Renal autotransplantation for ureteral lesions--the indication and the results of operation

Renal autotransplantation has been a treatment of choice for renovascular hypertension, renal artery aneurysm, complicated staghorn calculi, ureteral disorders and others. The paper reports 5 cases of extensively damaged ureter and discusses the indication and the results of operation. There were three cases of postoperative extensive ureteral stricture. One patient had postoperative ureteral injury with retroperitoneal abscess. The last one showed renal foreign body calculi with recurrent pyelonephritis after ureterocutaneostomy. The postoperative course of four patients had been uneventful revealing well functioning autotransplanted kidneys without hydronephrosis and infection during the follow-up period of 22 to 42 months. However, the patient with the ureteral injury and retroperitoneal abscess died of bleeding from renal vein anastomosis on the 15th postoperative day, since the renal pedicle showed marked inflammatory change including renal vein wall. Subsequently, autotransplantation is contraindicated in the cases with marked inflammation in the renal pedicle. In cases of various other ureteral lesions including long distance ureteral stricture, this procedure is recommended when neither the end to side ureteral anastomosis, Boari's bladder flap operation nor bladder hitch operation is feasible.     

Clinical effect of allylestrenol on benign prostatic hypertrophy

Allylestrenol at the daily dose of 50 mg was administered to 45 patients with benign prostatic hypertrophy. The treatment was performed for more than 12 weeks in 40 patients, and improvements, marked and moderate, were observed in 22 patients (55%) in the overall judgement. As side effects of this drug, decrease of potency was observed in 3 cases, decrease of libido in 1 case, pigmentation on breasts in 2 cases, palpitation in 2 cases, short breath in 1 case, and gastrointestinal symptoms in 1 case. However, these side effects were not serious. Our trial suggests that the treatment of benign prostatic hypertrophy with allylestrenol can be useful in urological clinics.     

Varying Methods of Sterilisation, and Their Effects on the Structure and Permeability of Dialysis Membranes

This study elucidates changes in membrane structure and permeabilitydue to the methods of sterilisation and the conditions underwhich they are carried out. Tubular dialysis membranes of regeneratedcellulose having various values for porosity were sterilisedby ethylene oxide gas, autoclave or gamma irradiation undervarying conditions. Non-sterilised membranes were included ascontrols. The solute permeability of the membranes was determinedusing ¹⁴C-urea. The membranes tested showed no difference in clearance of ureaor creatinine. Gamma-ray sterilisation under dry conditionsgreatly reduced the vitamin B₁₂ clearance and hydraulic permeabilityof membranes with a water content of below 60%. Hydraulic permeabilityincreased with gamma irradiation for membranes sterilised underwet conditions. A reduction in vitamin B₁₂ clearance for membraneswith a water content of above 60% resulted after autoclave sterilisation.Pore model calculation reveals that membrane shrinkage resultedfrom sterilisation both by gamma-rays under dry conditions,and by autoclave. Thus, the structure of dialysis membranesvaries with the method of sterilisation and the conditions underwhich the sterilisation is carried out.     

Inhalation provocation test with house dust allergen using tidal breathing

Using the modified 3-Hz oscillation method, the inhalation challenge test was performed with house dust allergen upon subjects while tidal breathing throughout the test. Their total respiratory resistance (Rrs) was continuously monitored with the inhalation of saline as a control, and 250-, 50-, and 10-fold diluted allergen solution to the inhalation of aerosolized metaproterenol. The starting point of the induced bronchoconstriction was checked and as soon as Rrs increased up to twice the base-line value, the subjects inhaled the aerosolized metaproterenol. From the dose-response curve of Rrs, the dose of inhaled allergen (minimum dose) as bronchial sensitivity was determined; also the decreasing rate of respiratory conductance, which was calculated from the slope of elevation of Rrs, as bronchial reactivity. It was found that the more diluted allergen required for a positive skin reaction, the more likely the patients were to have a subsequent positive bronchial inhalation challenge to house dust allergen. There was a relationship between the increased bronchial reactivity and the increased RAST score. These results indicate that this inhalation challenge test is specific, safe, and time-saving.     

Retinal sensitivity and spatial summation in amblyopia

The retinal sensitivity and the spatial summation function in the foveal and parafoveal regions of unilaterally amblyopic patients with eccentric fixation were studied psychophysically by means of a refined fundus perimeter; the device made possible continuous and simultaneous monitoring of the subject's fundus, fixation behavior and location of the stimulus on the retina, and enabled us to obtain selectively reliable data. In 9 out of 10 amblyopic eyes, the retinal sensitivity was the highest at the subject's eccentric fixation locus, demonstrating central relative scotoma. In the fovea of amblyopic eyes, the spatial summation curve showed an abnormal gradient when tested with small stimuli, suggesting an enlarged spatial summation area at the amblyopic fovea. On the other hand, the spatial summation curve at the eccentric fixation locus was comparable to that at the corresponding eccentric locus of the nonamblyopic fellow eye, suggesting the spatial summation function at the peripheral retina was normal in the amblyopic eye.     

The relationship between the arterial level of angiotensin-converting enzymes and arterial gas tension in bronchial asthma.

To study the mechanism which causes a lowered serum level of angiotensin-converting enzyme (ACE) in asthma patients, the changes in serum ACE in arterial blood gas tension was measured. Serum ACE was also determined in patients with chronic obstructive lung disease (COLD) and fibrosing lung disease (FLD). A reduced level of serum ACE was found in some patients with COLD, similar to that in patients with asthma. A significant relationship existed between the lowered serum ACE level and the degree of arterial hypoxia, especially in asthmatic patients and some patients with COLD. The significance of lowered serum ACE is discussed in relation to the pathogenesis and the mechanism of hypoxemia in patients with asthma, COLD and FLD.     

Influence of metoprolol on hemodynamics and respiratory function in asthmatic patients.

Studies of metoprolol in asthmatic patients showed beta 1-selective blocking properties on the adrenergic receptor. Metoprolol in a dose of 40 mg given orally to 9 asthmatic patients significantly decreased the pulse rate at 60 and 120 minutes and the systolic blood pressure at 120 minutes but did not cause any increase of respiratory impedance, measured by the forced oscillation technique. A double-blind test was carried out to compare the effects of metoprolol and inactive placebo on the respiratory response to isoproterenol in 24 asthmatic patients. In the metoprolol group, systolic blood pressure decreased significantly and pulse rate at rest also tended to decrease. There was no significant difference between the metoprolol and placebo groups in the respiratory response to an isoproterenol aerosol.     

Cleft on tricuspid anterior leaflet

We report a case of isolated congenital tricuspid regurgitation caused by a cleft in the anterior tricuspid leaflet associated with a patent foramen ovale. Preoperative echocardiography revealed severe tricuspid regurgitation resulting from anterior tricuspid leaflet prolapse. The patient underwent successful tricuspid valve repair with simple cleft suture and annuloplasty and direct closure of the patent foramen ovale.     

Effects of lansoprazole, clarithromycin and pH gradient on uptake of [14C]amoxycillin into rat gastric tissue

The effect of lansoprazole and clarithromycin on the uptake of [(14)C]amoxycillin into rat gastric tissue was investigated. After oral administration of [(14)C]amoxycillin, the levels of radioactivity in gastrointestinal tissue were two to 15 times higher than those in plasma. The level of radioactivity in glandular stomach was significantly higher when lansoprazole and [(14)C]amoxycillin were administered together. After intravenous administration of [(14)C]amoxycillin, there was less radioactivity in gastric tissue than after oral administration, and co-administration of lansoprazole and clarithromycin had no obvious effect. The gastric emptying rate of [(14)C]amoxycillin was not apparently affected by the co-administration of lansoprazole and clarithromycin. In vitro uptake of [(14)C]amoxycillin into gastric tissue depended on the pH, with uptake at pH 7.4 being four times greater than that at pH 4.0. The apparent synergic effects of lansoprazole are due to enhanced penetration of amoxycillin in gastric mucus and tissue by increasing intragastric pH and play an important role in the eradication of H. pylori.