Showing papers in "Scandinavian Journal of Urology and Nephrology in 1972"
TL;DR: The study of smooth muscle strips from the lower urinary tract of children and cats suggests that the sympathetic nervous system can subserve relaxation in the dome of the bladder and both contraction and relaxation inThe bladder base as well as in the proximal urethra.
Abstract: Autonomic receptor function was studied in vitro in smooth muscle strips from the lower urinary tract of children and cats. In strips from the dome of the bladder, cholinergic and β-adrenergic, but no α-adrenergic receptor function was demonstrated. In the bladder base as well as in the proximal urethra cholinergic and both α- and β-adrenergic receptors were found. This suggests that the sympathetic nervous system can subserve relaxation in the dome of the bladder and both contraction and relaxation in the bladder base as well as in the proximal urethra.
121 citations
TL;DR: An increased excretion of LMW protein in the presence of a normal creatinine clearance was only found in cases of nephrotic syndrome, and the possibility of a two-way uptake of low molecular weight protein into the proximal tubules is suggested.
Abstract: The occurrence of three low molecular weight proteins, α2-microglobulin,β2-microglobulin, and lyso-zyme in blood and urine has been studied with immuno-chemical methods in 25 healthy persons and 79 patients with different renal diseases at all levels of renal function. A negative correlation between creatinine clearance and the urinary excretion of all three proteins was found. The excretion in severe uremia was found to exceed the excretion, reported by other authors, in renal tubular disease. An increased excretion of LMW protein in the presence of a normal creatinine clearance was only found in cases of nephrotic syndrome. The possibility of a two-way uptake of low molecular weight protein into the proximal tubules is suggested.
69 citations
TL;DR: In 155 kidney transplantations in 142 patients a total of 19 arterial complications occurred: failing anastomosis in one patient, arterial occlusion in three, and stenosis in 15 patients, which led to graftectomy in all the cases.
Abstract: In 155 kidney transplantations in 142 patients a total of 19 arterial complications occurred: failing anastomosis in one patient, arterial occlusion in three, and stenosis in 15 patients. The occlusions led to graftectomy in all the cases. Arterial reconstruction was made in 3 patients with stenosis, but the blood pressure was normalized in only one patient.Venous complications occurred in 28 patients: six cases of thrombosis in the graft vein, which in 5 of the patients led to graftectomy; two cases of hemorrhage from the venous anastomosis, 19 cases of peripheral vein thrombosis, and one case of fatal pulmonary embolism.
64 citations
TL;DR: It is suggested that suspected renal masses should be investigated primarily by i.v. pyelography and ultrasonic scanning, and if a mass is encountered it should be punctured under the guidance of ultrasound, and the aspirate subjected to cytological evaluation.
Abstract: The principle in percutaneous puncture of renal masses under the guidance of ultrasound is described. 34 tumours, 43 cysts and four lesions of various sorts were punctured. On cytological evaluation malignancy was confirmed in 82% of the tumour cases and in one case of a malignant cyst. Fluid was aspirated from 90% of the cysts. These percentages will probably increase with increasing experience.It is suggested that suspected renal masses should be investigated primarily by i.v. pyelography and ultrasonic scanning. If a mass is encountered it should be punctured under the guidance of ultrasound, and the aspirate subjected to cytological evaluation. This will leave only a few questionable cases which should be submitted to arteriography.
62 citations
TL;DR: Urodynamic investigation reveals a high incidence of outlet disorders in women not suspected of suffering from cystocele, vesical descensus or decreased urethral resistance and it is proposed that all urological Department should be able to perform urodynamic investigations in addition to existing urology diagnostic methods.
Abstract: The equipment used in urodynamic and urostatic investigations at the Urological Laboratory, Gentofte Hospital, Copenhagen, is described. It is emphasized that recordings of pressure, flow and electromyography should be done simultaneously.1100 case studies have been performed over 2 years of laboratory service. A thorough analysis of the results in 500 consecutive cases is reported. The incidence of neurogenic bladder dysfunction in patients referred for non-neurogenic bladder disorders is 5–20 per cent. Urodynamic investigation also reveals a high incidence of outlet disorders in women not suspected of suffering from cystocele, vesical descensus or decreased urethral resistance. In more than 20 per cent of the patient material the urological diagnosis was changed following the urodynamic study. The great value of urodynamic investigation is discussed, and it is proposed that all urological Department should be able to perform urodynamic investigations in addition to existing urological diagnostic methods.
51 citations
TL;DR: Two new cases of the rare bladder tumour—meso-nephrogenic adenoma—have been reported in the literature, and two new cases are hereby added.
Abstract: Twelve cases of the rare bladder tumour—meso-nephrogenic adenoma—have been reported in the literature, and two new cases are hereby added. Possible aetiologies are discussed. The treatment does not differ from that of bladder papilloma. Since two tumours described were malignant, careful control should be exercised.
46 citations
TL;DR: When using an electrophysiological technique in 5 adult female cats the afferent input of the pelvic and pudendal nerves was found to be represented in one or more of the three dorsal sacral roots, but nut in the lowest lumbar or first coccygeal roots.
Abstract: When using an electrophysiological technique in 5 adult female cats the afferent input of the pelvic and pudendal nerves was found to be represented in one or more of the three dorsal sacral roots, but nut in the lowest lumbar or first coccygeal roots.In another series of 9 cats it was demonstrated that afferent stimulation of the transected pelvic or pudendal nerves resulted in a bladder response similar to that following efferent stimulation of the hypogastric nerves. This bladder reaction was a composite reflex response, the dominating feature of which was a bladder relaxation. The reflexes elicited by afferent stimulation of the pelvic or pudendal nerves were both found to be spinal reflexes with their afferent limbs passing the dorsal sacral roots and their efferent limbs in the hypogastric nerves. The reflex elicited by afferent pelvic nerve stimulation corresponds to Edvardsen's storage reflex. Reflex relaxation of the urinary bladder following afferent electrical stimulation of the pudendal nerve ...
46 citations
TL;DR: A new method for quantitating bladder sensibility by a semi-objective test is described and it is proposed that the test is used in routine urodynamic investigation, but it is especially indicated in patients suffering from diseases with peripheral neuropathy.
Abstract: A new method for quantitating bladder sensibility by a semi-objective test is described. Constant current square wave impulses are transmitted to the urinary bladder. To illustrate the correlation ...
44 citations
TL;DR: Patients who had undergone surgery involving coeco-cystoplasty or the creation of a cutaneous uretero-ileostomy were found to have massive funguria post-operatively, which, however, cleared spontane...
Abstract: The frequency of funguria in a normal material and in a material of patients with different types of urinary tract pathology not associated with stasis or bacterial infection was found to be 2.3% and 0.63% respectively. The urine specimens were clean voided midstream samples. When the frequency of funguria in the normal material was redetermined on more satisfactory urine specimens (for women, a catheterized sample, for men, a clean voided midstream sample), funguria was no longer found. Thus, what had seemed to be funguria had been due to contamination by vaginal or fecal flora. In an unselected male clinic material, funguria was found in 29 of 148 patients. The factors that predisposed to funguria in these patients seemed to be the combination of the presence of an indwelling catheter and antibiotic therapy. Patients who had undergone surgery involving coeco-cystoplasty or the creation of a cutaneous uretero-ileostomy were found to have massive funguria post-operatively, which, however, cleared spontane...
43 citations
TL;DR: The concentrations of TMP found in both the secretion and the tissue were at a thera-peutically active level (≥MIC × 5) with respect to the majority of those bacteria usually occurring in urinary tract infection.
Abstract: Following the administration of trimethoprim (TMP) by mouth in doses varying from 5.0 to 8.1 mg TMP per kg body weight per 24 hours over a period of 24–48 hours, the concentration was examined in either the prostatic tissue or the prostatic secretion, in a total of 13 patients. A microbiological method was employed to determine the concentration, using B. ptrmilis as test organism. A method of collecting the prostatic secretion was used which excluded the admixture of urine with higher antibiotic content than that of the secretion. Tissue was examined which was obtained both by open and closed (transperineal) biopsy. The concentrations of TMP found in both the secretion and the tissue (9–12 hours after the last administration of TMP) were at a thera-peutically active level (≥MIC × 5) with respect to the majority of those bacteria usually occurring in urinary tract infection.
35 citations
TL;DR: A new therapeutic principle with a cyto-toxic drug (Natulanar®) is presented for Peyronie's disease, resembling the spontaneous course of the disease.
Abstract: 58 patients given various forms of treatment for Peyronie's disease have been reinvestigated. The late results in general were poor, resembling the spontaneous course of the disease. A new therapeutic principle with a cyto-toxic drug (Natulanar®) is presented.
TL;DR: Patients with asymptomatic funguria could undergo fairly major operative procedures and even be treated with broad-spectrum antibiotics without the funguria giving rise to manifest fungous infection.
Abstract: 40 patients with asymptomatic funguria were followed for various periods of time. The funguria was allowed to remain untreated while the patient's primary diseases were treated in the customary way. Treatment with antibiotics and indwelling catheters favoured funguria. Funguria often disappeared when these faotors were no longer present. In 13 cases funguria disappeared in connection with the development of a Proteus infection. The simultaneous presence of funguria and bacteriuria due to other bacteria (E. coli, enterococci and Pseudomonas) was fairly common. Funguria could apparently be present for long periods of time without deleterious effects to the patients. The asymptomatic funguria that arises after the creation of ileal conduit or caeco-cystoplasty behaves like asymptomatic funguria of other origin. Patients with funguria could undergo fairly major operative procedures and even be treated with broad-spectrum antibiotics without the funguria giving rise to manifest fungous infection. If, however, ...
TL;DR: In an experimental study on 12 adult female cats, the dorsal sacral roots mediating the afferent inflow of the pelvic and pudendal nerves were transected and anastomoses were performed creating a non-physiological afferent pathway to the urinary bladder.
Abstract: In an experimental study on 12 adult female cats, the dorsal sacral roots mediating the afferent inflow of the pelvic and pudendal nerves were transected. In 4 animals, the S1 dorsal roots transected immediately distally to their ganglia were anastomosed with tubulation technique to the peripheral part of the transected S2 radicular nerves. In 5 animsals anastomoses were performed between the L7 dorsal roots and the S1 radicular nerves, thus creating a non-physiological afferent pathway to the urinary bladder. In 3 control animals all sacral dorsal roots were transected but no anastomoses were performed. The functional restitution of afferent fibers was assessed by the return of the micturition reflex and storage reflexes. The micturition reflex returned in the cystometrograms of 5 of 9 animlals with reconstructed dorsal roots after regeneration periods ranging between 8 and 11 months. The storage reflexes were present in approximately half of the animals with root anastomoses tested in final experiments ...
TL;DR: In patients with renal artery stenosis, a close association was found between increased systemic PRC and renal venous PRC-ratios <1.8 and Furosemide led to an increased release of reni...
Abstract: Renal venous catheterization was carried out in a consecutive series of 32 hypertensive patients with unilateral renal or renovascular disease. Plasma renin concentration (PRC) was measured in systemic and renal venous blood with a method allowing the expression of results in terms of Goldblatt Units. Blood samples were collected before and after intravenous injection of furosemide (0.33–0.66 mg/kg body weight).Systemic PRC was elevated in ten out of 19 patients with lesions of the main renal artery. Only one out of 11 patients with unilateral parenchymal renal disease had elevated systemic PRC. A unilateral significant veno-arterial renin concentration difference over the affected kidney was found in eight out of 15 patients with renal artery stenosis and in three, out of 11 patients with unilateral parenchymal renal disease. In patients with renal artery stenosis, a close association was found between increased systemic PRC and renal venous PRC-ratios <1.8. Furosemide led to an increased release of reni...
TL;DR: Measurement of the glomerular filtration rate (GFR) in 20 patients with normal and impaired renal function using a single injection of the indicator substance 51chromium-EDTA revealed an accurate correlation to the classical method of continuous inulin infusion.
Abstract: Measurement of the glomerular filtration rate (GFR) in 20 patients with normal and impaired renal function using a single injection of the indicator substance 51chromium-EDTA revealed an accurate correlation to the classical method of continuous inulin infusion. An analysis showed that the plasma disappearance curve of the indicator substance on which the mathematical calculation of the clearance is based, may be drawn from only four plasma activity measurements, when the study period is extended over at least four hours. This affords a practical, simple, and reproducible clinical method for determining the GFR.
TL;DR: Fourteen patients with flat carcinoma in situ of the urinary bladder are described and a malignancy grading of the epithelial changes found is recommended.
Abstract: Fourteen patients with flat carcinoma in situ of the urinary bladder are described. Of these, there were 3 patients without known carcinogenic exposure or previous bladder disease: Carcinoma in situ per se. The few vague and uncharacteristic symptoms and mucous membrane changes in connection with this rare disease are emphasized. The urine-cytology, a detailed cystoscopic evaluation, and multiple biopsies to determine the spread of the changes in the transitional epithelium are of importance in making the diagnosis. A malignancy grading of the epithelial changes found is recommended. The therapeutic possibilities and the prognosis are mentioned but should be considered as not yet clarified.
TL;DR: In 6 of 14 patients who were not nephrectomized mainly because the other kidney had a reduced function, the kidney scheduled for removal had the major function, and renography was used to determine how the function was distributed between the two kidneys.
Abstract: Plasma creatinine, IVP, GFR, and renography were analysed in 53 candidates for unilateral nephrectomy. Renography was used to determine how the function was distributed between the two kidneys. Twelve of 29 patients with normal plasma creatinine had decreased GFR. One-third of 74 individual kidneys showing normal function at IVP had GFR values below 30 ml/min. There was poor agreement between the radiological and renographic estimation of function distribution. In 6 of 14 patients who were not nephrectomized mainly because the other kidney had a reduced function, the kidney scheduled for removal had the major function. GFR and renography were particularly informative in cases with elevated plasma creatinine and normal IVP.
TL;DR: A 75-year-old man with metastasising prostatic carcinoma was treated with Estracyt® (estradiol-3-N[bis-(2-chlorethyl)]-carbamate-17-dihydrogen phosphate), showing complete regression of some lymph node metastases, and felt better, his general condition improved and the indwelling catheter could be removed.
Abstract: A 75-year-old man with metastasising prostatic carcinoma was treated with Estracyt® (estradiol-3-N[bis-(2-chlorethyl)]-carbamate-17-dihydrogen phosphate). Histological and cytological examination showed complete regression of some lymph node metastases. Renographic and roentgen examinations revealed regression of other lymph node metastases. The patient felt better, his general condition improved and the indwelling catheter could be removed. Treatment was continued for 2 months during which the patient received a total of 9.5 g Estracyt® i.v. No side effects were observed.
TL;DR: 5-Fluorocytosine was used in 6 cases of candidosis of the urinary tract and in 2 cases of Nystatin-resistant oral candidosis and in all patients the fungi disappeared and the conditions cleared up rapidly, and there were no subjective side-effects.
Abstract: 5-Fluorocytosine is, in fungi sensitive to the preparation, a competitive inhibitor of cytosine. In humans no metabolisation of the preparation takes place, and up to about 80% of it is excreted with the urine. It should therefore be an ideal substance for treating candidosis of the urinary tract. 5-Fluorocytosine was used in 6 cases of candidosis of the urinary tract and in 2 cases of Nystatin-resistant oral candidosis. In all patients the fungi disappeared and the conditions cleared up rapidly. There were no subjective side-effects, neither was there any effect on blood-picture, transaminases or kidney function.
TL;DR: The combination of nephroangiography and blood flow determination using dye-dilution technique in man with fistulae, hemangiomas and tumours should be valuable, especially if angiotensin is employed.
Abstract: The effects of percutaneous punctures of kidneys of rabbits were studied by nephroangiography and by determination of renal blood flow using a dye-dilution technique. The punctures were made during the actual examination or up to 7 days earlier. At puncture small fistulae immediately were created, often only detectable by the dye-dilution technique. Slight arterial hypertension was registered in one rabbit with fistula, perhaps due to focal ischemia. Various vasoactive drugs were tested in order to increase the diagnostic accuracy at angiography and at the dye-dilution study. Only angiotensin proved to be of advantage. The combination of nephroangiography and blood flow determination using dye-dilution technique in man with fistulae, hemangiomas and tumours should be valuable, especially if angiotensin is employed.
TL;DR: In this paper, the clearance rate for 51Cr-EDTA, inulin, 125I-hippuran and PAH was determined simultaneously in 25 patients using a constant infusion technique.
Abstract: Renal clearance rates for 51Cr-EDTA, inulin, 125I-hippuran and PAH have been determined simultaneously in 25 patients using a constant infusion technique. By measuring the radioactivity in whole blood and calculating the plasma activity by using the haematocrit value, the clearance determinations for 51Cr-EDTA can be somewhat simplified, The clearance of 51Cr-EDTA was slightly lower than the clearanca of inulin. In order to obtain a correct value for the glomerular filtration rate, the clearance value for 51Cr-EDTA should be multiplied by a correction factor of 1.041 when calculating on the basis of a whole blood activity determination and 1.099 when the calculation is based on a plasma activity determination. The clearance of 125I-hippuran averaged 79% of the clearance value for PAH. The probable cause of this difference is that some of the 125I-hippuran is rather firmly bound to plasma protein and therefore not available for renal excretion. If 125I-hippuran is used as a substitute for PAH in the determ...
TL;DR: The development of tumours adjacent to ure-terosigmoidostomies is brought to attention and the possibility of regular controls suggested for vigilance concerning obstructive symptoms.
Abstract: The development of tumours adjacent to ure-terosigmoidostomies is brought to attention. The literature on this subject is reviewed. To those previously reported we add three cases with development of cancer in the colon 20, 36 and 40 years after urinary diversion because of bladder extrophy. The need for vigilance concerning obstructive symptoms is stressed and the possibility of regular controls suggested.
TL;DR: Continuous recording of urinary flow rate can be achieved in many ways and an apparatus is described where the criteria for measurement are fulfilled and where the errors have been determined and eliminated.
Abstract: Continuous recording of urinary flow rate can be achieved in many ways. An apparatus is described where the criteria for measurement are fulfilled and where the errors of measurement have been determined and eliminated.
TL;DR: Percutaneous nephro-pyelostomy was used in 28 cases of ureteral obstruction and according to the experience, it is an easy and efficient way to get a temporary drainage of the renal pelvis, particularly in bad risk cases.
Abstract: Percutaneous nephro-pyelostomy was used in 28 cases of ureteral obstruction. According to our experience, it is an easy and efficient way to get a temporary drainage of the renal pelvis, particularly in bad risk cases.
TL;DR: The quotient between the activities of acid phosphatase and β-glucuronidase in cancerous tissue was only 10% of that in hyperplastic tissue, which may be of value in the identification of extra-prostatic metastases.
Abstract: A biochemical and histochemical study of acid phosphatase, alkaline phosphatase, nonspecific esterases, aminopeptidase and β-glucuronidase in human hyperplastic and cancerous prostatic tissue revealed that the quotient between the activities of acid phosphatase and β-glucuronidase in cancerous tissue was only 10% of that in hyperplastic tissue. The difference is probably due mainly to a histochemically demonstrated lower activity of acid phosphatase in the cancerous tissue. In soft tissue metas-tases in 2 patients the acid phosphatase/ β-glucuronidase quotient was of the same magnitude as that in the patient's primary prostatic carcinoma. In 2 cases the prostate showed metastases from other organs. In these secondaries the quotient differed considerably from that found in primary carcinomas of the prostate. The above novel observation may be of value in the identification of extra-prostatic metastases.
TL;DR: A long-term endemic caused by Klebsiella pneu-moniae occurred in the period 1966 to 1970 among patients in an urological unit, and a search for the Klebsies throughout the environment was futile except in one locality, namely in a soile...
Abstract: A long-term endemic caused by Klebsiella pneu-moniae occurred in the period 1966 to 1970 among patients in an urological unit. The multiresistant bacteria which were uniformly resistant to sulfonamides, ampicillin, and tetracyclines, were responsible for asymptomatic significant bacteriuria or overt urinary tract infection in 93 patients during an observation period covering one year (1967). Septicemia developed in 12 patients and 6 of the patients eventually succumbed. The endemic was provoked by two different types of Klebsiella: a chloramphenicol-sensitive and kanamycin-resistant one of capsular type 35, and a chloramphenicol-resistant and kanamycin-sensitive one of capsular type 7. Each of the two serotypes possessed their distinct phage pattern. Aseptic as well as antiseptic procedures were reviewed, but no flaws of any importance were disclosed either in the operating theatres or in the wards. A search for the Klebsiella throughout the environment was futile except in one locality, namely in a soile...
TL;DR: A follow-up investigation of 93 patients who had been nephrectomized for adenocarcinoma renis shows that the patients can be regarded as “fully cured” after 8 years of follow- up, at which time the survival is the same as the survival for a normal population.
Abstract: A follow-up investigation of 93 patients who had been nephrectomized for adenocarcinoma renis shows that the patients can be regarded as “fully cured” after 8 years of follow-up, at which time the survival is the same as the survival for a normal population. The prognostic value of different clinical parameters is evaluated in comparing the ”fully cured patients with the rest of the material.
Journal Article•
TL;DR: It is concluded that juxtarenal masses such as adrenal tumour, retroperitoneal tumours, abscesses and haematomas at a size of 3–4 cm or more are demonstrable ultra-sonically with a fair degree of accuracy.
Abstract: A procedure for routine ultrasonic scanning in search for juxtarenal masses is described. Experience gained in the practical use of the method is communicated. It is concluded that juxtarenal masses such as adrenal tumours and other retroperitoneal tumours, abscesses and haematomas at a size of 3–4 cm or more are demonstrable ultra-sonically with a fair degree of accuracy.
TL;DR: In most cases, the bladder stone is removed at the same time as a surgical attempt is made to correct the cause of the urinary stasis, and transurethral lithotripsy is useful.
Abstract: In most cases, the bladder stone is removed at the same time as a surgical attempt is made to correct the cause of the urinary stasis. There are, however, cases in which a possible mechanical obstruction can be removed transurethrally by electroresection, or in which the patient's condition makes an operation inadvisable (prostatic hyperplasia, paraplegic patients etc.). In these cases, transurethral lithotripsy is useful. We have used the Soviet Urat-I lithotriptor in 23 cases. The stones averaged 2-3 cm in size and the largest of them measured 8 cm. Regardless of their composition, all stones were crushed casily. No serious complications in connection with Ihe procedure occurred. The equipment can not be used for the crushing of ureteral stones.