W. Oosterlinck

Silicone foam elastomer: a significant improvement in postoperative penile dressing.

AbstractWe found silicone foam elastomer to be an excellent postoperative compressive penile dressing in hypospadias repair. Although compressive the material is elastic enough to avoid vascular occlusion and to allow slight swelling of the penis. It is never adherent to the wound and, thus, is removed easily without any harm to the patient.

A Clinical Study of 99m Technetium Dimercaptosuccinic Acid Uptake in Obstructed Kidneys: Comparison with the Creatinine Clearance

We studied 17 hydronephrotic kidneys owing to stenosis of the pyeloureteral junction. Preoperative uptake of 99mtechnetium dimercaptosuccinic acid was compared to early postoperative unilateral creatinine clearance, measured by urine collection from the nephrostomy tube. An excellent correlation was found. Therefore, uptake of 99mtechnetium dimercaptosuccinic acid represents a reliable parameter of renal function even in the presence of severe urinary tract obstruction. However, 99mtechnetium dimercaptosuccinic acid uptake should be measured more than 24 hours after injection of the tracer.

Diagnosis and localization of a complicated urinary tract infection in neurogenic bladder disease by tubular proteinuria and serum prostate specific antigen

Introduction: Urinary tract infection is the most frequent complication occurring in patients with spinal cord injuries and can cause renal failure and male infertility. We used the urinary α-1-microglobulin (α1Mg) as a marker for pyelonephritis and the serum prostate specific antigen (PSA) as a marker for prostatitis with reference to the currently available methods. The aim of our study is (1) to differentiate between upper (pyelonephritis) and lower urinary tract infection (cystitis, prostatitis) in neurogenic bladder disease, (2) to determine if high (⩽38.5°C) fever in a neurogenic bladder disease patient was due to urological (prostatitis, pyelonephritis) causes or not. Patients and methods: We evaluated 147 patients of whom 27 had acute pyelonephritis, 16 had prostatitis with fever, 13 had chronic pyelonephritis, 68 had cystitis; 23 were control patients of whom nine had fever (⩽38.5°C) and 14 did not. The diagnoses and localizations were made on the basis of clinical evidence, with a CT scan, urography, bladder wash-out tests, and five glass-specimen tests. The urinary α1Mg was determined using latex enhanced immunonephelometry and the serum PSA was measured using RIA. Results: For the urinary α1Mg, the sensitivity is 96% and the specificity 93% for the diagnosis of acute pyelonephritis. The serum PSA has a sensitivity of 69% and specificity of 96% in the diagnosis of prostatitis. The urinary α1Mg has a sensitivity of 96% and a specificity of 56% and the serum PSA has a sensitivity of 68% and a specificity of 100% in the differential diagnosis of prostatitis and pyelonephritis. The best discriminative parameter between pyelonephritis and prostatitis was the urinary α1Mg/serum PSA ratio with a sensitivity of 92% and specificity of 88%. Conclusion: Upper-tract infection with fever can be diagnosed in neurogenic bladder disease by determining the urinary α1Mg. In male patients, the serum PSA should be determined to distinguish upper-tract infection from prostatitis. High fever does not significantly influence our parameters so that we can differentiate whether or not high fever is due to urological causes.

Preliminary clinical experience with meptazinol, a new analgesic

The analgesic effect of intravenous meptazinol at various dosage levels was studied in 30 patients suffering from acute renal colic. Out of a total of 41 injections (dose range: 20 to 120 mg.) a favourable analgesic response was recorded on 39 occasions. The onset of action was rapid with the minimun duration of action of 1 hour. Higher doses increased the drugs action but were accompanied by nausea and dizziness. There was no overall effect on blood pressure or heart rate.

Meptazinol (Wy 22811), a new analgesic: preliminary pharmacokinetic data.

The authors report on the pharmacokinetic profile of a new analgesic, meptazinol, from studies of plasma and urine levels after intravenous injection in 4 healthy volunteers. Conjugated product is formed very soon after injection and its concentration changes little over the period studied compared with the unchanged product where a fast, then a relatively slow phase of decline can easily be distinguished, suggesting a two compartment open system model. Meptazinol is predominantly eliminated in this conjugated form by urinary excretion of the metabolites. Excretion is very rapid in the first few hours after dosing and elimination is almost completed after 24 hours.

Solubility of Calcium Oxalate Monohydrate and Hydroxyapatite in Edta Solutions

The effect of the addition of a buffer to an ethylenediaminetetracetic acid (EDTA) litholytic solution on the solubility of calcium oxalate monohydrate and hydroxyapatite is investigated. The experiments show that the addition of triethanolamine as a buffer to EDTA solutions at pH 8 and 8.5 enhances the solubility of these salts, confirming theoretical predictions. The solubility of calcium oxalate monohydrate at 25C in solutions with varying ratios of buffer to EDTA concentrations and an osmolality of 0.9 was determined. The solutions resulting in the highest solubility were finally tested for their litholytic ability at 37C. At pH 8 solubilities of 22.5 g X l-1 for calcium oxalate monohydrate and 20.2 g X l-1 for hydroxyapatite were obtained. The corresponding solubilities at pH 8.5 were respectively 24.5 g X l-1 and 19.2 g X l-1.

European Experience with 1-stage Urethroplasty with Free Full Thickness Skin Graft

A series of 57, 1-stage urethroplasties with a free full thickness skin graft is reported. Results were good in 90 per cent of the cases, fair in 2 per cent and bad in 8 per cent. The bad results were noted in elderly men, suggesting that decreased viability of the surrounding tissues is a contraindication to this type of operation.

Preliminary clinical experience with dezocine, a new potent analgesic

The analgesic effect of a single intravenous dose of dezocine at various dosage levels was studied in 41 patients suffering from acute renal colic. Twenty milligrams was found to be a very effective dose. Out of 25 injections an excellent response was recorded on 21 occasions, with a mean duration of effect of 3.5 hours. In a further 3 patients, pain relief was considered as fair and of shorter duration. Pronounced dizziness was a nearly constant side-effect of the drug. There was no overall effect on blood pressure or heart rate.

A plea for antireflux operations in adults: review of 50 cases.

The results of antireflux operations in 41 cases of primary and 9 cases of secondary vesicoureteral reflux in adults are presented. Reflux was eliminated in all cases and there were no postoperative complications. Most patients had a long history of urinary tract infection preoperatively, which was eliminated in 64.1 per cent of the cases after surgical correction of the reflux. A relapse of infection occurred in 30.8 per cent of these cases. Chronic pyelonephritis remains active in 5.1 per cent of the cases. There were 6 patients with serum creatinine levels higher than 1.8 mg. per cent who underwent a successful antireflux procedure without an increase of serum creatinine levels. An antireflux operation should be preferred over long-term conservative management in most cases of symptomatic vesicoureteral reflux in adults less than 50 years old.

An open comparative trial of three doses of ciramadol used intravenously in renal colic

In an open investigation, ciramadol, a partial agonist opioid, was found to be a potent analgesic when given intravenously in patients experiencing renal colic. Single intravenous doses of 20, 30 and 40 mg of ciramadol were given to 11, 11 and 12 patients with renal colic, respectively, and good pain relief was obtained in 10, 11 and 10 patients, respectively. Vomiting and nausea occurred in 9 patients, 4 in the 20 mg group, 2 in the 30 mg group and 3 in the 40 mg group. This adverse effect was related to standing and walking following the ciramadol injection.