bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Changes in Epidemiological Factors on the Composition and Racial Distribution of Renal Calculi
Authors: BEUKES G. J. , BRUIYN H. DE , VERMAAK W. J. H. 
Published: November 2008

Summary— One thousand and two calculi, which occurred in both black and white patients during a 15‐year period, have been analysed by the X‐ray diffraction technique. Calcium oxalate calculi were the most common irrespective of race. Whewellite calculi were equally distributed in both race groups, while weddelite stones appeared to be much less common amongst blacks; the opposite applied for struvite and the rare ammonium acid urate stones. The other calculi were approximately equally distributed between the two race groups. A statistically significant rising trend in the prevalence of renal stones in blacks, accompanied by changes in the ratios of the major stone forming constituents, have been a prominent feature of this survey. However, the aforementioned remained unchanged in white patients. Contrary to previous impressions, total urates exceed phosphates in whites as a major stone forming constituent. The composition of upper urinary tract stones in blacks, during the 3‐year period 1981 to 1983, was very similar to the composition previously reported for the Sudanese.The profile of renal stones in blacks over the last 3 years, however, is now becoming substantially different from that of the other previously reported surveys and may be approaching that of their white compatriots. A change in the dietary patterns in blacks is occurring which is also reflected in an increasing incidence of ischaemic heart disease and which may also be responsible for the observed changes in renal stones.
Ureteroscopy and Ureteric Calculic how Useful?
Authors: KINDER R. B. , OSBORN D. E. , FLYNN J.T. , SMART J. G. 
Published: November 2008

Summary— The results of management in 134 patients admitted to hospital during 1985 with ureteric colic are presented in relation to the size and position of a ureteric stone. Spontaneous passage of a stone occurred in 100 patients and 34 required surgical intervention. Stones measuring 5 mm or less in maximum dimension passed spontaneously in 92% of cases; stones measuring 6 mm or more had only a 28% chance of passing.Of 34 surgical procedures 19 were endoscopic. In three cases a stone was removed under vision with ureteroscope and Dormia basket. In five patients ureteric dilatation before attempted ureteroscopy permitted later passage of the stone. In 1986 similar results were obtained with ureteroscopic stone removal performed in three cases. Fewer open operations and more Dormia basket extractions were performed in 1986.In this series the size of the stone was closely related to outcome. The high chance of spontaneous passage (75% in 1985 and 84% in 1986) puts the need for surgical intervention, and in particular ureteroscopy, into perspective in the management of patients with ureteric colic.
Development of Bladder Tumour Containing HPV Type 11 DNA after Renal Transplantation
Authors: QUERCI DELLA ROVERE G. , OLIVER R. T. D. , McCANCE D. J. , CASTRO J. E. 
Published: November 2008

Summary— We report a case of bladder cancer developing in a patient after renal transplantation in whom it was possible to demonstrate DNA evidence for infection of the tumour with HPV Type 11.The significance of the observation is discussed in relation to the hypothesis that immunosurveillance can control the development of malignancy.
Teflon Injection in Female Stress Incontinence. Effect on Urethral Pressure Profile and Flow Rate
Authors: VESEY S. G. , RIVETT A. , O'BOYLE P. J. 
Published: November 2008

Summary— Thirty‐six females with genuine stress incontinence (GSI) were treated by bladder neck teflon injection. Urethral pressure profilometry (UPP) and uroflowmetry were performed both pre‐and post‐operatively on 18 patients. In 24 patients who were either completely cured or improved by this procedure, the mean urine flow rate was reduced by 23% and the mean functional profile length increased by 9% compared with pre‐operative values. Although these findings appear to explain the mechanism by which teflon improves continence, these differences were not statistically significant.Fourteen of the 18 patients who had not responded to previous anti‐incontinence procedures were successfully treated by teflon injection. The improved response rate in these patients was not statistically significant. It was not possible to predict with certainty those patients most likely to respond to teflon injection. However, in women with normal or near normal pelvic floor anatomy the procedure had an acceptable success rate. In view of the simplicity, lack of morbidity and the ease with which it can be performed and repeated, bladder neck teflon injection deserves consideration as an alternative, particularly where open surgery has failed.
Long‐term Outcome of Boys with Posterior Urethral Valves
Authors: PARKHOUSE HELEN FITZMAURICE , BARRATT T. M. , DILLON M. J. , DUFFY P. G. , FAY J. , RANSLEY P. G. , WOODHOUSE C. R. J. , WILLIAMS D. I. 
Published: November 2008

Summary— One hundred and fourteen boys with posterior urethral valves were treated between 1966 and 1975. Four died during the first hospital admission, 6 died from renal failure during childhood, 1 died from other causes and 15 were lost to follow‐up. Eighty‐eight were reviewed 11 to 22 years after diagnosis and the renal outcome of 98 patients is therefore known. Approximately one‐third of patients presented under 1 month of age, between 1 month and 1 year, and over 1 year respectively. Bilateral vesicoureteric reflux was observed in one‐quarter of the boys, more frequently in those presenting in the first month of life. Half of the patients were treated by primary valve ablation and half underwent temporary upper tract diversion: the outcome was worse for the diverted group.One‐third of the boys had a long‐term bad outcome for renal function. This outcome was associated with early presentation, bilateral vesicoureteric reflux and day‐time urinary incontinence after the age of 5 years. The association of bad outcome with incontinence points to continuing bladder dysfunction as a major determinant of long‐term outcome for renal function.
The Value of Sonography in the Diagnosis and Follow‐up of Patients with Blunt Renal Trauma
Authors: FURTSCHEGGER A. , EGENDER G. , JAKSE G. 
Published: November 2008

Summary— Eighty‐eight patients with blunt renal trauma were examined sonographically. Rupture of the kidney was diagnosed in 41 patients and contusion of the kidney in 45. The correlation between operative findings, sonography and urography showed positive sonographic findings to be correct in all patients with rupture of the kidney. In 4 patients with normal sonograms, the diagnosis of a contusion was based on the urographic results. Three patients underwent angiography. An intimal lesion was seen in 2 and a tear of the renal artery in 1.The results of our investigation suggest that sonography should be applied in the first place in the evaluation of blunt renal trauma. It is the investigation of choice during follow‐up after surgical as well as conservative therapy.
Clinical Significance of Ureteric Diameter on Intravenous Urography after Spinal Cord Injury
Authors: ARNOLD E. P. , COWAN I. A. 
Published: November 2008

Summary— The ureteric diameter on IVU was compared with the MCU findings of reflux or lower urinary tract dysfunction in a group of patients followed up after spinal cord injury. A wide ureter was associated with reflux in 20%, but 8 normal sized ureters on IVU also refluxed—5 of them to a significant degree. In the non‐refluxing group, wide ureters were noted more often in patients whose bladder pressures were high and wildly fluctuating than in those with normal bladder pressures. Similarly, the incidence of reflux was higher in patients with high bladder pressures and wild fluctuations of bladder pressure than in those with normal pressures.While a wide ureter on IVU should arouse suspicion that reflux or lower urinary tract dysfunction might be present, these conditions are not necessarily excluded by the finding of a ureter of normal size.
Transrectal Ultrasound versus Cystography In the Evaluation of Anatomical Stress Urinary Incontinence
Authors: BERGMAN A. , McKENZIE CLAUDETTE J. , RICHMOND J. , BALLARD C. A. , PLATT L. D. 
Published: November 2008

Summary— Thirty‐two female patients with clinical and urodynamic findings of genuine stress urinary incontinence were evaluated before and 6 months after surgery for stress urinary incontinence. Twenty‐nine control patients had identical evaluations before and 6 months after surgery which did not involve the urethrovesical junction. Twenty‐four patients with primary bladder instability had similar evaluations and served as a second control group.Anatomical landmarks indicating support to the urethrovesical junction were evaluated by the position of the urethra at the most dependent point in the bladder on straining and the urethral descent on straining to beneath the posterior ramus of the symphysis pubis on bead chain cystography. The urethrovesical junction drop on straining was evaluated by transrectal ultrasonography.Cystographic and ultrasonographic tests for the position of the urethrovesical junction at the most dependent position in the bladder during straining were very sensitive in women with stress urinary incontinence (94 and 87% respectively) but much less specific (45 and 48% respectively). When evaluating anatomical support to the urethrovesical junction and its descent on straining, these tests were both highly sensitive (97 and 94% respectively) and specific (76 and 96% respectively) in women with genuine stress urinary incontinence.Simple clinical tests for support of the urethrovesical junction, such as the Q tip test, are nonspecific in patients with stress urinary incontinence. Transrectal ultrasonography is a simple and quick out‐patient procedure. The availability of ultrasound equipment in most clinics and the high sensitivity and specificity of the test make it an attractive and cost‐effective alternative to X‐ray cystography in the pre‐operative evaluation of anatomical support to the urethrovesical junction.
A Technique for Total Substitution of the Lower Urinary Tract without the Use of a Prosthesis
Authors: R. MUNDY A. 
Published: November 2008

Summary— A technique is described for total replacement of the lower urinary tract in women in which a pedicled labial skin tube is created and anastomosed to a substitution cystoplasty with a submucosal tunnelled type of “anti‐reflux” anastomosis which provides a continence mechanism. The patients thereafter void by intermittent self‐catheterisation.This technique has been used in 6 women as part of total pelvic reconstruction for vesico‐vagino‐rectal fistula following radical radiotherapy, with or without a Wertheim's hysterectomy, for carcinoma of the cervix. A similar technique using a pedicled preputial/penile skin tube has been used in 2 men following a cystoprostato‐urethrectomy for transitional cell carcinoma of the bladder.
The Effects of Transurethral Prostatectomy on Serum Prostate Specific Antigen
Authors: VESEY S. G. , GOBLE N. M. , STOWER M. J. , HAMMONDS J. C. , SMITH P. J. B. 
Published: November 2008

Summary— Serum prostate specific antigen (PSA) was recorded in 75 patients immediately before and after transurethral resection of the prostate (TURP). Fifty‐eight patients had benign prostatic hypertrophy (BPH) and 17 had prostatic carcinoma (CaP). In patients with BPH there was a statistically significant rise in PSA immediately following TURP. No such rise was seen in patients with prostatic carcinoma.A statistically significant correlation was identified between the weight of the benign hypertrophic prostate and the baseline pre‐operative serum PSA.Because of the effects of TURP on serum PSA it is important to avoid PSA estimations immediately following such surgery. The failure of the malignant prostate to release PSA in significant amounts during TURP suggests that the elevated levels of PSA found in patients with prostatic carcinoma arise not from the local disease but from its metastases.
Influence of Antisperm Antibodies on Human Sperm Function
Authors: AITKEN R. J. , PARSLOW J. M. , HARGREAVE T. B. , HENDRY W. F. 
Published: November 2008

Summary— Antisperm antibodies have been found in about 8% of men with infertility and in 60 to 80% of patients following vasectomy. I n order to investigate the way antibodies influence sperm function we studied serum and seminal plasma from patients with infertility (n = 61) or undergoing vasovasostomy (n = 25). These antisera were characterised to determine their TAT titre, the nature of the target antigens and their capacity to interfere directly with fertilisation.The results indicate that antibodies from both groups of patients exhibit a capacity to stimulate or suppress sperm/oocyte fusion. The proportion of samples showing stimulatory activity was higher (50%) in the vasovasostomised population than in patients with infertility (21%). The remainder of the antisera suppressed sperm/oocyte fusion. There was no correlation between the titre of antisperm antibodies and their capacity to influence sperm function, indicating that it is the nature of the target antigens which is of significance rather than the antibody concentration. Western blot analysis indicated that these antisera targeted a group of sperm surface antigens with molecular weights of 30kD (35,45,66,90 and 115kD). Monoclonal antibodies are now being prepared in order to determine which of these specific components are involved in the suppression of sperm function.
Single Dose, Oral Antibiotic Cover for Transurethral Prostatectomy
Authors: SHEARMAN C. P. , SILVERMAN S. H. , JOHNSON M. , YOUNG C. H. , FARRAR D. J. , KEIGHLEY M. R. B. , BURDON D. W. 
Published: November 2008

Summary— A double‐blind, randomised, placebo‐controlled study was carried out to determine the incidence and significance of bacteriuria in 110 patients undergoing transurethral resection of the prostate (TURP) and to assess the effect of a single pre‐operative dose of Ciprofloxacin, a 4‐quinolone antibiotic.Fifteen (68%) of the 22 patients in the placebo group with a positive post‐operative urine culture subsequently developed a clinically apparent urinary tract infection (UTI) or received antibiotics in view of a positive urine culture. Adequate prostatic concentrations of Ciprofloxacin were achieved in all who received the drug. A significant reduction in the number of positive post‐operative urine cultures and urinary tract infections requiring antibiotic therapy was achieved in this group. Six patients (5.5%) developed clinical evidence of septicaemia, 5 of whom were in the placebo group. No organisms resistant to Ciprofloxacin were encountered.Prior to surgery, 19% of all patients were found to have previously unsuspected bacteriuria. Ciprofloxacin tended to reduce the chances of this group developing a UTI or requiring antibiotics. Further, there was a highly significant reduction in post‐operative infective complications in those with sterile urine at the time of resection who had received the drug.This study suggests that antibiotic cover for TU RP is of clinical benefit. Ciprofloxacin may prove suited to this purpose, although further experience with the drug is still required.
Adenine Phosphoribosyltransferase Deficiency: 2, 8‐Dihydroxyadenine Urolithiasis in a 48‐year‐old Woman
Authors: USENIUS J.‐P. , RUOPURO M.‐L. , USENIUS R. 
Published: November 2008

Summary— We report the first patient in Finland and Scandinavia with a deficiency of adenine phosphoribosyltransferase (APRT). About 30 clinically affected patients have been reported in the literature. APRT deficiency is an enzyme disorder which is inherited autosomally in a recessive manner. The use of adenine in purine metabolism is disturbed and it accumulates in the body, where it is oxidised to poorly insoluble 2, 8‐dihydroxyadenine by xanthine oxidase. The dihydroxyadenine forms stones which can be mistaken for uric acid stones.Our patient had had frequent episodes of urolithiasis and the diagnosis was finally made after pyelolithotomy and stone analysis. The total APRT deficiency was detected in the haemolysate of erythrocytes. Partial eficiency of APRT in the patient's relatives showed heterozygosity of the enzyme defect.The only clinical manifestation of the defect is the formation of urinary stones. This can be prevented by diet and allopurinol.
Functional Innervation Patterns in the Corpus Spongiosum and Glans in the Dog
Authors: KIMOTO Y. , ITO Y. 
Published: November 2008

Summary—The neural control of smooth muscle cells in the corpus spongiosum, helicine artery and bulbus giandis of the dog was investigated in relation to the mechanism involved in erection, using isometric tension recording and micro‐electrode methods.In the corpus spongiosum, field stimulation evoked twitch‐like contractions followed by relaxations. These relaxations were enhanced and prolonged by neostigmine and partly suppressed by atropine. Guanethidine abolished the twitch‐like contractions and increased muscle tone. The relaxations observed after pre‐treatment with guanethidine were abolished by tetrodotoxin (TTX), thereby indicating that these muscles are innervated by adrenergic excitatory, cholinergic and non‐adrenergic non‐cholinergic inhibitory nerves.In the helicine artery and bulbus glandis, field stimulation evoked contractions and these contractions were abolished by guanethidine or TTX, indicating that these muscles are innervated by adrenergic excitatory nerve fibres. After pre‐treatment with guanethidine and atropine, muscle relaxation appeared in response to field stimulation in the helicine artery but not in the bulbus giandis, indicating that the helicine artery in the corpus spongiosum is also innervated by non‐adrenergic non‐cholinergic inhibitory nerves in addition to the excitatory adrenergic nerves. In the smooth muscle cells of the corpus spongiosum, slow potential changes were correlated with spontaneous contractions and field stimulation evoked excitatory or inhibitory junction potentials.The neural mechanism involved in erection is discussed in relation to the topical difference in the autonomic innervation patterns in the corpus spongiosum, helicine artery and bulbus giandis.
Torsion of Scrota1 Contents in Children
Authors: McCOMBE A. W. , SCOBIE W. G. 
Published: November 2008

Summary— One hundred and forty consecutive cases of torsion of scrota1 contents were reviewed retrospectively. There were 95 cases of torsion of the testicular appendage and 45 cases of testicular torsion. Testicular torsion was more common on the left and patients tended to present earlier with more systemic upset in the form of vomiting, abdominal and groin pain than patients with torsion of a testicular appendage. Pathognomic features of examination were an elevated or ectopic testis in 50% of cases of testicular torsion and a palpable tender blue nodule in 21% of cases of torsion of a testicular appendage.We believe that it is often possible to distinguish between these two conditions and, where this is possible, a trial of conservative management is justified for torsion of a testicular appendage.
Relative Value of Antibiotics and Catheter Care in the Prevention of Urinary Tract Infection after Transurethral Prostatic Resection
Authors: STRICKER P. D. , GRANT A. B. F. 
Published: November 2008

Summary— One hundred patients were prospectively randomised into two groups to receive either a single dose of 1 g ampicillin and 80 mg gentamicin pre‐operatively or no antibiotic prophylaxis. The incidence of breakage in the continuity of the closed drainage system was documented. All patients with urinary tract infection (UTI), catheterisation, clinical prostatic carcinoma, neurogenic bladder and bladder tumours were excluded. UTls, bacteraemia and fever were noted. There were 7 late exclusions. The incidence of UTI in the control and antibiotic groups was 16 and 17% respectively. No blood cultures were positive. There were no significant differences in the incidence of fever between the two groups.A break in the closed drainage system occurred in 13 patients. Fifteen of the 93 developed UTI. A break in the closed drainage system occurred in 7 of the 15 patients (40%) with UTI. Of the 78 patients without UTI, 8 had a break (10%). This difference was highly significant.We recommend that less emphasis be placed on prophylactic antibiotics and more on avoiding breakage of the closed system in the prevention of UTI after transurethral resection of the prostate (TURP) in the low risk situation.
Urethral Dilatation Compared with Cystoscopy Alone in the Treatment of Women with Recurrent Frequency and Dysuria
Authors: RUTHERFORD A. J. , HINSHAW K. , ESSENHIGH D. M. , NEAL D. E. 
Published: November 2008

Summary— The relative merits of cystoscopy alone and cystoscopy plus urethral dilatation were compared in a randomised study of women with recurrent frequency and dysuria.One hundred women were studied before and at least 6 months after operation. A detailed questionnaire was completed, the severity of the symptoms was scored and patients underwent urodynamic investigation. Forty‐eight patients underwent cystoscopy alone and 52 underwent urethral dilatation. The two groups were well matched with regard to age, parity, menopausal status, previous gynaecological surgery and severity of symptoms.A significant improvement in symptoms was observed in both groups after treatment: 30% had no residual symptoms, 50% were improved and 20% were no better. However, no difference in final outcome was observed between those who had undergone cystoscopy alone and those who had undergone urethral dilatation. Furthermore, 7 patients who underwent urethral dilatation experienced transient stress incontinence of urine, a complication not observed in women who underwent cystoscopy alone. No benefit was observed from the addition of urethral dilatation to cystoscopy alone in women with recurrent frequency and dysuria.
The Biphasic Nature of Renal Functional Recovery Following Relief of Chronic Obstructive Uropathy
Authors: JONES D. A. , GEORGE N. J. R. , O'REILLY P. H. , BARNARD R. J. 
Published: November 2008

Summary— Twenty‐one patients with chronic obstructive uropathy due to high pressure chronic retention of urine underwent renal functional assessment both during the period of obstruction and repeatedly up to 3 months following its relief. Glomerular filtration rate (GFR) was determined using clearance of 99mTc‐DTP A and iohexol. Creatinine, water, urea and electrolyte excretion was assessed from timed urine collections.Excretion of water, urea and electrolyte was normal during obstruction but increased dramatically immediately following relief (e.g. sodium 110 to 234 mmo1/24 h). Values returned to normal by 2 weeks (sodium excretion 148 mmo1/24 h). No further significant changes occurred up to 3 months. Mean 99mTc‐DTPA and iohexol clearances during obstruction were 59.0 and 50.5 ml/min respectively. Following relief of obstruction, no significant improvement occurred at 2 weeks but did at 3 months (mean = 68.4 and 55.7 ml/min). Mean creatinine clearance during obstruction was 32.5 ml/min. This improved 2 days following relief to 46 ml/min. No further improvement was seen until 3 months (mean = 57.3 ml/min).It was concluded that recovery of renal function from obstructive injury occurs in two phases, an early tubular phase lasting up to 2 weeks and a later, predominantly glomerular phase, between 2 weeks and 3 months. There is some disparity between creatinine clearance and more accurate measurements of GFR which may be explained by tubular excretion of creatinine in the early phase of recovery.