[Reduction of the period of catheterization by use of fibrin glue after transurethral resection of the prostate].
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Biomedical subjects
Publications and source records attributed to M Luke.
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In two groups composed of 228 patients with bladder tumors and 37 patients with upper urinary tract (UUT) tumors, we compared the transitional cell carcinoma in respect to sex, age, grade of dysplasia, staging, and survival. No differences could be established between the two groups, and we found the same 5-year survival rates of approximately 26% and 29%, respectively, for the invasive carcinomas.
Comparing the relationship between upper urinary tract tumors and blood group ABO and the rhesus system showed that patients with blood group A and blood type rhesus positive had more invasive tumors with a higher grade of dysplasia than patients with blood group O and blood type rhesus negative.
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Thirty-seven patients with upper urinary tract tumours were evaluated for grade, stage, histological type, location, presence or absence of vascular invasion, abnormalities in the urothelium adjacent to the tumours, tumour multiplicity and patient survival. A good correlation between tumour grade and stage was found in the transitional cell tumours. Squamous cell carcinomas and adenocarcinomas were high-stage tumours. Vascular invasion was present in most high-grade tumours, squamous cell carcinoma and adenocarcinomas. Four patients had multifocal tumours of both pelvis and ureter. Three developed ureteric stump carcinomas and 13 had further development of bladder carcinomas. The cumulative 5 and 10 year survival rates were 43 and 23% respectively.
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A 77-year-old male presented himself with acute urinary retention, and a history of infravesical obstruction. Cystourethroscopy failed to show the obstruction. A malignant schwannoma (MS) causing impression in the bladder was removed through a laparotomy. Postoperatively there were no urologic symptoms, and the urodynamic investigations had changed to normal.
A teenager with massive rectal bleeding had a positive 99mTc-pertechnetate abdominal scan. At laparotomy, an arteriovenous malformation of the jejunum was found. There was no evidence of a Meckel's diverticulum. The persistent problem of the positive technetium scan warrants increased utilization of preoperative visceral angiography.
A method for instilling a two-component fibrin adhesive into the prostatic cavity after transurethral resection of the prostate is described. In a prospective, controlled study, 30 consecutive patients undergoing transurethral prostatectomy (TURP) were randomised either to receive treatment with the local instillation of fibrin adhesive into the prostatic cavity or to a control group that received no special treatment post-operatively. There were no complications either during application of the fibrin adhesive or in the follow-up period. Post-operative blood loss was significantly reduced in the fibrin group (P less than 0.01).
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We investigated the electrogenic transport of glucose in the upper part of the duodenum in 11 healthy subjects by means of simultaneous intestinal perfusion of test solutions and measurement of the corresponding potential differences between blood and the duodenal lumen. The technique entailed continuous perfusion and registration of potentials through one single lumen of the probe. The basal potential difference during infusion of 154 mM NaCl was -4.9 +/- 0.5 mV (mean +/- 1 SEM). This was not significantly different from the level obtained during infusion of a standard perfusate composed like plasma: -4.3 +/- 0.5 mV. Perfusion of iso-osmolar solutions containing increasing concentrations of glucose raised the transmucosal potential difference progressively. The relation followed Michaelis-Menten kinetics, from which the apparent transport constants were calculated: Kappm = 53 mM and Vappmax = 9.9 mV. By means of repeated experiments, we examined day-to-day changes of basal potentials and electrogenic glucose transport. No significant differences or systematic variations were found.
The thickness of the unstirred water layer in the normal upper duodenum was measured in 11 healthy volunteers. We used the technique of simultaneous intestinal perfusion and measurement of the corresponding transmucosal potential differences (pd). The unstirred layer was calculated from the half time required to establish an Na+ diffusion potential across this layer. At a flow rate of 17 ml/min the thickness was 351 +/- 13 microns (mean +/- 1 SEM). The level increased significantly as the flow rate was reduced. The results were used to calculate estimates of the real transport constants, which describe the carrier-mediated electrogenic transport of glucose in the normal upper duodenum. Pdrealmax was calculated to be 1.1 +/- 0.15 mV, Jrealmax 6.6 nmol/cm2 X sec, and Krealm 25.8 mM. The origin of the transport-related potential change during glucose absorption was examined. It is suggested that about 60% of the total measured potential response may be attributed to a Na+ diffusion potential across the intestinal unstirred water layer.
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The clinical course after closing of a temporary colostomy was studied in 56 patients, 26 with loop colostomy and 30 with terminal colostomy. No significant difference was found in the complication rate or hospital stay between the two groups. It is concluded that terminal colostomy is preferable, as a standard procedure, because it is more acceptable to the patient and gives a complete diversion of the fecal stream.
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