bluuebunny/crossref_metadata_2025 huggingface dataset:
RECURRENT RENAL CALCULI AND HYPERPARATHYROIDISM1
Authors: McIntosh HamishW. , Balfour J. A. , Duffy M. H.
Published: November 2008

The results of screening fifty individuals with recurrent renal calculi are reported. Five instances of primary hyperparathyroidism due to tumours of these glands have been proven by the operative and histological findings. Reliance on the determination of the serum calcium level will lead to failure of diagnosis in some instances. The diagnosis can best be made by relying on a combination of techniques to measure the urinary excretion of calcium while the individual is on a low intake and at the same time estimating the tubular reabsorption of phosphate.
THE INVESTIGATION AND SIGNIFICANCE OF PERSISTENT AND RECURRENT URINARY INFECTION IN CHILDREN
Authors: Forsythe W. I. , Wallace I. R.
Published: November 2008

Seventeen boys and thirty‐four girls were investigated because of persistent or recurrent urinary infection.

The investigation of these patients is discussed in detail and the limitations of various radiological techniques are considered.

The importance of intravenous pyelography and micturition cystography in the initial investigation is stressed.

It was noted that in boys, congenital anomalies causing obstructions or stasis were present in 65 per cent., whereas in girls obstructive anomalies were rare. However, in the latter, abnormal widening of the internal vesical sphincter and vesico‐ureteral reflux were common.
SOME ANATOMICAL AND TECHNICAL CONSIDERATIONS OF THE EMPLOYMENT OF ILEUM IN UROLOGY
Authors: Johnson William
Published: November 2008

The blood supply of isolated ileal loops is considered and a method of ensuring their viability is suggested. The technical details of the operation are described.
HUNNER'S ULCER
Authors: M.Ch. C. H. Kinder , F.R.C.S.E. R. D. Smith
Published: November 2008

Hunner's ulcer is a rare condition; only twenty‐seven definite cases have been seen at St Peter's and St Paul's hospitals in the last ten years. During this period forty‐two patients were classified as having this condition. The average age was 53, and all but two were women. The symptoms common to the whole group were frequency and pain when the bladder was full. and these were temporarily relieved by hydrostatic dilatation of the bladder. The urine was always sterile. The cystoscopic appearances, although insignificant in comparison with the symptoms, were specific and were found only in the free part of the bladder.

Treatment is discussed. Conservative therapy, apart from dilatation, was not effective. Ureterosigmoidostomy was performed ten times with two deaths; the surviving patients obtained complete relief. Ileocystoplasty was carried out three times, but its value is difficult to assess. It appears that either the stoma has to be very wide or extensive partial cystectomy has to be performed for relief of symptoms.

The differential diagnosis is from tuberculous and other forms of chronic cystitis. and carcinoma of the bladder. Hunner's ulcer is only one form of chronic interstitial cystitis.

The letiology is still unknown and the possible causes are discussed. It is not likely to be infective, but may be due to hormonal influences and may be partly psychosomatic. The pathology is quite non‐specific.
A CLINICAL EVALUATION OF NEPHROTOMOGRAPHY
Authors: M.Chir. W. F. W. Southwood. , Marshall V. F.
Published: November 2008

Nephrotomography as described by Evans et al. has been evaluated from the clinician's point of view. At the present time it appears that intrarenal masses can be diagnosed as simple cysts or neoplasms with 90 to 95 per cent. accuracy. The technique requires some practice and precision, but thus far no major complications have occurred.
BILATERAL PRIMARY CARCINOMA OF THE URETER WITH USE OF ILEAL GRAFT FOR URETERAL REPLACEMENT : CASE REPORT
Authors: Crassweller Peter O.
Published: November 2008

A brief review of the subject of primary carcinoma of the ureter has been presented, with the addition to the literature of another case of primary bilateral carcinoma. Although the patient shows some degree of nitrogen retention, it is felt that this is not due to the type of loop used, and that the U‐shaped segment with one side antiperistaltic is a satisfactory structure for ureteral replacement.
THE SIGNIFICANCE OF IMPAIRED CARBOHYDRATE TOLERANCE FOLLOWING URETEROCOLIC ANASTOMOSIS
Authors: Wilson G.
Published: November 2008

1. Two‐hour glucose tolerance tests were performed on thirteen patients with ureterocolic anastomoses.

2. Impaired carbohydrate tolerance was found in three patients on at least one occasion; in only one of these patients was there evidence of acidosis.

3. Six other patients with acidosis had normal carbohydrate tolerance.

4. Starvation appears to have been the greatest contributory factor to defective carbohydrate tolerance in the patients tested, though acidosis might have been an additional factor in one patient.

5. Attention is drawn to a possible diagnostic hazard, that is, hyperglycæmia in a patient with clinical acidosis during the administration of intravenous dextrose solution.
THE OCCURRENCE AND SIGNIFICANCE OF VESICO‐URETERAL REFLUX IN CHILDREN
Authors: Forsythe W. I. , Whelan R. F.
Published: November 2008

Four hundred and forty‐five children between 3 and 15 years of age have been examined by micturating cysto‐urethrography: 430 children had enuresis, ten urinary infection, and five had miscellaneous symptoms. A vesico‐ureteral reflux occurred in sixty‐one children.

The relationship between reflux and obstructive abnormalities, reflux and non‐obstructive abnormalities, and reflux and infection has been studied. The findings indicate that lower urinary tract obstruction is not a common cause of vesico‐ureteral reflux in children and that other abnormalities, e.g., wide bladder‐neck anomaly, are not commonly associated with vesico‐ureteral reflux. There was a high incidence of association between vesico‐ureteral reflux and megaureter particularly with pyelitis, but whether the infection was the cause of the reflux or vice versa was not clear.

Fifteen children with reflux were examined in detail in the upright position and it was found that the reflux was not confined to any one stage of filling or emptying. The height of the reflux did not seem to depend on whether the patient was in the supine or vertical position.

In this series, thirty children showed a vesico‐ureteral reflux without any other apparent abnormality of the urinary tract, i.e., there was no evidence of obstructive uropathy. no evidence of neurogenic uropathy, e.g., spina bifida with neurological signs, no history of previous urinary infection, and repeated examinations of urine were normal.
MUCIN‐SECRETING CARCINOMA OF THE PROSTATE
Authors: Edgar W. M.
Published: November 2008

A case of mucin‐secreting carcinoma of the prostate is reported and the literature reviewed. Three other published cases were found, and one of these is of a different histological type. In the case reported here and in the two similar cases found in the literature, the patients were within the age group in which prostatic carcinoma is found most often. The particular zone f the prostate in which the tumour in the present case originated is the most usual site of origin of carcinoma of this organ. There is insufficient information available for it to be said whether the clinical course of the condition is the same as in the commoner varieties of prostatic carcinoma.
A NOTE ON THE SEX CHROMATIN IN ENLARGED PROSTATES
Authors: Lennox Bernard , Smith Ferguson , Mack W. S. , Stewart J. S. S.
Published: November 2008

We have been unable to confirm the anomalous findings of Coutts et al. relating to the nuclear sex of enlarged prostates.
A CASE OF HODGKIN'S DISEASE WITH UNUSUAL PRESENTATION
Authors: Keith Marjory A. , Park James N.
Published: November 2008

A case of Hodgkin's granuloma is reported on account of some unusual clinical features and autopsy findings.
Experimental Percutaneous Renal Infarction
Authors: GOLDIN ALAN R. , NAUDE JOHAN H. , HICKMAN ROSEMARY
Published: November 2008

Careful injection of barium into the renal artery of pigs produced complete infarction with no untoward sequelae. The literature is reviewed and potential application to man discussed.
Therapeutic Percutaneous Renal Infarction
Authors: GOLDIN ALAN R. , NAUDE JOHAN H. , THATCHER GEOFFREY N.
Published: November 2008

Successful therapeutic renal infarction in a patient requiring nephrectomy is reported. The method and precautions of the technique are discussed.
Evaluation of the Xenon‐133 Renal Blood Flow Method
Authors: COSGROVE MALCOLM D. , MOWAT PAUL
Published: November 2008

The features of the 133Xe renal blood flow profile in the normal kidney have been described. It is suggested that the xenogram may be particularly useful in:

 The assessment of renal trauma cases.

 The evaluation of the non‐functioning kidney.

 The preoperative definition of renal vein thrombosis in renal carcinoma cases.

 The quantitation of renal ischaemia.

 The diagnosis of transplant rejection.

The technique is recommended for the evaluation of difficult diagnosis renal problems in the hope that it may shed some light and in the knowledge that it will do no harm.
Divided Renal Function Studies in Hypertension
Authors: JAKOBSEN BENT E.
Published: November 2008

Divided renal function studies were performed in 82 patients with hypertension and renai artery stenosis.

The results were divided into 3 groups: (1) Positive tests with reduced urinary flow and increased creatinine and PAH concentrations in the urine on the affected side. (2) Negative tests with urinary flow and creatinine and PAH concentrations in the urine equal on both sides. (3) Negative tests with markedly reduced urinary flow on one side, but with equal creatinine and PAH concentrations on both sides.

Of the 82 patients, 25 were subjected to nephrectomy or arterial reconstruction. In the latter, the test had been positive in 15 and negative in 10. Postoperative improvement in the hypertension was almost equally frequent in the 2 groups.
Pyelo‐Colonic Diversion in Children
Authors: JOHNSTON J. H.
Published: November 2008

External urinary diversion by the method of pyelo‐colostomy has been performed in 8 children. It is suggested that this procedure may give better long‐term results than cutaneous ureteroileostomy when the ureters are dilated and of poor contractility.
The Management of Kidney Transplants Damaged during their Removal from the Donor
Authors: SALAMAN J. R. , CLARKE A. G. , CROSBY D. L.
Published: November 2008

Cadaver kidneys may be easily damaged during their removal from the donor. The current shortage of kidneys for transplantation makes it important that every kidney should be transplanted if at all possible.

In a series of 137 renal transplants, we have had to deal with 1 renal artery avulsion, 18 polar arteries devoid of aortic patches, 1 renal vein avulsion multiple renal veins and 2 severed ureters. The manner in which these injuries have been dealt with is described.

As a means of preventing injuries in the future, it is suggested that the definition of death might hi re‐examined so as to permit the removal of kidneys from donors with an intact circulation.
The Genito‐urinary Manifestations of Herpes Zoster
Authors: RICHMOND WILLIAM
Published: November 2008

Three cases of herpes zoster involving different spinal cord levels causing urinary retention are presented.

Review of the literature has revealed similar cases and a separate syndrome of zoster cystitis.

In the light of our reported cases and others previously recorded the neuropathic mechanisms are discussed and a scheme of management is described.
Carcinoma of the Urinary Tract and Urinary Retention in Uganda
Authors: ANTHONY P. P.
Published: November 2008

Carcinoma of the urinary tract in Uganda shows some unusual features.

Squamous cell carcinoma is the predominant histological type. This is associated not with urinary schistosomiasis, which only occurs in one small area of the country, but with longstanding posterior urethral strictures of gonococcal origin. This association is found in both bladder and urethral carcinomas, the relative frequency of the latter being unusually high. Possible aetiological factors include dietary overload with tryptophan and increased beta‐glucuronidase activity. The presence of a stricture is likely to have an enhancing effect on carcinogenesis and is the major factor in producing a high incidence of squamous cell growths through urinary stasis, infection and metaplasia.
Muco‐epidermoid Carcinoma of the Penis
Authors: SHRIKHANDE SUMATI S. , SIRSAT M. V.
Published: November 2008

A case of muco‐epidermoid carcinoma of the penis in a Hindu male aged 40 is reported because of its rarity. It is the first case seen at the Tata Memorial Hospital during the past 30 years.
Blood Background Subtraction Renography in Acute Renal Failure
Authors: LAVENDER S. , BROWN J. N.
Published: November 2008

Serial computer assisted blood background subtraction renograms have been performed in 8 patients with acute renal failure.

One patient showed an initial tracing identical to that from a case with a bilateral nephrectomy; in 2 patients initial tracings were indistinguishable from those of cases of advanced chronic parenchymal renal disease; however all 3 patients made a complete recovery.

In 3 patients symmetrical continuously rising renograms were obtained as previously reported in acute renal failue.

In 2 patients asymmetrical renograms were obtained which could have been interpreted as indicating obstructive uropathy.

Renography in acute renal failure must be interpreted with extreme caution.

We are grateful to Professor A. Polak and Dr H. A. Lee for their advice.
Recurrent Mesenteric Venous Thrombosis Complicating Renal Transplantation
Authors: SALAMAN J. R. , MAHMOOD K.
Published: November 2008

Mesenteric venous thrombosis developed in a patient 9 months after successful cadaveric renal transplantation. Following small bowel resection the thrombosis recurred and ultimately this spread to involve the portal and splenic veins with fatal results.
Some Aspects of the Adult Urinary Stone Problem in Great Britain and Northern Ireland
Authors: SUTOR D. JUNE , WOOLEY SUSAN E. , ILLINGWORTH J. J.
Published: November 2008

In a collection of 856 urinary calculi from Great Britain and Northern Ireland, the most abundant and frequently occurring crystalline constituents are the mono‐ and di‐hydrates of calcium oxalate and hydroxy‐ and carbonate‐apatite.

On the basis of composition, most stones can be assigned to a few well‐defined groups. The most common composition type, accounting for 34% of the collection, is that composed of calcium oxalate+calcium phosphate. The oxalate can be either or both of the hydrates, often both are present, but the calcium phosphate is generally hydroxyapatite. Stones consisting of pure calcium oxalate make up 27% of the total, while those comprised of struvite+calcium phosphate contribute 17%. In the latter variety the calcium phosphate is almost invariably carbonate‐apatite. The other group considered consists of the pure calcium phosphate calculi which account for 7% of the collection.

The incidence of stones in relation to their site in the urinary tract and the patient's age and sex has been investigated, together with the effect of the stone site, patient's age and sex on the distribution of calculi in the main composition groups and the effect of composition, site, age and sex on the stone weight. Most of these variables have a significant effect on one another.

The incidence of stones is also related to daily occupation, professional workers being 10 times more likely to develop urolithiasis than labourers.

We thank the Medical Research Council and Nuffield Foundation who financed most of this work and Mr D. Sturt who kindly agreed to the participation of the Computer Centre in this project. We are greatly indebted to Mr N. W. Please for advice and many helpful discussions on the statistics and for carrying out the analysis of variance. Finally, we are grateful to the many surgeons and physicians who provided the stones and the data.
High‐Dose Delayed Urogram in the Detection of the Occult Ectopic Ureter
Authors: HUTTON IAN M. , GREEN N. ALAN
Published: November 2008

Two cases of unilateral and 2 of bilateral ureteral duplication with ectopy are presented.

Five of 6 ectopic renal segments were visualised directly without instrumentation by means of high‐dose urograms with delayed films. This technique is recommended in the investigation of possible ureteral ectopy.

We are grateful to Mr Guy Baines of Birmingham for referring Case 2 and also to Mr J. Gordon Smart of Leicester for the loan of radiographs in Case 4.
Simplified Cystography in Stress Urinary Incontinence
Authors: TANAGHO EMIL A.
Published: November 2008

Lateral cystograms done with a urethral catheter in place clearly define the vesico‐urethral segment. Lateral X‐ray films at rest and with straining while the patient is lying on the flat X‐ray table determine the initial resting position and the degree of mobility of the vesico‐urethral segment.

Normally the vesico‐urethral junction is opposite the lower third of the pubic bone and moves about 0–5 to 1–5 cm downward and posteriorly with straining.

In true stress incontinence, the intrinsic urinary sphincteric mechanism is usually intact (unless surgically damaged), yet weakened by lack of pelvic support–which leads to excessive mobility and/or abnormal resting position of the vesico‐urethral segment. Surgery can correct only these 2 defects if present.

Simplified cystographic studies can offer valuable information in confirming the diagnosis and in assessing the prognosis.
Evaluation of Immunological Reactivity in Bladder Cancer
Authors: O'BOYLE P. J. , COOPER E. H. , WILLIAMS R. E.
Published: November 2008

The cytotoxic activity of lymphocytes from patients with bladder cancer on T24 bladder cancer cells in tissue culture have been studied. The technical problems are described and the suitability of the method as part of the assessment of the patients' immune reactivity discussed. On balance the technical difficulties outweigh its theoretical advantages.
The Control of Severe Bleeding from the Bladder by Intravesical Hyperbaric Therapy
Authors: HAMMONDS J. C. , WILLIAMS J. L. , FOX MILES
Published: November 2008

Intravesical hyperbaric therapy has been used successfully to control severe haemorrhage from the bladder following radiotherapy and multiple tumours in 8 treatments on 7 patients.

A good long‐term palliative effect has also been achieved in the majority.

The treatment is relatively free from side‐effects, can be repeated, and is recommended as the primary treatment in bleeding from the irradiated bladder free of tumour and in the otherwise inoperable patient.

In operable lesions it controls the bleedinglongenough for the patient to be adequately prepared for major surgery.

We would like to acknowledge the considerable help given to us by the Anaesthetic Department and the devoted attention of the Sister and Nurses on the Keeling Ward. We are indebted to the Photographic Department of the United Sheffield Hospitals for the photographs.
Renal Angiomyolipoma Causing Hypertension: A Case Report
Authors: FUTTER N. G. , COLLINS W. E.
Published: November 2008

A patient with asymptomatic hypertension due to a renal angiomyolipoma is described. The possible causes for hypertension, in particular increased renin secretion is discussed.

We would like to thank Dr G. R. I. Powers and Dr E. Liepa of the Department of Radiology and Pathology.
The Surgery and Problems of the Ureter in Human Renal Transplantation
Authors: BEWICK M. , COLLINS R. E. C. , SAXTON H. M. , ELLIS F. G. , MCCOLL I. , OGG C. S.
Published: November 2008

This study describes the urological complications associated with 200 consecutive renal allotransplantations performed between May 1967 and March 1973. Of these 176 were cadaver kidneys and 24 kidneys were from live donors.

An outline of the surgical technique is followed by details of the postoperative management in straight‐forward and complicated cases. Details of radiological techniques are discussed.

Urological complications are divided into those occurring soon after surgery and those developing after 3 months of satisfactory function. The possible causes are listed and means of identifying them described. The outcome of the various complications is described.

There was an overall incidence of urological complications of 13–5% (5% due to primary obstruction and 7 % due to primary fistula formation). The mortality directly due to a urological complication was 4% and was highest (2%) in those due to primary urinary obstruction.
The Use of Frusemide and Epsilon‐Amino‐Caproic‐Acid in Transurethral Prostatectomy
Authors: SMART C. J. , TURNBULL A. R. , JENKINS J. D.
Published: November 2008

A randomised prospective clinical trial has been performed to assess the effectiveness of giving e‐amino‐caproic‐acid to patients routinely receiving a frusemide diuresis, following transurethral prostatectomy. A significant reduction in postoperative blood loss, and fewer problems related to catheter management and infection were noted in the group of patients receiving E.A.C.A.

We wish to thank Dr D. Pearce and Dr W. E. Waters for their help in devising the trial, Mr R. Rumble and Mr B. Howard for their technical assistance and the nursing staff of Southampton General Hospital for their cooperation.
The Crystalline Composition of Prostatic Calculi
Authors: SUTOR D. JUNE , WOOLEY SUSAN E.
Published: November 2008

The composition of 28 prostatic calculi has been determined by X‐ray diffraction. 14 stonesconsisted entirely of 1 or more of the following calcium phosphates‐carbonate‐apatite, hydroxy‐apatite and whitlockite. Most of these are likely to be true or endogenous prostatic calculi formed from the prostatic fluid. The other 14 stones contained compounds which can precipitate from urine but are unlikely to precipitate from the prostatic secretion. These are the exogenous type forming at least in part from urine. Whittockite which was found to be a major constituent of the true stones has been identified in them for the first time. Its discovery shows that salivary and prostatic calculi are similar in composition in that they consist of apatite or apatite + whitlockite.

This work was financed by the Medical Research Council.
Technetium‐99M Polyphosphate Bone Scanning in Carcinoma of the Prostate
Authors: LENTLE BRIAN C. , MCGOWAN DAVID G. , DIERICH HELGA
Published: November 2008

In 100 consecutive patients with newly diagnosed carcinoma of the prostate examined by X‐ray, skeletal metastases were diagnosed in 18 patients. The additional use of bone scanning with 99mTc‐P.P. increased this figure to 34.

Of the 16 patients with metastatic disease demonstrated on a bone scan but not apparent at the initial reading of the radiographs, confirmatory evidence has been forthcoming in 11.

X‐ray examination, which need only be of limited scope, remains desirable. It is necessary to exclude false positive bone scans due to coincidental abnormalities such as Paget's disease of bone.

We are indebted to Mrs Mary Laschowski both for assistance in carrying out this analysis, and for considerable secretarial help.

The illustrations were kindly prepared by Mr Karl Leisner and the statistical analyses carried out by Dr Michael Grace.
Lymphography in Carcinoma of the Prostate
Authors: ZINGG E. J. , FUCHS W. A. , HÉRITIER P. , GÖTHLIN J.
Published: November 2008

60 patients with carcinoma of the prostate of all clinical stages were investigated by lymphography.

Positive lymphographic findings were present in about 50% of the cases.

The more advanced tumours were found to metastasise more frequently.

Lymphography is indispensable to select patients with clinically limited disease to the prostate for radical prostatectomy.

The anatomical display of the iliac and aortic lymph nodes on the lymphogram facilitates the selection of the portal fields in external beam megavoltage radiotherapy.
Adrenal Suppression in the Treatment of Carcinoma of the Prostate
Authors: ROBINSON M. R. G. , SHEARER R. J. , FERGUSSON J. D.
Published: November 2008

Experience of 26 patients with carcinoma of the prostate treated by adrenal suppression with aminoglutethimide is reviewed. 60% of hormone resistant tumours showed some response.

A fall in plasma testosterone beyond that achieved by oestrogens was not observed.

A high incidence of side‐effects was noted.

A limited role for aminoglutethimide in the management of prostatic carcinoma is suggested.

Our thanks are due to the Consultant Surgeons, St Peter's Hospitals who referred their cases to us for investigation. We acknowledge with thanks the help of Dr I. F. Sommerville and Mr M. D. Mansfield, Department of Clinical Endocrinology, Chelsea Hospital for Women, who performed testosterone assays. Aminoglutethimide was supplied by Ciba Laboratories Ltd, Horsham, Sussex. This work was supported by a grant from the St Peter's Research Trust.
Fine Structural Changes in Rat Prostate 5 Months After the Experimental Introduction of 20‐Methylcholanthrene
Authors: AUGHEY ELIZABETH , SCOTT ROBERT , MCLAUGHLIN IAN
Published: November 2008

The fine structure of hypertrophied cells in rat prostate parenchyma after exposure to 20‐methylcholanthrene is described, and some features such as degenerating mitochondria, increase in smooth membranes and lysosomes suggest that these cells are passed their peak. This is supported by the sloughing of these cells and their consequent replacement by a stratified epithelium originating in the basal undifferentiated reserve cells.

Keratinisation of the epithelium with the presence of typical tonofibrils is regarded as evidence of a fully‐developed squamous cell carcinoma.

This work was supported by a grant from the Cancer Research Campaign.
Malignant Lymphoma of the Testis in Indians
Authors: SAMPAT MRUDULA B. , SIRSAT M. V. , KAMAT MURALIDHAR R.
Published: November 2008

The pathological and clinical features of 17 cases of malignant lymphoma of testis seen at Tata Memorial Hospital, Bombay, from the year 1941 through 1972 are presented. Malignant lymphoma accounts for 3–8 % of 445 histologically proved cases of testicular malignancies in our material.

The material has been divided into 3 groups: (i) Testicular tumour as the only manifestation throughout the course of the disease (3 cases); (ii) Testicular tumour followed by dissemination during the course of the disease (12 cases); (iii) Testicular tumour following generalised lymphoma (2 cases).

Bilateral testicular tumours are rare but when they do occur malignant lymphoma accounts for the larger number of cases. Of 4 bilateral testicular tumours found in the total number of 445 testicular malignancies 3 belonged to malignant lymphoma group.

The maximum number of patients (14) were between the ages of 40 and 68 years. Two cases of lymphoma occurred in patients aged 5 years and 16 years respectively.

Malignant lymphoma of testis is a disease with a poor prognosis. The majority of the patients died within a year following orchidectomy. One patient is alive and free from disease for 5 years and 6 months after orchidectomy.

Hodgkin's disease of the testis is very rarely reported. We have seen 2 cases in our material.
Rare Combination of Duplication of Genito‐urinary Tract, Hindgut, Vertebral Column and Other Associated Anomalies
Authors: DUTTA TRIPTA , GEORGE V. , MEENAKSHI P. K. , DAS G.
Published: November 2008

Two children, one male and one female have been presented with more or less identical rare congenital deformities of genito‐urinary tract, hindgut and vertebral column.

Both the children had completely separate urinary systems, each comprising 1 kidney ureter, bladder, urethra and penis in the boy with no communication at any level.

The genital organs in both cases were completely duplicated, the boy having 2 penes and double scrotum containing a normal testis in each and the girl had 2 vaginal orifices and 2 uteri as demonstrated by 2 cervices projecting into the 2 vaginae (no other test to demonstrate the 2 uteri were done).

Both the children had duplication of hindgut and anorectal atresia, complete in the boy and partial in the girl. The girl also had reverse rotation of the hindgut.

Both the children had defects in the vertebral column. The boy had hemivertebra, first lumbar rib on the right side and double sacrum. The girl had malformation of the sacrum with spina bifida and diastasis of pubic bones.

The anomalies in the girl on the whole showed an attempt at reduplication of single organs and fusion of paired ones.
The Staging of Renal Parenchymal Tumours
Authors: PETKOVIĆ S.
Published: November 2008

The relation between the anatomical features in the development of renal parenchymal tumours and the prognosis are analysed. It is suggested that the clinical and anatomical classification must be revised.*
Conservative Renal Surgery for Adenocarcinoma. The Place of Bench Surgery
Authors: WICKHAM J. E. A.
Published: November 2008

A brief review of reported cases of tumours in solitary kidneys and of bilateral simultaneously occurring tumours is reported.

1 case of bilateral simultaneously occurring tumour and 3 cases of tumour occurring in solitary kidneys are reported.

The treatment of these cases by simple partial nephrectomy under regional hypothermia is described.

The place of ex vivo“Bench Surgery” for this condition is discussed.
Continuous Perfusion of Human Cadaveric Kidneys for Transplantation
Authors: STEPHENSON T. P. , HENDRY W. F. , WARD J. P. , WICKHAM J. E. A.
Published: November 2008

63 cadaveric kidneys have been preserved for up to 36 hours by continuous perfusion on a Gambro machine. 52 kidneys were transplanted: 13 (25%) functioned immediately, 23 (44%) functioned after 2 to 28 days, and 16 (31%) failed to function. 11 kidneys with poor perfusion flow characteristics were discarded. Of 30 kidneys followed for more than 18 months, graft survival was 50%.

Analysis of warm and cold ischaemia data, of perfusion flow rates and biochemical studies, and comparison of function of 18 pairs of kidneys only one of which was continuously perfused, suggests that this method of preservation effectively extends the preservation time to 36 hours, but does not improve the immediate function and non‐function rates, and does not provide an accurate assessment of viability.
A Study of 137 Cases of Renal Trauma
Authors: PRYOR JOHN P. , WILLIAMS J. P.
Published: November 2008

Renal injuries are rarely a threat to life and all patients should have an intravenous urogram performed at the time of admission.

Patients with a normal urogram may be mobilised for early discharge.

Patients with minor abnormalities of the urogram, but in whom all the collecting system is visible, rarely caused any difficulties in management. Should the haematuria persist beyond a week, then arteriography should be performed. The arteriogram sometimes shows the presence of major cortical lacerations with minor abnormalities of the intravenous urogram.

If the initial urogram fails to opacify the injured kidney, immediate arteriography is required to exclude a vascular injury. We also believe that early arteriography is advisable in those patients where part of the kidney appears to be non‐functioning as it is in this group of patients that operation may become necessary. The indications for renal arteriography are summarised in Table II.
Is Urography Necessary for Patients with Acute Retention of Urine Before Prostatectomy?
Authors: MARSHALL VILLIS , SINGH MANMEET , BLANDY J. P.
Published: November 2008

In 180 urograms performed on 203 patients admitted to hospital with acute or acute‐on‐chronic retention of urine 38 abnormalities were noted, most of them being related to upper tract obstruction.

Of 4 diverticula detected only one needed treatment.

Waiting for the urogram imposed an extra delay of more than 3 days between admission and operation and an equal prolongation of the whole hospital stay.

There appears to be no justification for routine urography prior to prostatectomy in the patient admitted with urinary retention.
Identification of a Prostate in Female Praomys (Mastomys) Natalensis using 3H steroids
Authors: GHANADIAN R. , HOLLAND J. M. , CHISHOLM G. D.
Published: November 2008

The female of the species Praomys (Mastomys) Natalensis has a ventral prostate similar both in position and in histological appearance to the ventral lobe of the male prostate. The hormonal uptake of this female prostate has been investigated using [3H] testosterone and [3H] oestradiol.

The results showed that the uptake of these steroid hormones by the prostate was identical to our findings in the male prostate.

The potential value of a female prostate in prostatic research is discussed.
Immunological Effects of Orchidectomy
Authors: CASTRO J. E.
Published: November 2008

Orchidectomy caused a non‐specific increase of immunological reactivity in mice evidenced by accelerated rejection of skin allografts, increased response to oxazolone and sheep erythrocytes. These changes were associated with an increase of thymic size.

The response to pneumococcal polysaccharide, which depends upon B‐cells, was not increased.

Orchidectomised mice showed protection against induced methylcholanthrene sarcomas and transplantable tumours; tumours which are not obviously hormone dependent.
The Natural History of Renal and Ureteric Calculi
Authors: MARSHALL V. , WHITE R. H. , SAINTONGE MARK CHAPUT DE , TRESIDDER G. C. , BLANDY J. P.
Published: November 2008

In a prolonged follow‐up of a series of 416 patients at The London Hospital Stone Clinic it was found that recurrence could still occur even as long as 10 years after the first stone, though this risk decreased slowly year by year.

Recurrence is seldom related to hypercalciuria or urinary infection except when infection is caused by or associated with B. proteus in women.

Claims for the value of any form of therapy for stone disease must be evaluated against the background of the natural history of lithiasis.
The Residual Renal Stone
Authors: SINGH MANMEET , MARSHALL VILLIS , BLANDY JOHN
Published: November 2008

A study of the observer error built in to contact preoperative radiography for renal stones shows that particles less than 2 mm in diameter are likely to be missed.

The radiographic follow‐up of 100 patients from whom 120 large staghorn calculi have been removed over a period of up to 10 years shows that new calculi may form in kidneys which have been completely cleared, and that residual stones do not always grow, but equally often pass spontaneously, or remain unchanged.
Some Data on Urinary Stones which were Passed
Authors: SUTOR D. JUNE , WOOLEY SUSAN E.
Published: November 2008

Out of a group of 979 patients with urinary calculi, 175 had passed their stone(s). Comparison of data for stones which had been passed with data for the whole group shows many significant differences.

Calculi composed entirely of calcium oxalate are more likely to be expelled than any other composition variety. The chance of this happening is 1 in 3 and it is even higher when the person is under 50 years of age. The probability of calculi composed of calcium oxalate + calcium phosphate being expelled is 1 in 5 and this also increases for younger patients. Infection stones consisting of calcium phosphate + struvite have only a 1 in 19 chance of being passed.

Many of the stones passed (130) are under 0·10 g in weight. However, there is a similar relationship between composition and weight among both the stones that were passed and the whole group. In both groups, pure oxalate stones are the lightest, infection stones are the heaviest and stones composed of calcium phosphate and calcium phosphate + calcium oxalate are of intermediate weight.
Bilateral Pelvi‐Ureteric Avulsion Following Closed Trauma
Authors: BOSTON V. E. , SMYTH B. T.
Published: November 2008

A 9‐year‐old girl suffered severe multiple injuries in a road traffic accident. Following a period of anuria an intravenous pyelogram was performed indicating bilateral pelvi‐ureteric rupture. Continuity was eventually achieved on both sides following two attempts at ureteral anastomosis. One year after the accident the child is well and the kidneys and ureters are functionally normal.

Early diagnosis and treatment is essential in order to achieve a good functional result. This is aided by an awareness of the condition and is confirmed by intravenous and retrograde pyelography. The anastomosis is performed over a polythene splint, supported by a defunctioning nephrostomy for several weeks.

The aetiology remains obscure, although there have been many suggestions regarding the mechanics of pelvi‐ureteric avulsion.
The Congenital Refluxing Megaureter: Experiences with Surgical Reconstruction
Authors: JOHNSTON J. H. , FARKAS A.
Published: November 2008

A series of 17 children with congenital refluxing megaureters underwent ureteric tailoring and reimplantation.

The results obtained suggest that such surgery should be restricted to those cases in which an obstructive element is introduced as a result of the reflux or in which ascending infection is further damaging the already prenatally defective kidney parenchyma.
A Clinical Evaluation of Hydrostatic Pressure Treatment for Carcinoma of the Bladder
Authors: COOMBES G. B.
Published: November 2008

A small clinical series of patients treated by hydrostatic bladder dilatation is reported.

The methods used, the complications and technical difficulties encountered are described. 4 patients out of 14, who had a complete course of treatment are free of any further tumour 12 months later, which in the context of their previous progress is a considerable improvement. These 4 patients did not appear to have any particular feature which, on clinical assessment, would have allowed us to be more selective in applying this treatment.
The Distribution and Retention of Cadmium 115m in the Rat Following Injection into the Prostate
Authors: AUGHEY E. , SCOTT R. , KING P. C. , EAST B. W. , HARRIS I. A. , BODDY K.
Published: November 2008

The gonadal effects produced by injection of cadmium in the rats are well known. The effects of direct injection into the prostate are less well understood. The present experiments indicated the retention of cadmium by the various lobes of the rat prostate following direct injection of radioactive cadmium into the organ.

The cells of the prostate are capable of retaining cadmium in measurable amounts up to at least 6 weeks following the injection. The subcellular fractions were measured with respect to cadmium activity and these are indicated. In addition measurements were made in organs which are known to be affected by cadmium, that is, the kidney and the testicle. The affinity of the kidney for cadmium is confirmed.

The areas of the prostate gland with a high zinc content appear to retain less cadmium than areas of the gland which are known to have a low zinc content. This suggests a possible zinc protective mechanism.
Adrenergic and Cholinergic Receptors in the Human Prostate, Prostatic Capsule and Bladder Neck
Authors: CAINE MARCO , RAZ SHLOMO , ZEIGLER MARCIA
Published: November 2008

The adrenergic and cholinergic receptors of the human prostatic capsule, prostatic “adenoma”, and bladder neck, were investigated by the in‐vitro isometric technique.

The prostatic capsule was found to be very rich in both α‐adrenergic receptors and cholinergic receptors. The prostatic adenoma was moderately rich in α‐adrenergic receptors, but cholinergic receptors were absent. β‐adrenergic receptors were absent in the prostatic adenoma, and there was an equivocal response in less than half the specimens of the prostatic capsule.

An attempt was made to distinguish between the trigonal component at the posterior bladder neck, and the true bladder neck muscle both posteriorly and antero‐laterally. The results indicate that the “posterior bladder neck” seen at operation is predominantly trigonal muscle, and is poor in cholinergic receptors. The adrenergic response is variable in the true bladder neck muscle, but is present and strong in the trigonal muscle. This response is characteristically gradual in its development.

In view of the findings in this investigation, it is suggested that certain instances of acute retention of urine in prostatic patients are due to over‐stimulation of the α‐adrenergic receptors, particularly those in the prostatic capsule. Similarly, the accepted clinical contraindication to the use of cholinergic drugs for retention in the prostatic patient is supported by the distribution of the cholinergic receptors in the tissues examined.
The Effect of Dicynene on Blood Loss during and after Transurethral Resection of the Prostate
Authors: SYMES J. M. , OFFEN D. N. , LYTTLE J. A. , BLANDY J. P. , SAINTONGE D. M. CHAPUT DE
Published: November 2008

The effect of Dicynene on blood loss during and after transurethral resection for benign enlargement of the prostate was studied in 76 patients.

Median loss of blood at operation was 17 ml in those given Dicynene compared with 72 ml in the placebo group (p = < 0·001).

Median postoperative blood loss was 38 ml in the Dicynene group, and 103 ml in the placebo group (p = 0·05).

Clinical evidence of deep vein thrombosis was found in neither group.

Dicynene helps to reduce blood loss in transurethral resection.
Peyronie's Disease
Authors: CHESNEY J.
Published: November 2008

The history and clinical features of Peyronie's disease are briefly reviewed.

The results of treatment with procarbazine (“Natulan”) are presented.

It is concluded that treatment with procarbazine is often effective and is indicated in a selected group of patients, provided the appropriate precautions in its use are undertaken.
Treatment of Peyronie's Disease with Procarbazine
Authors: OOSTERLINCK W. , RENDERS G.
Published: November 2008

The treatment of 10 cases of Peyronie's disease with procarbazine, a cytotoxic drug, is presented. The results were disappointing.
Evaluation of Differential Renal Function Studies in Segmental Renal Artery Occlusion
Authors: PFAU ALPHONSE , RAZ SHLOMO , ROSENMANN ELIEZER , SCHWARTZ ARMIN
Published: November 2008

3 patients with suspected renal segmental ischaemia are presented. In 2 of them segmental renal artery stenosis was demonstrated radiographically and the differential renal function studies predicted the outcome of surgery accurately. In the last patient no segmental renal artery stenosis was demonstrated on angiography, and surgery did not benefit this patient in spite of positive differential renal function studies for “curable” renal segmental ischaemia.

Some haemodynamic aspects, as expressed by the differential renal function studies, are discussed.
Regression of Metastases after Nephrectomy for Renal Cell Carcinoma
Authors: SILBER SHERMAN JAY , CHANG CHENG‐YANG , GOULD FRANK
Published: November 2008

A case of an extensive renal cell carcinoma with temporary regression of pulmonary metastases is reported.
Ureterometrographic Studies on Human Subjects with Normal Urinary Tract System
Authors: TABATABAI M. , KADIVAR R.
Published: November 2008

Ureteral motility was studied in 40 subjects with normal urinary tract systems.

Although the contraction waves were often monophasic in shape some were characterised by the presence of a notch on the contraction or relaxation limb of the peristaltic complex, indicating that notched complexes do not necessarily signify obstructive uropathy.

Retrograde filling of the bladder to within its physiologic limits with isotonic saline solution markedly changed the pattern of the ureteral activity.
Urinary Diversion: the Physiological Rationale for Non‐refluxing Colonic Conduits
Authors: RICHIE JEROME P. , SKINNER DONALD G.
Published: November 2008

In order to make an accurate comparison between ileal and colonic conduits, an ileal conduit was created from one kidney and a non‐refluxing colonic conduit from the other kidney in 16 adult mongrel dogs.

Colonic loops do not reflux, have equal resting pressures and rate of emptying when contrasted with ileal conduits, and carry a lower incidence of stomal complications. Colonic conduits respond more favourably to acute occlusion and produce a significantly lower rate of pyelonephritis at 3 months.

These factors suggest that colonic conduits offer a definite advantage for long‐term urinary diversion.
Whole Body Potassium in Patients with Uretero‐sigmoid Anastomoses
Authors: BODDY KEITH , KING PRISCILLA C. , STEWART W. K. , FLEMING LAURA W.
Published: November 2008

Total body potassium was measured by whole body counting in 11 patients with uretero‐sigmoid anastomoses who had undergone cystectomy 4 months to 13 years previously.

The measured total body potassium was not significantly different in any of the patients from the “normal” value for the individual patients, predicted from height and age. It was only significantly different from that predicted from height, age and weight in 1 patient.

In the series as a whole, the measured values of whole body potassium were not significantly different from the “normal” values estimated by either relationship.

From measurements of skinfold thickness, the lean body mass of each patient was estimated. The mean potassium content, 62·0 mEq/kg LBM in the male patients was within the normal range.

The absence of potassium depletion may derive from the successful abolition of hyperchloraemic acidosis by long‐term alkali therapy.
Plasma Zinc Levels in Prostatic Disease
Authors: WILLDEN ELIZABETH G. , ROBINSON M. R. G.
Published: November 2008

Plasma zinc concentrations rise in men over the age of 55 years and fall in women of a similar age‐group. They are higher in men with clinically diagnosed benign prostatic hyperplasia, but the level does not appear to be related to the size of the gland. Plasma zinc concentrations are not helpful in the diagnosis or management of carcinoma of the prostate, but may prove useful in excluding this diagnosis.
The Concentration of Sulphamethoxazole and Trimethoprim in Human Prostate Gland
Authors: OOSTERLINCK W. , DEFOORT R. , RENDERS G.
Published: November 2008

Sulphamethoxazole and trimethoprim concentrations were measured in 19 enucleated human prostate glands.

Good concentrations of sulphamethoxazole were found after 4 days of treatment: the ratio of plasma concentration to that of prostate varied from 1·25 to 3·29. The trimethoprim concentrations were 2 to 3 times higher in the prostate than in the plasma. These high concentrations were reached very rapidly after the first dose of trimethoprim.

The results are compared with data from the literature.

The combination sulphamethoxazole‐trimethoprim should be of value in the treatment of bacterial prostatitis.
Leiomyosarcoma of Penis—Case Report and Review of the Literature
Authors: HAMAL P. B.
Published: November 2008

Summary

A case of low‐grade leiomyosarcoma of the penis is described. The patient was treated by partial amputation, and is alive and free of recurrence for 6 months.

Ten other previous cases are reviewed and discussed.
Sarcoidosis of the Penis treated by Radiotherapy
Authors: WHITTAKER M. , ANDERSON C. K. , CLARK P. B.
Published: November 2008

A case of sarcoidosis of the penis is reported which initially caused ulceration around the external urethral meatus.

After an immediate response to steroid therapy, the disease recurred locally in spite of continuing therapy and involved other parts of the penis.

Partial amputation of the penis was performed but further ulceration occurred at the cut ends of the corpora cavernosa in the penile stump. This ulceration healed after radiotherapy.
Idiopathic Fat Necrosis in the Scrotum
Authors: DONOHUE ROBERT , UTLEY WILLIAM L. F.
Published: November 2008

2 cases of idiopathic scrotal fat necrosis are presented. The aetiology and differential diagnosis are discussed. Trauma, cool temperature and ocean water all appeared to be relevant factors in its production.