in almost equal amounts in the lower urinary tract (LUT). Magnesium ammonium phosphate and urate/uric acid were the stones found mainly in the upper and lower urinary tracts respectively of children.
The Colonic Conduit: a Better Method of Urinary Diversion?
Authors: HILL J. T. , RANSLEY P. G.
Published: November 2008

Summary— The colonic conduit urinary diversion has been assessed in a retrospective study of 47 children in order to compare the results of this operation with that of other forms of urinary diversion. The overall complication rate was 81%. The rate of stomal stenosis was 34% and that of upper tract dilatation was 36%. These results are very similar to the complication rate for the ileal conduit, which is now the most popular form of urinary diversion.

It is suggested that all forms of urinary diversion have a high long‐term complication rate and that other means of management should be considered more seriously.
The Value of the 24‐hour Urine Analysis in the Assessment of Stone‐Formers Attending a General Hospital Outpatient Clinic
Authors: RYALL ROSEMARY L. , MARSHALL V. R.
Published: November 2008

Summary— The daily urinary excretion of calcium, oxalate, uric acid and glycosaminoglycans, and 24‐h urinary volume and pH, were measured in 39 normal men and 65 male patients who had formed at least one calcium oxalate stone. No significant difference could be found between the two groups of subjects with respect to any of the urinary parameters. Nonetheless, a higher proportion of stone‐formers than normals had daily excretion levels of oxalate in excess of the normal 95th percentile. On the other hand, there was no difference between the proportion of stone‐formers and normals who fell into this category with respect to calcium excretion.

It was concluded that a single 24‐h urine analysis is of limited practical value in explaining the occurrence of stones or in predicting the likelihood of further episodes in unselected stone‐formers attending a general hospital outpatient clinic.
The Treatment of Large Bladder Diverticula
Authors: BLACKLOCK A. R. E. , GEDDES J. R. , SHAW R. E.
Published: November 2008

Summary— Thirty‐eight cases of large bladder diverticula treated surgically between 1970 and 1979 were reviewed. Twenty‐two underwent diverticulectomy alone and 19 of these had no further trouble during a follow‐up period averaging 4.5 years. Three other patients who had undergone resection of a small prostate gland prior to diverticulectomy might also have been cured by diverticulectomy alone. In at least half of the patients presenting with large bladder diverticula no obstructive factor was present and it is concluded that primary diverticula are more common than was previously thought.

Clinically, primary diverticula may be distinguished from secondary on the basis of symptoms, cystoscopic findings of trabeculation and urodynamic studies. A more extensive application of the transperitoneal approach in performing diverticulectomy is recommended.
Recovery of Radiologically Functionless Obstructed Kidneys
Authors: Ibrahim A. , Fahal A. H.
Published: November 2008

Summary— Eleven patients had radiologically non‐functioning and unilaterally obstructed kidneys with normal kidneys on the other side. The kidneys were divided into three groups according to the urinary pH of the obstructed kidney at operation: Group 1 (pH 6.0 or less); Group 2 (pH 6.1–7.1); Group 3 (pH > 7.1). The obstruction was corrected in all patients despite the pre‐operative radiological findings or the morphological appearance at operation. Radiological recovery was assessed 2 months post‐operatively and was found to be good in all patients in Group 1. In Group 2, recovery was good in one patient, moderate in two and absent in one. In Group 3 there was no evidence of radiological recovery in either patient.
Biochemical Effects in Patients with Calcium Oxalate Stone Disease during Combined Treatment with Bendroflumethiazide and Magnesium Oxide
Authors: Ahlstrand C. , Tiselius H.‐G.
Published: November 2008

Summary— Thirteen patients with calcium oxalate stone disease were treated with 2.5 mg bendroflumethiazide and 200 mg magnesium oxide twice daily for 1 year, and the effects on serum and urine constituents were evaluated. Serum magnesium and potassium decreased, whereas urate increased during treatment. The association of decreased urinary calcium and increased urinary magnesium resulted in a reduced Ca/Mg quotient and apparently a lower risk of forming urine supersaturated with calcium oxalate. Combined treatment with a thiazide and magnesium appears to alter the composition of urine in a way that might be more favourable than treatment with either substance alone.
Ureteroureteric Reflux. Pathological Entity or Physiological Phenomenon?
Authors: O'Reilly P. H. , Shields R. A. , Testa H. J. , Lawson R. S. , Edwards E. Charlton
Published: November 2008

Summary— The clinical, urographic and radionuclide examinations of 28 consecutive patients with incomplete duplication of the upper urinary tract are presented. Four possible types of urodynamic abnormality can occur in this condition and 3 of these were found in 8 of the 28 patients. The urodynamics of normal and duplex upper tracts are reviewed and the question of whether the abnormalities represent a pathological process requiring surgery or a harmless physiological variant is examined.
Urography and Cystoscopy in Bladder Mucosal Abnormality
Authors: Hussain Sarwat , Aisha H. A. , Saleh T.
Published: November 2008

Summary— A prospective study was carried out on 60 patients. The diagnostic usefulness of intravenous urography (IVU) compared with that of cystoscopy in assessing the state of the bladder mucosa was evaluated. Collectively, radiology was as good as cystoscopy in suggesting the final diagnosis of the location and severity of a mucosal lesion.

The after‐micturition film (AMF) from IVU was the single most informative film which produced correct results in 59 of 60 patients. The full bladder film was the least useful examination and in 45 cases suggested an incorrect or misleading diagnosis.
Transuretero‐ureterostomy—a Review of its Use in Modern Paediatric Urology
Authors: CHILTON C. P. , VORDERMARK J. S. , RANSLEY P. G.
Published: November 2008

Summary— Transuretero‐ureterostomy (TUU) was performed on 55 patients with a mean age of 10 years at operation and a mean follow‐up of 4 years. The indications for this procedure are described and, if followed, it is safe and easily performed. The indications for its use may be as a primary procedure for unilateral ureteric pathology, as a salvage procedure, after failed ureteric reimplantation or as part of a urinary undiversion. There have been no deaths and only one patient later required a nephroureterectomy.
Bilharzial Uropathies and a Scheme for Primary Medical Care
Authors: ABDEL‐HALIM RABIE E.
Published: November 2008

Summary— Fifty patients suffering from the late effects of urinary bilharziasis were studied. A preliminary idea about the incidence of bilharzial cancer in the endemic area of Jeezan is presented. The role of ileal loop ureteric replacement in extensive ureteropathy is emphasised.

A scheme is proposed for the categorisation of bilharzial patients on the basis of their symptoms in order to detect complicated cases at the primary medical care level.
Evaluation of Screening Tests for Detecting Sacral Autonomic Neuropathy in Diabetes Mellitus: A Preliminary Study
Authors: BOOTH C. M. , HARRISON M. J. G. , GREEN J. F.
Published: November 2008

Summary— In 6 patients with diabetes mellitus and 6 non‐diabetic “controls” referred for urological assessment, sacral electromyelography (SER) and electrical stimulation of the anal reflex were compared with pressure/flow videocystourethrography (VCU) for the detection of sacral neuropathy, whilst electrocardiography (ECG) was used to screen for generalised autonomic neuropathy.

Five diabetics had evidence of a neuropathic bladder on VCU and on electrical stimulation all 5 had an absent anal reflex, which may thus prove to be a simple, reliable, non‐invasive screening test for sacral neuropathy.
The Artificial Urinary Sphincter in Children
Authors: LIGHT J. K. , SCOTT F. B.
Published: November 2008

Summary— One hundred and thirty‐two children underwent implantation of the AS792 artificial urinary sphincter over the past 5 years: 90% had an excellent result following the implantation. Thirty‐one patients (24%) required further surgery to correct a malfunction of the device. The device was removed in 5.3% of the patients and the incidence of infection was 3.8%. The artificial urinary sphincter has been shown to be a reliable means of achieving urinary incontinence in children. With attention to patient selection and meticulous surgical technique, a high success rate can be expected.
Long‐term Follow‐up after Transurethral Prostatic Resection With or Without a Short Peri‐operative Antibiotic Course
Authors: GRABE M. , HELLSTEN S.
Published: November 2008

Summary— This study was undertaken to analyse the results in 192 patients who 3 to 4 years earlier had undergone transurethral resection (TUR) in a controlled clinical trial on the value of a short peri‐operative course of antibiotics. The survival rate was comparable in both groups. Most deaths were due to cardiovascular disease and/or cancer of the prostate and the gastrointestinal tract. Infectious events predominated in the control group and more antibiotics were prescribed for these patients during follow‐up than for the patients in the peri‐operative antibiotic group. Bacteriuria was found in 24% of patients, evenly distributed between the groups. Eighty‐three per cent were satisfied with the results of prostatectomy but 38% complained of symptoms from the lower urinary tract. The maximum urinary flow rate was not influenced by the presence of bacteriuria and/or symptoms. There was no difference between the groups regarding mortality or morbidity except for the frequency of post‐operative urethral stricture formation, which was significantly higher in the controls. It was concluded that prospective long‐term follow‐up is indicated to assess the effect of short peri‐operative antibiotic courses.
Minor Defects of the Sacrum and Neurogenic Bladder Dysfunction
Authors: GALLOWAY N. T. M. , TAINSH J.
Published: November 2008

Summary— Minor defects of the sacrum are common and often dismissed as normal. The radiographs of 100 patients with urinary incontinence revealed sacral abnormalities in 43. Sacral evoked responses were measured and compared independently with the radiological findings. Patients who had defective closure of the dorsal neural arches of S1 or S2 all had abnormal nerve studies. We suggest that incomplete development of the bones of the dorsal neural arches of the upper sacrum may be a marker of incomplete neurogenesis of the sacral nerves. The sacral neurological deficit is subtle and difficult to demonstrate, but it is real and may be important in the pathogenesis of incontinence.
Pelvic Lymphadenectomy and Radical Cystectomy for Transitional Cell Carcinoma of the Bladder with Pelvic Nodal Disease
Authors: ZINCKE H. , PATTERSON D. E. , UTZ D. C. , BENSON R. C.
Published: November 2008

Summary— Past and present methods of treatment for patients with stage D, (T1‐4 N+ M0) transitional cell cancer of the urinary bladder have proved to be largely ineffective. This report on 57 patients with stage D, disease confirms this impression and demonstrates that radical operation alone is associated with a 5‐year survival rate of only 10%. Survival is related to tumour grade and to the number of pelvic lymph nodes involved; furthermore, complete lymphadenectomy may contribute to improved patient survival. Effective treatment programmes for stage D1 bladder cancer are lacking and efforts should be directed toward developing treatment protocols that combine radical cystectomy and meticulous pelvic node dissection with an effective adjuvant systemic treatment programme.
Serum and Tissue Tumour Markers in Seminomas
Authors: FORD T. F. , BUTCHER D. N. , SAMUELL C. T. , MASTERS J. R. W. , PARKINSON M. CONSTANCE , OLIVER R. T. D.
Published: November 2008

Summary— The serum expression of the tumour markers hydroxybutyric dehydrogenase (HBD), beta human chorionic gonadotrophin (βHCG), alphafetoprotein (αFP) and placental alkaline phosphatase (PLAP) has been assessed in a consecutive series of 50 patients with pure seminoma. In pre‐orchiectomy sera from 15 patients with stage 1 disease, HBD was elevated in 5, βHCG in 3, αFP in 1 and PLAP in 1 (of 3 only). In 27 patients with stage 2 or 3 disease, prior to chemotherapy, serum HBD was elevated in 19, βHCG in 11, αFP in 2 and PLAP in 10 (of 18). The presence of βHCG was investigated immunocytochemically in primary tumour tissue from 39 patients. It was demonstrated in 6 of 21 tumours from patients with stage 1 disease and 5 of 18 with stage 2 or 3 disease.
Inhibitors of Urinary Stone Formation in 40 Recurrent Stone Formers
Authors: FRANÇOIS B. , CAHEN R. , PASCAL B.
Published: November 2008

Summary— The excretion of four inhibitors of urinary stone formation (zinc, magnesium, citrates and glycosaminoglycans (GAG)) was studied in 20 normal controls and 40 recurrent calcium stone formers who were placed on a fixed diet restricted in calcium, oxalates and purines. We were unable to show any abnormality in the excretion of Zn, Mg or GAG.

In 11 patients, a low level of urinary citrate was a significant feature that was associated in most cases with a urinary pH value above 6. Citrate concentration (per litre) and output (per 24 h) were found to be lower than in the controls in 19 and 33% respectively of the determinations. The overall ratio of average urinary citrate concentration in patients and controls was 0.56, a figure in agreement with previous data.
Comparison of Primary Orchiectomy with Oestrogen Therapy in Advanced Prostatic Cancer; A 2‐Year Follow‐up Report of a National, Prospective Prostatic Cancer Study
Authors: HAAPIAINEN R. , RANNIKKO S. , ALFTHAN O.
Published: November 2008

Summary— Two hundred and seventy‐seven patients with advanced prostatic cancer were treated by either orchiectomy or oestrogen. During the 2‐year follow‐up period, the response to treatment was considered more favourable in the oestrogen group, and this response was particularly emphasised in patients with poorly differentiated tumour and metastases at the time of diagnosis. Further evaluations included the cardiovascular side effects of oestrogen therapy.
Urethral Rhinosporidiosis Analysis of 27 Cases
Authors: SASIDHARAN K. , SUBRAMONIAN P. , MONI V. N. , ARAVINDAN K. P. , CHALLY R.
Published: November 2008

Summary— An analysis of 27 cases of urethral rhinosporidiosis is presented. Only 11 cases have been previously reported. The disease is chronic and causes no systemic derangement. The key to diagnosis is its characteristic histology and diathermy excision provides the best treatment.
99mTc DTPA Scanning with Diuretic Washout. Is it Useful in the Investigation of Obstruction in the Presence of Gross Renal Tract Dilatation?
Authors: HUNTER G. J. , GORDON I. , SWEENEY L. , TODD‐POKROPEK A. , RANSLEY P. G.
Published: November 2008

Summary— Diuretic‐enhanced 99mTc DTPA renal scanning aims to determine whether or not a kidney is obstructed. In the presence of gross renal tract dilatation the validity of this technique is questioned. Twenty‐eight patients (51 kidneys) with the prune belly syndrome, characterised by gross dilatation and tortuosity of the ureters, were studied. These patients underwent diuretic 99mTc DTPA scanning at the time of diagnosis and at yearly intervals thereafter. Long‐term clinical follow‐up (3 years) with serial serum creatinine was available in all children. In all cases renal function remained stable and on this basis urinary tract obstruction was excluded. Analysis of the first 99mTc DTPA scan included differential function, whole kidney mean transit time (WKMTT) and the time taken for tracer activity to fall to 75% of peak activity after diuretic stimulus (T75). Using the 99mTc DTPA scan, obstruction can be excluded if the WKMTT is less than 5 min or, in the presence of a prolonged WKMTT, if the diuretic stimulus results in a T75 of less than 5 min. A T75 of between 5 and 10 min is considered equivocal and a T75 exceeding 10 min means that obstruction cannot be excluded. 99mTc DTPA scanning, using these criteria for diagnosis, provided false positive information in 22 kidneys (43%). There were no false negatives. 99mTc DTPA scanning with diuretic washout, using WKMTT and T75 criteria, is not appropriate for the detection of renal tract obstruction in the presence of marked upper renal tract dilatation, since the false positive rate of 43% is unacceptably high.
Sacral Reflex Latency in Acute Retention in Female Patients
Authors: FIDAS A. , GALLOWAY N. T. M. , VARMA J. , McINNES A. , CHISHOLM G. D.
Published: November 2008

Summary— Neurophysiological measurements of the innervation of the lower urinary tract were performed on 14 female patients presenting with unexplained acute urinary retention. The method consisted of (a) static electromyography (EMG) of the anal and urethral sphincter with the patient relaxed, coughing and gripping, (b) the study of sensory thresholds on the dorsal nerve of the clitoris and in the urethra, (c) the measurement of sacral reflex latencies (SRL) from the dorsal nerve of the clitoris to the anus and urethra and from the urethra to the anus.

The results showed that all 14 patients had significant defects in the innervation of their lower urinary tract. These findings suggest that a neurological explanation for acute retention in women should always be sought before making any other diagnosis.
Sexual Dysfunction after Prostatectomy
Authors: BOLT J. W. , EVANS C. , MARSHALL V. R.
Published: November 2008

Summary— One of the major and disconcerting complications of prostatectomy is impotence. Several studies have reported only a small reduction in potency rates following prostatectomy but have not examined the effect of surgery per se on a group of men in whom one could expect a significant incidence of reduced potency. In order to rectify this defect, a prospective study was undertaken to assess the effect of transurethral resection of the prostate (TU RP) and other general surgical procedures on two age‐matched populations. In all cases potency and ejaculatory function and frequency of intercourse were assessed pre‐ and post‐operatively. Potency was retained in 86% of men undergoing TURP and in all of the men undergoing general surgical procedures (p<0.01). Of those men who indicated that they were capable of having sexual intercourse prior to operation, 88% were unaffected by TURP. In the general surgical group 97% were unaffected. Thus it would appear that TURP has a significant effect on sexual function which cannot be accounted for by the stress of surgery or the age of the population undergoing operation.
Obstructive Nephropathy: Comparison between Parenchymal Transit Time Index and Frusemide Diuresis
Authors: BRITTON K. E. , NAWAZ M. K. , WHITFIELD H. N. , NIMMON C. C. , CARROLL M. J. , GRANOWSKA M. , MLODKOWSKA E.
Published: November 2008

Summary— Sixty‐three patients presenting with the clinical problem of renal outflow disorder were studied using 99mTc DTPA. The techniques of frusemide diuresis and parenchymal transit time index analysis were compared and both shown to be successful in aiding the decision as to the presence or absence of significant outflow obstruction.
Prospective Study of Intravesical Dimethyl Sulphoxide in the Treatment of Chronic Inflammatory Bladder Disease
Authors: BARKER S. B. , MATTHEWS P. N. , PHILIP P. F. , WILLIAMS GRANT
Published: November 2008

Summary— Thirty patients with biopsy‐proven chronic inflammatory bladder disease were treated with intravesical dimethyl sulphoxide (DMSO). Satisfactory symptomatic relief was achieved in 80% of patients completing treatment and no significant side effects were encountered. Despite the improvement in symptoms there was no significant alteration in the endoscopic or morphological appearance of the bladder after treatment. Intravesical DMSO is safe and relatively easy to administer and seems to have a place in the management of patients with this difficult problem.
Trials and Tribulations in Prostatic Cancer
Authors: KIRK D.
Published: November 2008

The unique prevalence of carcinoma of the prostate in the elderly male population (Franks, 1954), the ability to control (albeit temporarily) metastatic disease which for many other tumours would produce a hopeless situation (Resnick and Grayhack, 1975) and the long history of operative management of the primary tumour going back to the dawn of modern urology (Young, 1905) all affect in some way our perspective of the disease. It is subject to intense clinical and scientific study, but 80 years after the first radical prostatectomy and after 40 years of hormonal therapy, there remain many dilemmas in its management.
The Role of Partial Cystectomy in the Treatment of Recurrent Invasive Bladder Cancer Following Radiotherapy
Authors: MATTHEWS P. N. , MINTON M. J. , HAW M. , PHILIP P. F.
Published: November 2008

Summary— Seventeen patients with recurrent invasive bladder cancer following radical radiotherapy were treated by partial cystectomy. Thirteen patients required augmentation enterocystoplasty, using an ileal patch in 10 patients and large bowel in the others. After 4 years' follow‐up, eight patients are alive and disease‐free with good bladder function. Of the nine patients who died, six died from bladder cancer and three of these suffered local recurrences. Responsiveness to radiotherapy or tumour stage were not helpful in predicting local recurrences, but all patients who had this complication had anaplastic tumours. In selected patients this procedure offers an alternative to salvage cystectomy, especially where a urinary diversion may be inappropriate.