bluuebunny/crossref_metadata_2025 huggingface dataset:
LATENT CARCINOMA OF THE BLADDER
Authors: Cooling C. I.
Published: November 2008

MALIGNANT disease usually presents clinically with symptoms referable to the primary focus or origin, but occasionally this is not so, and the first indication of the existence of a malignant tumour is the appearance of metastases. The discovery of the primary focus is often a diagnostic problem, and the manner of investigation depends upon the known metastatic behaviour patterns of tumours. Carcinoma of the bladder rarely causes this problem, but two such cases are reported here.
A CASE OF ECTOPIA VESICR IN AN ELDERLY WOMAN
Authors: Clinton‐Thomas C. L.
Published: November 2008

1. A case of ectopia vesicae in an elderly woman is reported.

2. Despite the age of the patient there was no evidence of damage to the kidneys and no neoplastic change in the bladder.

3. The operative treatment, which was carried out in one stage, is described.
HANGING BLADDER STONES FORMED ON UNABSORBABLE SUTURE AND LIGATURE
Authors: Levack JamesH.
Published: November 2008

Two cases of hanging bladder stone are described. They were both phosphatic stones.

There may be some difficulty in the interpretation of a plain X‐ray of such a condition.

It is shown that these calculi had formed on unabsorbable material in the bladder wall: in the one case a nylon stitch and in the other a linen thread ligature.

It is inadvisable to use such ligature or stitch material at cystotomy or vesico‐urethral suspension in preference to electro‐coagulation or the use of catgut.
PHAOCHROMOCYTOMA OF THE ADRENAL WITH PAROXYSMAL HYPERTENSION
Authors: Fraser HughR. L. , Turner RichardW. D. , Band David
Published: November 2008

The physiological effects of adrenaline and of noradrenaline are summarised and the differences between the two are related to symptomatology in cases of phzochromocytoma.

The problem of diagnosis of phzochromocytoma is discussed and the various pharmacological tests relevant to this are described.

The estimation of the adrenaline and noradrenaline content of the urine is believed to be the best of the various special pharmacological tests available for diagnosis.

The special procedures available for anatomical localisation of the tumour are mentioned and the particular value of presacral perirenal insufflation of oxygen in this problem is described.

Details of management in a case of phzochromocytoma during operation and in the post‐operative period are described.

One case of phzochromocytoma is reported in detail and the application of special diagnostic tests and management during and after resection of the tumour are described.

The results of assay of the adrenaline and noradrenaline content of the tumour are given.
RENAL CALCIFICATION AND CALCULUS FORMATION1
Authors: Pyrah L. N. , Raper F. P.
Published: November 2008

In this paper is considered the calcification which may be found in apparently normal kidneys. Some diseases in which renal calcification occurs are described. dealing first with those in which the calcification is mainly microscopic and largely of pathological interest. arid secondly with those in which the calcification may be associated with stone formation arid therefore of interest to the urologist. Calcification seen on radiographs of the kidney when exposed at operations for stone is described. and finally the urinary calcium excretion in a group of patients with stone is considered.
CALCIFICATION AND CALCULUS FORMATION IN THE UPPER URINARY TRACT1
Authors: Stewart H. Hamilton
Published: November 2008

Stones in the kidney are divided into primary and secondary.

A series of 152 consecutive partial nephrectomies performed in infected and non‐infected cases for the treatment of calyceal stones (primary) is described with a recurrence rate of 7.9 per cent. over a period of sixteen years.

The lymphatic theory of stone formation (Carr) has been helpful in explaining the cause of recurrent primary stone.

A “stone‐forming” segment must be removed if recurrence of primary stone is to be prevented.

In the treatment of secondary stones, elimination of residual urine in the kidney is necessary if recurrence is to be avoided.

The surgeon, when dealing with these cases, is dependent upon radiographs of the highest quality. The surgeon and radiologist must work as a unit.
PRIMARY TUMOURS OF THE URETERS AND RENAL PELVES: SURVEY AND ANALYSIS OF TWELVE CASES 1
Authors: Lund Flemming , Lundwall Finn
Published: November 2008

Twelve cases of primary tumours of the renal pelves and ureters are reported. In age, the patients averaged 61 years; all had hæmaturia. In most of the cases the tumour was located in the renal pelvis or the distal part of the ureter. In ten instances the diagnosis was made before the operation, and the necessity of thorough, possibly repeated, X‐ray examination of the urinary tract (intravenous urography and retrograde uretero‐pyelography) is emphasised. These tumours are clinically malignant, showing a marked tendency to metastasise and a high incidence of recurrence. The only way of avoiding or reducing the frequency of recurrences is a radical operation (nephro‐ureterectomy with bladder resection), regardless of the location of the tumour and the histological grade of its malignancy. Five patients who underwent radical operations have not developed recurrences after follow‐up periods ranging from one to eleven years.
UNILATERAL RENAL CHYLURIA
Authors: Compston Nigel , Ellerker Geoffrey
Published: November 2008

A further case of unilateral renal chyluria is presented.

The ætiology and mechanism of production are discussed.

Possible forms of treatment are mentioned.
VESICO‐ILEAL FISTULÆ DUE TO CROHN'S DISEASE
Authors: Ebrill Denis
Published: November 2008

Three personal cases of regional enteritis complicated by bladder fistulæ: have been reported. Some of the important lessons which have been learnt from these have been mentioned.
THE SURGICAL SPREAD OF CANCER IN UROLOGY1
Authors: Boreham Peter
Published: November 2008

Six cases of recurrence of carcinoma of the bladder occurring in the urethra are presented. Three of these were in the posterior and three in the anterior urethra.

Another five cases are presented which developed metastases in the prostatic cavity after a prostatectomy had been performed in the presence of a carcinoma of the bladder.

Fifteen cases of recurrence of carcinoma of the bladder in the scar of an open operation are discussed.

After approximately 5 per cent. of open operations on the bladder the first recurrence was in the scar.

Methods of preventing implantation metastases from urinary cancer are discussed.
A CONSIDERATION OF THE PROCESSES INVOLVED IN THE DEVELOPMENT OF THE PREPUCE IN MAN
Authors: Glenister T. W.
Published: November 2008

As the result of the examination of thirty‐eight human fœtuses it is concluded that the prepuce results from a combination of preputial fold formation and ingrowth of a cellular lamella. These processes are closely linked with the formation and fusion of the urethral folds on the glans. This fact accounts for the formation of the frenulum in normal males and the disposition of the prepuce in females and in cases of hypospadias.
CROSSED RENAL ECTOPIA WITHOUT FUSION
Authors: Caine Marco
Published: November 2008

A case of crossed renal ectopia without fusion, which presented as an acute appendicitis, is recorded.

Attention is drawn to the relatively high incidence of malignant change in the cases reported previously.

My thanks are due to Mr B. H. Page, under whose care the patient was treated, for permission to publish this case.

This case was reported to the Section of Urology of the Royal Society of Medicine on 24th February 1955, and I am indebted to the Honorary Editors of the Proceedings for their permission to publish it.
SOME OBSERVATIONS ON THE DISTRIBUTION OF RADIOACTIVE ZINC IN PROSTATIC AND OTHER HUMAN TISSUES
Authors: Daniel Owen , Haddad Farid , Prout George , Whitmore Willet F.
Published: November 2008

Intravenous injections of 65Zn containing 50 to 100 μc. of radioactivity and 50 to 100 μg. of carrier zinc have been given to fifteen patients suffering from various forms of malignant disease and the radioactive content of blood and other tissues estimated twenty to ninety‐six hours later. Results expressed as 65Zn organ/blood ratios have been compared with zinc organ/blood ratios calculated from data reported by other workers from chemical determinations on similar tissues. The radioactive and chemical ratios are generally of the same order with the exception of muscle which had a much lower, and liver and certain samples of carcinomatous prostatic tissue which had a much higher 65Zn ratio than Zn ratio. Carcinomatous prostatic tissue from one patient had a 65Zn tissue/blood ratio of 40, which is twice as much as the highest ratio found in any other tissue.

This study was supported by the New York Cancer Committee and the Lerner Fund. The writers gratefully acknowledge the assistance of Miss Eva Simmel in preparing the autoradiographs.
WATERHAMMER PULSE ASSOCIATED WITH METASTATIC CARCINOMA FROM THE PROSTATE AND EXTREME ELEVATION OF BLOOD ACID PHOSPHATASE
Authors: Erasmus L. D. , Kloppers P. J.
Published: November 2008

A case of prostatic carcinoma is described in which widespread metastases were associated with extreme elevation of the blood acid phosphatase and a waterhammer pulse. The phosphatase level and the raised pulse pressure returned to normal as treatment caused regression of the lesions. Possible mechanisms which may explain the vasomotor changes are discussed.
THE USE OF THE ISOLATED ILEAL LOOP IN PÆDIATRIC UROLOGY1
Authors: Rickham P. P.
Published: November 2008

The use of the isolated ileal loop in pædiatric urology is discussed. A series of fifteen children between 6 months and 10 years of age operated upon during the last two years is reported. The indications for operation, the technique, and the post‐operative complications are discussed.
A CASE OF HERPES ZOSTER WITH INVOLVEMENT OF THE URINARY BLADDER1
Authors: Gibbon Norman
Published: November 2008

A case of herpes zoster is described in which the third and fourth sacral segments were involved on the left side, and in which an eruption on the left side of the bladder was accompained by retention of urine.

Thirteen other case reports have been reviewed in which bladder symptoms complicated sacral zoster. There appears to be an inverse relation between the severity of the bladder eruption and the incidence of retention of urine, and this may be explicable on the basis of variable spread of the virus within the nervous system.
AN ELECTROPHORETIC STUDY OF THE SERUM GLOBULINS IN VESICAL AND PROSTATIC CANCER1
Authors: Scott L. Stuart , Chalmers J. G.
Published: November 2008

A comparison has been made of the serum globulins of vesical and prostatic cancer with those of normal serum by filter‐paper electrophoresis.

The changes found in bladder carcinoma were an increase in alpha‐l globulin with a corresponding decrease in gamma‐globulin.

In prostatic cancer the changes are mainly in alpha‐l and beta globulin.
HYPERTENSION IN HYPERPARATHYROIDISM1
Authors: Hellströum John , Birke Gunnar , Edvall C. A.
Published: November 2008

A series comprising 105 cases of hyperparathyroidism is presented. Ninety‐five of these cases were successfully parathyroidectomised and have been satisfactorily followed up.

The principal aim of the investigation has been to establish the incidence of hypertension in hyperparathyroidism and to find out if any correlation exists between the renal damage and the occurrence of hypertension. The possibility of a relationship between other symptoms of hyperparathyroidism and hypertension is of interest, and the behaviour of the blood‐pressure and renal function following parathyroidectomy has been investigated.

The following results were obtained:—

Seventy per cent. of the cases had hypertension some time during the observation period, the distribution being as follows:50 per cent. constant hypertension; 20 per cent. hypertension before, but normal blood‐pressure after, parathyroidectomy; and 30 per cent. developing hypertension after parathyroidectomy.

The presence of renal calculi or severe renal infection was not demonstrably correlated to hypertension. Nephrolithiasis seemed to be the predominating symptom in the normotensiv group. If any correlation between nephrocalcinosis and hypertension existed at all, it was a slight one. The patients with parathyroid osteitis were mainly referable to the hypertensive groups and were infrequent in the normotensive group and the group with post‐operatively normalised blood‐pressures.

The mortality was 20 per cent. The causes of death were azotæmia in eleven cases, sequek of hypertension (cerebral vascular accidents and cardiac failure) in eight, and other causes in two cases (suicide and arteriosclerosis).

A striking correlation was found between the extent of renal damage (reflected by functional studies and routine biopsies) and the severity of hypertension. The results also indicate that the impairment of renal function preceded the development of hypertension, which implies that the hypertension of hyperparathyroidism may be of renal origin.

The actual mechanism producing these manifestations is not clear from the findings in this investigation. Further studies are necessary, and are, in fact, proceeding in this series.
THE TREATMENT OF BLADDER‐NECK SCLEROSIS BY RETROPUBIC RECONSTRUCTION1
Authors: Macalister.F.R.C.S.E. C. L. O.
Published: November 2008

Retropubic reconstruction offers an alternative to endoscopic resection in bladder‐neck sclerosis. Experience in twenty‐two cases suggests that the method deserves further trial.
THE ÆTIOLOGY AND TREATMENT OF DIVERTICULUM OF THE BLADDER1
Authors: Miller Ashton
Published: November 2008

One hundred and five cases of vesical diverticulum are analysed.

The ætiology is discussed, and it is suggested that urethral obstruction and bladder‐wall hypertrophy exist in all cases.

It is suggested that congenital bladder‐neck obstruction is the obstructing factor.

The mechanics of formation and enlargement of a diverticulum are considered, and it is suggested that the pouch always enlarges and remains within the layers of the bladder wall.

The indications for treatment are discussed, and it is suggested that the presence of residual urine in the diverticulum is the only reliable indication for operation.

Operative details are considered and an alternative and simpler operation is described.

Urinary infection, calculus. carcinoma of the bladder and renal failure are considered as to their effect on treatment.
TREATMENT OF URINARY INFECTIONS WITH NITROFURANTOIN (FURADANTIN)
Authors: F.R.C.S. MichaelSalvaris
Published: November 2008

Nitrofurantoin has established itself in the treatment of urinary infections. Its effects in sensitivity tests in vitroagainst the organisms which invade the urinary tract are of a high order, and it is superior to many antibiotics and sulphonamides. It is of particular use in Proteus infections.

It is a safe drug to administer, since reactions are few, and as yet no fatal cases have been recorded in the literature which could be ascribed specifically to its use.

Nitrofurantoin is rapidly excreted in the urine, reaches antibacterial levels within thirty minutes of oral administration, and is largely eliminated within six to eight hours. It appears to be more effective in acid urine and more soluble in alkaline urine.

The blood level is low (0.2 mg. per 100 ml.) and has been challenged as perhaps too low for adequate treatment of fulminating systemic infections, yet the therapeutic response appears satisfactory.

The results of sensitivity tests in vitrowith nitrofurantoin are compared with those of the commonly used antibiotics and sulphonamides. A report on the use of nitrofurantoin in 145 cases of urinary infection is included. Of these, rather less than one half were acute and the remainder were chronic.

The response to treatment was very good in the acute cases and, as well as might be reasonably expected in the chronic cases, in view of the causative factors.
RETROCAVAL URETER REPLACED BY A SEGMENT OF ILEUM
Authors: F.R.C.S. AndrewN. McCrea
Published: November 2008

A case of retrocaval ureter is described. The initial operation of section and re‐anastomosis failed. An ileal replacement of the ureter was then carried out. Alternative methods of treatment are discussed.
THE COMPLICATIONS OF URETHRAL STRICTURE
Authors: F.R.C.S.(Ed.) A. Marshall
Published: November 2008

1. The results of a study of 146 patients suffering from urethral stricture are presented and compared with those of other writers.

2. The main upper tract lesions found were stone, dilatation, and pyelonephritis.

3. The main lower tract lesions were a post‐voiding residual urine of over 3 oz., bladder diverticula, chronic prostatitis, and prostatic calculi.

4. These complications are shown to be influenced by the age of the patient, the duration of symptoms, the diameter of the stricture, and the presence of urinary infections.

5. In view of the high incidence of complications in all types of stricture it is suggested that a plastic type of operation to reconstruct the urethra might be used to a much greater extent in treatment.
TRANSPERITONEAL URETEROLITHOTOMY
Authors: Michalowski E. , Modelski W.
Published: November 2008

Up to now we have performed three transperitoneal urcterolithotomies as recommended by Kneise (1935). The technique described by this writer was modified inasmuch as we combined the transperitoneal approach with retroperitoneal drainage, thus avoiding the danger of the urinary extravasation and infection.
THE TRANSPERITONEAL REMOVAL OF CERTAIN VESICAL DIVERTICULA AND A RADIOGRAPHIC TECHNIQUE FOR DIAGNOSIS
Authors: Pyrah L. N. , Keates P. G.
Published: November 2008

The transperitoneal removal of certain medium‐sized and large vesical diverticula is a valuable alternative to other methods of removal; there is less trauma to the bladder than in extra peritoneal or transvesical methods of removal, since not only can the sac be excised without opening the bladder but only a relatively small area of the bladder wall requires dissection. The possibility of infecting the general peritoneal cavity may formerly have been an important argument against the use of this route, especially in patients who had had repeated catheterisation resulting in cystitis. In our clinics the great majority of prostate patients in recent years have either been admitted with acute retention without a catheter having been passed, or have been investigated in the out‐patient clinics and have had no instrumentation prior to immediate pre‐operative cystoscopy; the urine in consequence is usually free from infection. Moreover, the greater control of infection in the urinary tract, should it exist, by the use of antibiotics and sulphonamides, has made the urologist much less fearful of opening the peritoneal cavity for operation on the bladder than used to be the case. The radiographic technique described has proved a valuable aid in the selection of cases for the transperitoneal operation. Ten successful cases of transperitoneal diverticulectomy have been described.
URETHRAL DIVERTICULA AND CALCULI
Authors: Wood Kenneth
Published: November 2008

Two cases of urethral diverticula are reported; in one case the sac was empty and in the other there was a large stone weighing 104 g.

Urethral diverticula are congenital or acquired, the latter being the consequence of peri‐urethral abscess, trauma, or stricture.

Irrespective of origin the changes that can occur in a urethral diverticulum are the same and depend upon the size of the communication with the urethra; either acute infective episodes occur or, if there is adequate drainage into the urethra, a stone slowly forms.

The diagnosis of an infected empty sac is made by urethrogram. If a calculus is present it can be palpated and the diagnosis confirmed radiologically and by urethroscopy.

Treatment is by excision of the diverticulum and removal of any calculi present, combined with temporary diversion of the urinary flow.
DIVISION OF THE EXTERNAL URETHRAL SPHINCTER IN THE TREATMENT OF THE PARAPLEGIC BLADDER: A Preliminary Report on a New Procedure
Authors: Ross J. Cosbie , Gibbon N. O. K. , Damanski M.
Published: November 2008

1. Division or resection of the external sphincter is a new operation designed to relieve retention of urine (or a high residue) in patients with an open bladder‐neck and a narrow, rigid external sphincter area and in whom subarachnoid alcohol block, pudendal neurectomy or a bladder‐neck resection have failed to help. The operation converts a chronic retention to an easily expressible bladder.

2. Ten patients are reported.

3. The operation technique is described.

4. During the post‐operative period care is necessary in preventing or dealing with clot‐retention and with severe infection due to absorption of organisms in the urethra.

5. The operation should not be attempted in patients with grossly dilated upper urinary tracts and in those with uncontrollable infection.

6. The eight surviving patients have been spared the catheter life and, possibly, subsequent damage to the upper urinary tract.
Neonatal Renal Tumours
Authors: HILTON CLARE , KEELING JEAN W.
Published: November 2008

Seven cases of neonatal renal tumours are described and their histological differences to those of nephroblastoma are discussed.

From these and their favourable prognosis, they are considered hamartomatous and emphasis is laid on their management by surgery alone.
Sodium Excretion after Relief of Urinary Tract Obstruction in Children
Authors: GHAZALI S. , BARRATT T. M.
Published: November 2008

After relief of obstructive nephropathy urinary sodium excretion rose in 39 of 50 children to a mean in the whole group of 59% above preoperative levels.

There was a significant positive correlation between the increase in sodium excretion in the first 24 hours after operation and the increase in GFR at 1 week.

The data are compatible with the hypothesis that the reversibly obstructed kidney is characterised by nephron underperfusion and enhanced proximal reabsorption of filtrate due to hydrodynamic factors.
The Effect of Ubretid on Bladder Function after Recent Complete Spinal Cord Injury
Authors: SMITH P. H. , COOK J. B. , PRASAD E. W. M.
Published: November 2008

Recordings of bladder pressure and urine flow have been carried out in 4 patients in the early weeks after spinal cord injury in the control situation, following the injection of 0–25 mg carbachol, and after injection of 0–5 mg Ubretid.

In the control situation the bladder pressure remains constant and low.

Following the injection of carbachol there is a predictable rise in the bladder pressure of 30 to 60 cm of water which gradually falls towards the base line after 30 to 50 minutes and, on occasions, is associated with a flow of urine.

After the injection of Ubretid the basal bladder pressure rises and rhythmical contractions occur, of 10 to 60 cm of water in maximum height but in no case did this assist the patient to void urine.

In our view Ubretid is not indicated in the management of the bladder in early weeks after spinal cord injury.
Bilateral Breast Metastases from Carcinoma of the Prostate
Authors: SCOTT JAMES , ROBB‐SMITH A. H. T. , BURNS IAN
Published: November 2008

A case of bilateral breast metastases developing in a patient with carcinoma of the prostate while on oestrogen therapy is described.

Differentiation between prostatic metastases and primary breast tumours under these circumstances is important as the treatment for each is different.

Such differentiation may be difficult by conventional histological techniques, but histochemical analysis can resolve the problem, as was possible in this case.
Composition of Urinary Calculi by X‐ray Diffraction. Collected Data from Various Localities. Parts XV‐XVII
Authors: SUTOR D. JUNE , WOOLEY SUSAN E.
Published: November 2008

An X‐ray diffraction study of the composition of upper tract urinary stones from 3 centres in Great Britain shows that the calcium oxalates and the calcium phosphates are the most abundant and frequently occurring crystalline constituents, and that the most common varieties of stones are those composed of pure calcium oxalate and calcium oxalate+calcium phosphate. The relative proportions of these types, however, vary in the different areas.

Infection stones consisting of struvite + calcium phosphate are the next important type in the collections from Bristol and Dundee, but there are few of these stones in the collection from the Royal Navy.

In a small collection of lower urinary tract calculi from Dundee, stones composed of calcium oxalate + calcium phosphate again predominate, but they are exceeded by infection stones if the different varieties of these are grouped together.

Whereas a few composition types dominate the collections of upper urinary tract calculi, there are many more combinations of constituents found in the collection of lower tract stones.
The Incidence, Investigation and Treatment of Idiopathic Hypercalciuria
Authors: ROSE G. ALAN , HARRISON A. R.
Published: November 2008

A hundred and eight patients with renal calculi attending a single clinic were studied in order to try and establish the primary cause of their stones. Sixty‐six of these patients (61 %) proved to have idiopathic hypercalciuria, confirming that this is the most common cause of renal calculi in adult males.

A total of 87 patients with idiopathic hypercalciuria were investigated. Plasma calcium was normal with no “tendency to a low plasma calcium”, plasma inorganic phosphate was only 0–5 mg/100 ml below normal, and plasma urate only 0–5 mg/100 ml above normal.

The long‐term effect on the urinary calcium of patients with idiopathic hypercalciuria treated with bendrofluazide and/or cellulose phosphate has been studied. The success rate in lowering urinary calcium was 54% for thiazide alone, 60% for cellulose phosphate alone, and 100% in the small number treated with both drugs together. The overall success rate was 75 %, but may yet rise further.
A Personal Experience with 37 Turner‐Warwick Scrotal Inlay Urethroplasties
Authors: ASHKEN MICHAEL HANDLEY
Published: November 2008

The use of the Turner‐Warwick scrotal inlay urethroplasty has been reviewed in 37 cases, of whom 25 have been completed with closure of their urethroplasties.

The patients have been delighted with their micturition even during the review stage but slight post‐micturition dribbling and impaired ejaculation have been reported in a few cases.

The use of fine Dexon absorbable sutures throughout all stages of the urethroplasty has been recommended.

I wish to express my gratitude to Richard Turner‐Warwick for initiating me into this technique of scrotal inlay urethroplasty.
The Role of Some Tryptophan Metabolites in Certain Diseases of the Genito‐Urinary System1
Authors: AL‐HADITHI NAJIM A.
Published: November 2008

Thin‐layer chromatography (qualitative and quantitative) was used to examine the excretion of 4 tryptophan metabolites, kynurenine and 3‐hydroxy‐kynurenine, anthranilic acid and xanthurenic acid.

The control group showed a small range of variation from day to day and from person to person, except for one who was on the contraceptive pill. She showed a marked increase in the amount of the metabolites excreted.

The excretion was increased in a proportion of the kidney and bladder neoplasm patients. In the calculus cases, 2 showed a marked rise, while of the patients with prostatic hyperplasia 1 had a very high excretion as did 1 of the cases of retroperitoneal fibrosis.

High excretion can occur in a variety of conditions but as yet is no aid to diagnosis.
Renal Angiomyolipoma–Report of 5 Cases
Authors: MA MICHAEL KIN GAY , CHAN KEENG WAI
Published: November 2008

Five cases of unilateral renal angiomyolipoma seen in Chinese patients in Hong Kong are reported.

The clinical manifestations are reviewed in 57 cases which included 52 collected in the literature. The predominant features are pain (73.7 %), haematuria (26.3 %) and the presence of a loin mass (42.1%).

Among various investigative procedures, renal angiogram is probably the most useful.

We would like to thank Professor G. B. Ong, Dr T. B. Teoh and Dr K. T. Tham for their kind assistance in the study of these cases.
Sodium Cellulose Phosphate in Vitamin D Intoxication
Authors: QURESHI M. S. A. , MOORE RALPH , GOLDSMITH H. J.
Published: November 2008

A case of hypercalcaemia due to iatrogenic vitamin D intoxication is reported. Following treatment with prednisolone and sodium cellulose phosphate early symptomatic improvement occurred. The 24‐hours urinary calcium excretion returned to normal after 5 weeks of treatment but the patient became normocalcaemic only after 13 months. Renal function also improved marginally over this period.

Wae wish to thank the staff of the biochemistry department, Sefton General Hospital for their help.
Further Experience with the Rectosigmoid Bladder
Authors: GHONEIM M. A. , ASHAMALLAH A.
Published: November 2008

89 patients suffering from carcinoma of the bladder treated by cystectomy and construction of a rectal bladder were reviewed.

The immediate postoperative mortality was 12.5 %, most deaths being due to infection.

64 patients had been followed for 6 months to 3 years.

The 64 patients possessed a total of 115 kidneys, and there was radiological evidence of postoperative deterioration in 23 instances. Anastomotic stricture formation was the commonest complication.

Measurement of rectal bladder capacity showed the functional to be smaller than the anatomical. This was shown radiologically to be due to a change of posture; the capacity is greater when the patient is supine than when he is erect.

Nearly all patients were continent by day; leakage at night occurred in 40 %

29 of 32 patients were at work 1 year after operation.
Prostatic Calculi as a Source of Recurrent Bacteriuria in the Male
Authors: EYKYN SUSANNAH , BULTITUDE M. I. , MAYO M. E. , LLOYD‐DAVIES R. W.
Published: November 2008

Three patients with recurrent symptomatic bacteriuria are presented, in each of whom radio‐opaque prostatic calculi were present and were shown to harbour the infecting organism.

We thank Dr B. Rowe for kindly typing the E. coli strains and Miss C. Jenkins for careful technical assistance.
Determination of the Optimum Temperature for Regional Renal Hypothermia during Temporary Renal Ischaemia
Authors: WARD J. P.
Published: November 2008

To determine the optimum temperature at which the in situ kidney should be maintained while it is ischaemic, 47 mongrel dogs were studied.

35 of these underwent 90 minutes of left renal ischaemia with the kidney temperature maintained at 37°, 30°, 22°, 15°, 10°, 5° and 0° C respectively.

The effect on renal function was determined by measurements of G.F.R. before and at regular 15‐minute intervals after the ischaemic period. Computer statistical analysis exposed the optimum temperature to be 15° C.

Renal artery blood flow, renal histology, 51Cr labelled platelets and renal arteriography were used to determine the mechanism of ischaemic injury.

Quantitation of renal cell injury confirmed that no additional protection to ischaemia could be gained by cooling below 15° C.

15° C is recommended as the optimum temperature for use in clinical renal hypothermia.
A Critical Review of the Management of Bladder Neoplasia using a Modified Form of Helmstein's Pressure Therapy
Authors: GLASHAN R. W.
Published: November 2008

30 patients with proven bladder malignant disease have been treated by Helmstein's hydrostatic pressure technique.

Massive necrosis of tumour tissue has been shown to occur at cystoscopy, cytologically and on histological examination.

Double contrast cystography can indicate reduction in tumour size within 2 weeks of treatment. Haematuria is usually stopped with diminution of frequency and dysuria.

This treatment is suitable for large bulky T1 tumours and advanced T4growths where palliation is the only treatment possible but not for T2and T3growths.

Elderly and ill patients can tolerate this therapy easily and there were no serious side‐effects in this series.
A Study of the Bladder Blood Flow During Distension in Rabbits
Authors: DUNN M.
Published: November 2008

This study has shown that there is a linear relationship between bladder blood flow and bladder pressure. At a bladder pressure of 80 mm Hg (blood pressure in rabbits varying from 90/60100/70 mm Hg) the blood flow in the bladder is minimal.

It is suggested that bladder distension at 80 mm Hg in rabbits leads to hypoxia in the bladder wall as a result of the reduced blood flow.

Prolonged bladder wall hypoxia occurring as a result of prolonged bladder distension may be responsible for selective necrosis of bladder tumours.
The Technique and Results of One‐stage Island Patch Urethroplasty
Authors: BLANDY J. P. , SINGH MANMEET
Published: November 2008

27 one‐stage island patch urethroplasties have been performed with the longest follow‐up of 3 years.

The method seems to have most of the advantages of standard 2‐stage scrotal flap urethroplasty, and is suited to all but the most difficult and complicated strictures at any site in the urethra.
Hypertension and Renal Artery Stenosis with Aneurysm Formation in a Solitary Kidney in a Patient with Neurofibromatosis
Authors: HARDY D. G. , HATELY W. , NEWTON J. R. , DATHAN J. R. E. , BLANDY J. P. , EADIE D. G. A. , GOODWIN F. J.
Published: November 2008

A case of hypertension in a patient with neurofibromatosis and renal artery stenosis with aneurysm formation in a solitary kidney is descrited.

Studies of plasma renin activity and body sodium content are presented and have been related to findings in patients and experimental animals with renovascular hypertension.

A reconstructive operative procedure is described in which the kidney is perfused in situ.
Urodynamic Observations Following Spinal Trauma
Authors: THOMAS D. G. , SMALLWOOD R. , GRAHAM D.
Published: November 2008

A method of the urodynamic investigation of paraplegic and quadriplegic patients is described. Serial measurements of the urethral pressure profile in patients with developing reflex micturition demonstrate a rising pressure at the external urethral sphincter with time following spinal trauma.

Patterns of micturition with detrusor‐sphincteric imbalance are described in patients with both early and well‐established reflex micturition.
The Relationship of the Urinary Cations, Calcium, Magnesium, Sodium and Potassium, in Patients with Renal Calculi
Authors: WELSHMAN S. G. , MCGEOWN M. G.
Published: November 2008

Calcium, magnesium, sodium and potassium were estimated in the 24‐hour urine collections of 101 idiopathic male stone‐formers, 89 male patient controls and 59 young male adult controls.

The results were calculated in terms of 24‐hour volume and 1 g of creatinine. The concentrations of the 4 cations, relative to a gram of creatinine, were also determined in the early‐morning urines of 41 male stone‐formers and 43 young male adult controls.

No difference was observed in the 24‐hour excretion of calcium, magnesium and sodium between the stone‐formers and controls. The mean daily potassium excretion, however, was significantly reduced in the urine of stone‐formers.

The linear regression equations were calculated for calcium on magnesium, calcium on sodium, and calcium on potassium, using the 24‐hour excretion values of these cations. Only the calcium on potassium line of stone‐formers was significantly different from that of the normal subjects.

A significant increase by stone‐formers in the urinary calcium concentration of their early‐morning specimens was found. The high concentration of urinary calcium in overnight urines of stone‐formers combined with a low magnesium concentration might possibly contribute to the development of renal stone disease.
Oestrogen Therapy and Serum Cortisol in Carcinoma of the Prostate
Authors: MORALES ALVARO , KRAUS ARTHUR S. , BRUCE ANDREW W.
Published: November 2008

Patients with prostatic cancer, receiving oestrogen therapy were found to have elevated serum Cortisol levels and lymphopenia. Oestrogens are known to have a profound effect on the immune system; the possibility that this effect is mediated through the adrenal cortex is discussed. The significance of these findings, however, remains to be determined.
Serial Fluorine‐18 Bone Scans in the Follow‐up of Carcinoma of the Prostate
Authors: BUCK A. C. , CHISHOLM G. D. , MERRICK M. V. , LAVENDER J. P.
Published: November 2008

74 patients with prostatic cancer were studied annually by combined radiological and fluorine‐18 scan survey over a 5‐year period.

The results of the long term follow‐up of bone scans is reported.

At the time of the initial diagnosis 71·5% of the patients had advanced disease and 56% had radiological or scan evidence of metastases. A critical evaluation of the scans resulted in the detection of early bone lesions in 25% of patients with no radiological evidence of metastases. Follow‐up of these patients has shown that scan abnormalities preceded radiological changes from between 1 to 4 years and there was good correlation proven histologically by bone biopsy or autopsy in more than half of the patients. In patients with a positive bone scan and positive

X‐rays the scan abnormalities were more extensive than the corresponding X‐ray lesions. When bone healing occurred with endocrine treatment this was more readily apparent on the X‐rays. False negative scans were not seen with fluorine‐18 which allows for greater accuracy in the detection of skeletal metastases.

Bone scanning has enabled correct staging to be carried out.

This study confirms the high incidence of cardiac and vascular complications in patients treated with oestrogens.
Vas Anastomosis: a Return to Simplicity
Authors: SCHMIDT STANWOOD S.
Published: November 2008

Vas anastomosis is successful in restoring sperm to the ejaculate in 80 to 90% of cases.

A simple, end‐to‐end, mucosa‐to‐mucosa anastomosis performed with non‐absorbable, monofilament sutures is, in the author's opinion, the best procedure.

Pregnancies follow in about one‐third of the cases.
Ampicillin, Carbenicillin Indanyl Ester, and Nifuratel in the Treatment of Urinary Infection in Domiciliary Practice
Authors: Davies B. I. , Mummery R. V. , Brumfitt W.
Published: November 2008

A total of 120 patients, including 53 pregnant women with significant bacteriuria, received 163 7‐day courses of oral antimicrobial agents allocated in a randomised manner. The cure rates after 6 weeks' follow‐up ranged from 73% to 86%, and there was no statistical difference between preparations of ampicillin, carbenicillin indanyl ester, and 2 different formulations of nifuratel. Side‐effects occurred in 30% to 40% of the courses of penicillin drugs, but in under 15% of the course of nifuratel.

It is concluded that the new oral preparation of carbenicillin is a useful addition to the list of antimicrobial agents which are effective in the treatment of urinary infections in domiciliary patients. Furthermore, nifuratel has been confirmed as a highly active non‐toxic drug which is valuable in the treatment of urinary infections.
Terodiline, Emepronium Bromide or Placebo for Treatment of Female Detrusor Overactivity? A Randomised, Double‐blind, Cross‐over Study
Authors: ANDERSEN J. R. , LOSE G. , NØRGAARD M. , STIMPEL H. , ANDERSEN J. T.
Published: November 2008

Summary— In a randomised, double‐blind study, 20 women with idiopathic detrusor instability and associated symptoms were treated with terodiline 25 mg bd, placebo, and emepronium bromide 200 mg tds—each drug being given for 3 weeks with placebo as wash‐out period before cross‐over. The results were evaluated according to drug preference, frequency charts and elimination of detrusor instability on cystometry. Serum levels of both drugs were monitored as control of tablet intake.

The preference for terodiline to placebo was statistically significant: 14/3 women (P<0.05), and the majority of women (12/4) preferred terodiline to emepronium. Terodiline also gave a small but significant reduction in 24 h micturition frequency and eliminated detrusor instability in almost 50% of the patients (P<0.05). Side effects were frequent but mild in all three treatment periods. It was concluded that terodiline offers an alternative in the treatment of female detrusor instability.
One Hundred Artificial Sphincters
Authors: NURSE Diane E. , MUNDY A. R.
Published: November 2008

Summary— One hundred patients with urinary incontinence of various aetiologies underwent implantation of an artificial urinary sphincter (AUS). In 40 patients various reconstructive procedures of the lower urinary tract were carried out at the same time.

In 93 patients the results were successful and they are continent. Six are incontinent and 4 of these await AUS replacement. One patient has had a urinary diversion with the sphincter still in situ and functioning.

The complication rate was 45% (of which 29% were designated “sphincter‐related”). Half of these were accounted for by two complications: one was a change in bladder behaviour in patients with neuropathic bladders and the other was stress incontinence as a direct result of implanting low pressure devices. If these two factors and the “sphincter‐unrelated” problems are discounted, the complication rate was 13%.

The AUS is a satisfactory and successful method of treatment for sphincter weakness incontinence regardless of aetiology and the results suggest no contraindication to implantation at the same time as reconstructive surgery of the lower urinary tract.
Three‐monthly GnRH Agonist (Buserelin) for Prostatic Cancer
Authors: WAXMAN J. , SANDOW J. , ABEL P. , BARTON C. , KEANE P. , WILLIAMS GORDON
Published: November 2008

Summary— A new slow release formulation of buserelin given as a 3‐monthly depot injection has been evaluated in 4 patients with advanced prostatic cancer previously maintained on shorter acting depots. Treatment was maintained for a mean period of 21 months. Steady state urinary buserelin concentrations were reached by the beginning of the third treatment week and maintained until the end of the third treatment month. Serum testosterone remained suppressed in the castrate range for the duration of the study. Seven previously untreated patients were entered into treatment. Serum testosterone was suppressed into the castrate range between the seventh and fourteenth days after implantation. This preparation offers an advantage for the patient and clinician over existing methods of GnRH analogue administration and will now enter further clinical trial.
Complete Urethral Stricture of the Membranous Urethra: a Different Perspective
Authors: KERNOHAN R. M. , ANWAR K. K. , JOHNSTON S. R.
Published: November 2008

Summary— Seven patients with complete rupture of the membranous urethra secondary to trauma were treated by internal optical urethrotomy (OU). All underwent initial suprapubic catheter drainage. The diagnosis of complete urethral rupture was confirmed by ascending and descending urethrograms and subsequent urethroscopy. OU was performed 3 weeks to 8 years following injury. Although all patients required further OUs for recurrent strictures, all can pass urine satisfactorily. Two patients have slight stress incontinence. This technique is a viable alternative to more conventional procedures for this condition.
The Stamey Endoscopic Bladder Neck Suspension in the Elderly
Authors: GRIFFITH‐JONES M. D. , ABRAMS P. H.
Published: November 2008

Summary— The Stamey procedure was performed on 21 women aged 65 to 81 years; 17 were cured (completely dry) or significantly improved (maximum 1 pad/day). Urethral length was significantly increased by the operation but maximum urethral pressure and maximum flow rate were unchanged. Complications were few.
Management of the Contralateral Testis in Patients with Testicular Germ Cell Cancer
Authors: FORDHAM M. V. P. , MASON M. D. , BLACKMORE C. , HENDRY W. F. , HORWICH A.
Published: November 2008

Summary— Patients with testicular germ cell tumours (TGCT) are at increased risk of developing a tumour in the contralateral testis. Such a tumour may be preceded by carcinoma in situ (CIS), which is more common in patients with infertility, atrophic testis or a history of cryptorchism. Of 1219 patients with TGCT seen at the Royal Marsden Hospital between 1962 and 1984 in whom the contralateral testis was managed by surveillance, 38 (3.1%) developed a second tumour and 8 died of germ cell tumours. Seventeen of 26 assessable patients (65%) exhibited at least one of the known aetiological risk factors for carcinoma in situ. Diagnosis of carcinoma in situ may lead to more appropriate management of the contralateral testis.
Sperm Morphological Analysis: Comparison of Two Methods in Human Semen
Authors: BADENOCH D. F. , EVANS P. R. , GRAY A. , EVANS S. J. W.
Published: November 2008

Summary— Sperm morphological analysis was performed by 2 methods: light microscopy on Papanicolaou stained material and scanning electron microscopy. Both methods were found to have acceptably low levels of observer error and a positive correlation existed between them. Sperm morphology was analysed by both methods in 2 groups: (1) 104 proven “fertile” men, husbands of women who had just given birth and whose paternity had been proven by HLA studies with > 95.5% certainty; (2) 53 infertile men from primary infertile marriages in whom no female cause could be found and excluding those with azoospermia. There was no statistically significant difference in medians between the 2 groups when sperm morphology was analysed by light microscopy, but analysis by scanning electron microscopy did show a significant difference.
Continent Cutaneous Ileostomy (Kock Pouch) prior to Renal Transplantation
Authors: MARECHAL J. M. , SANSEVERINO R. , GELET A. , MARTIN X. , SALAS M. , DUBERNARD J. M.
Published: November 2008

Summary— Two patients in end‐stage renal failure and with neurogenic bladders due to spina bifida complicated by myelomeningocele were considered for renal transplantation.

One patient had had a right nephrectomy and urinary diversion via an ileal conduit; the other, after various external drainage procedures (cystostomy, bilateral nephrostomy), had had a tubular ileocystoplasty. Both underwent 2 surgical procedures prior to renal transplantation: in case 1 we performed a left nephrectomy and then ileal conduit removal + Kock pouch; in case 2 a bilateral nephrectomy was performed via 2 posterior incisions and then we removed the ileocystoplasty and formed the pouch.

The continent ileostomy was formed according to the original technique with slight modifications. The patients have been followed up for 12 and 15 months after transplantation.
Long‐term Results of Colposuspension
Authors: WHEELAHAN J. B.
Published: November 2008

Summary— A series of 102 patients were treated by a technique of colposuspension similar to the Pereyra operation, in which a pair of monofilament sutures were tied over the rectus muscle; 79% of patients (78/99) reviewed 1 year after the operation were continent. During further follow‐up (mean 4.5 years) there were 7 late failures, all within 4 years. Kaplan‐Meier lifetable analysis showed 69% probability of continence at 5 years. The main factors associated with recurrent or persistent incontinence were detrusor instability (60% incontinent: 9/15) and previous failed colposuspension or multiple vaginal repairs (55% incontinent: 11/20). In the absence of these risk factors 90% of patients maintained continence throughout the follow‐up period. This technique has given results at least equal to those reported for the Burch and Marshall‐Marchetti‐Krantz techniques of colposuspension.