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Biomedical subjects

R B Kinder

Publications and source records attributed to R B Kinder.

13 recordsLinked to original sources
PubMed1989

Prospective study of routine scrotal ultrasonography in urological practice.

The value of routine scrotal ultrasonography has been evaluated in a prospective study of 109 men with scrotal symptoms or signs. Ultrasonography had a sensitivity of 100% and specificity of 99% for testicular tumour. Clinically useful information was provided in 53% of patients and 8% might have avoided surgery if the ultrasound report had been heeded. Ultrasonography did not provide any additional information in patients with scrotal pain and an entirely normal scrotum clinically, and in those with epididymal cysts in whom the testis was palpably normal. If these 2 groups had been excluded from routine scrotal ultrasonography there would have been a 25% reduction in the number of examinations without any reduction in diagnostic yield.

Adolescent↗
PubMed1989

A prospective study of the value of conventional CT, dynamic CT, ultrasonography and arteriography for staging renal carcinoma.

The value of dynamic CT scanning for staging renal carcinoma was studied prospectively in 28 patients and the results compared with those of ultrasonography, arteriography and conventional CT. Arteriography correctly staged 48% of tumours; ultrasonography and conventional CT correctly staged 50% and dynamic CT correctly staged 72%. Dynamic CT staged renal carcinoma more accurately than ultrasonography, conventional CT or arteriography and it is suggested that arteriography should be restricted to specific indications such as the mapping of arterial anatomy and therapeutic renal artery embolisation.

Adult↗
PubMed1987

Ureteroscopy and ureteric calculi: how useful?

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.

Endoscopy↗
PubMed1987

Pathophysiology of idiopathic detrusor instability and detrusor hyper-reflexia. An in vitro study of human detrusor muscle.

Muscle strips from urodynamically normal bladders and from bladders exhibiting idiopathic detrusor instability or detrusor hyper-reflexia were compared under isometric conditions in an organ bath. Spontaneous contractions developed more often in unstable and hyper-reflexic muscle and were of greater amplitude, frequency and basal tension. Electrical field stimulation caused a frequency-dependent contraction which was largely abolished by both tetrodotoxin (TTX) and atropine in all three muscle types. Comparison of their frequency response curves demonstrated a significantly greater sensitivity than that of unstable and hyper-reflexic muscle to low stimulation frequencies. Acetylcholine caused a dose-related contractile response in all muscle types. There were no significant differences between the dose response curves of unstable and hyper-reflexic muscle, and those of normal muscle. The results suggest that the pathophysiology of the involuntary detrusor contraction is common to both idiopathic detrusor instability and detrusor hyper-reflexia and that this is related to a disorder of an intrinsic neuromodulatory mechanism within the detrusor muscle.

Acetylcholine↗
PubMed1985

Atropine blockade of nerve-mediated stimulation of the human detrusor.

The effect of atropine on the isometric contractile response of isolated human detrusor muscle strips to electrical field stimulation has been studied. A 94.1% reduction in the response in the presence of tetrodotoxin demonstrated the neuronal nature of the stimulus. Atropine caused a 92.7% inhibition of the response. It was concluded that the nerve-mediated stimulus in human detrusor is cholinergic in nature and that "atropine resistance" does not occur in man.

Action Potentials↗
PubMed1985

Vasoactive intestinal polypeptide in the hyper-reflexic neuropathic bladder.

The distribution of nerves containing vasoactive intestinal polypeptide (VIP) in the hyper-reflexic neuropathic bladder was investigated using immunocytochemistry and radioimmunoassay. Biopsy specimens were taken from the bladders of 21 patients with urodynamically proven detrusor hyper-reflexia and from 20 control patients with no urodynamic abnormality. The results showed a reduction in the number of VIP immunoreactive nerves and a reduction in VIP concentration in the hyper-reflexic bladder when compared with control samples.

Adult↗
PubMed1985

Inhibition of spontaneous contractile activity in isolated human detrusor muscle strips by vasoactive intestinal polypeptide.

In a study of 75 isolated human detrusor muscle strips, spontaneous contractions and an associated sustained rise in basal tension were observed in 43 (57%). Vasoactive intestinal polypeptide (VIP) caused significant reductions in the frequency and amplitude of spontaneous contractions and a fall in basal tension. The results suggest that VIP may have a role as an inhibitor of spontaneous activity in the human detrusor.

Depression, Chemical↗