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Biomedical subjects

H N Whitfield

Publications and source records attributed to H N Whitfield.

At least 109 records · Page 6Linked to original sources
PubMed1981

Inosine in ischaemic renal surgery: long-term follow-up.

Inosine, a purine nucleotide, has been used in 33 patients as a method of preventing ischaemic renal damage. The long-term results have been reviewed with a mean follow-up of 28 months. Inosine was administered either intra-arterially or intravenously. Renal function was assessed by serum creatinine, creatinine clearance and divided function renography. Inosine afforded satisfactory protection in ischaemic periods of up to 60 min, particularly if pre-operative function was normal. It was less reliable if pre-operative function was poor or in ischaemic periods greater than 60 min. Inosine is a helpful aid in ischaemic renal surgery.

Adolescent↗
PubMed1981

The late results of conservative surgery for upper tract urothelial carcinomas.

In a selected series of 14 patients, upper tract urothelial tumours were excised with preservation of the ipsilateral kidney. The 5-year survival rate was 83%. The ipsilateral local recurrence was 5/14 (36%) but in 4 cases salvage surgery was effective and in 2 cases a functioning kidney was still preserved. The results of conservative surgery and its indications are discussed.

Adult↗
PubMed1980

Hypothermic nephrolithotomy in solitary kidneys.

The functional effects of nephrolithotomy performed with ischaemia and cooling have been studied in a series of 29 operations performed on patients with a solitary kidney. There was temporary post-operative functional deterioration in every patient, but this was followed by rapid and satisfactory recovery, often with functional improvement, in 27 out of the 29 cases. Only 2 patients showed minor functional deterioration, but both benefited clinically from their surgery and remain well. No patient required permanent dialysis support. A previous study by Wickham (1979) has shown satisfactory results from 250 cases of nephrolithotomy performed with ischaemia and cooling, but in these cases it was not possible to assess the degree of compensation provided by the non-operated kidney. The study of patients undergoing surgery to solitary kidneys obviates the question of contralateral functional compensation.

Humans↗
PubMed1980

The diagnosis of pelviureteric junction obstruction.

The distinction between a dilated upper urinary tract which is obstructed and a dilated but unobstructed system is of fundamental importance. This differentiation may be difficult to make with methods of diagnosis currently available. Standard intravenous urography provides good morphological information about the collecting system but is unreliable in the assessment of urodynamic upper tract function and renal parenchymal function. Pressure/flow studies may provide useful urodynamic information but the method has certain disadvantages. Standard probe renography is unreliable in differentiating upper urinary tract stasis from obstruction. A quantitative method of diuretic urography and a new quantitative gamma-camera renal radionuclide investigation are described and the results of these investigations are compared with urodynamic studies in patients with upper urinary tract obstruction at the level of the pelviureteric junction.

Follow-Up Studies↗
PubMed1979

Obstructive nephropathy: successful evaluation with radionuclides.

A non-invasive test of nephron function, the renal parenchymal transit time (P.T.T.) index, is shown to be as accurate as antegrade pressure measurements in diagnosis of renal outflow obstruction. It is more sensitive than conventional methods of demonstrating the associated obstructive nephropathy. P.T.T. is useful in following the effects of surgery, or of temporising, in patients with confirmed or potential outflow tract obstruction. Renal radionuclide P.T.T. analysis gives the functional information essential for the management of patients in whom intravenous urography reveals a dilated renal pelvis.

Dilatation, Pathologic↗
PubMed1979

Intravenous inosine for ischaemic renal surgery.

The use of the intravenously administered nucleotide inosine is described for the protection of function in the human kidney undergoing ischaemic renal surgery. The treatment of 7 patients is described. The simplicity of the technique is emphasised.

Creatinine↗
PubMed1979

Negative pressures in surgical drains.

Laboratory and clinical experiments were done to measure the pressure in tube drains. It was found that the fluid in drains connected to floor bags exerted a negative pressure equal to the height of the fluid column in the tube. There was no negative pressure when the drain opened into a urostomy bag at wound level. It is suggested that this negative pressure might tend to maintain a urinary fistula once a leak in the suture line has begun.

Drainage↗
PubMed1979

The modified lumbotomy versus the oblique loin incision for renal surgery.

The time to full mobility and total analgesic requirements have been assessed in 40 patients undergoing renal surgery by the oblique loin incision or the posterior lumbotomy approach. By these criteria the lumbotomy group fared better than patients who had oblique incisions. We consider lumbotomy to be a valuable incision which should be in the repertoire of every urologist.

Analgesics↗
PubMed1978

The distinction between obstructive uropathy and nephropathy by radioisotope transit times.

Deconvolution analysis of different regions of interest on gamma camera renography enables obstructive lesions causing impairment of nephron function to be distinguished from obstructive lesions which parenchymal function is unimpaired. Quantitation of isotope transit time through the parenchyma is a reliable method of diagnosing upper urinary tract obstruction.

Adolescent↗
PubMed1978

Inosine: clinical results of ischaemic renal surgery.

Ten patients requiring ischaemic renal surgery for calculus or tumour were operated on with the kidney protected by perfusion with a room temperature solution of inosine. The warm ischaemic times ranged from 35 to 75 min (mean 57.1 min). Post-operative recovery was uneventful in all patients. No adverse cardiodynamic effects due to inosine were noted. There was only moderate transient depression in renal function as assessed by gamma camera renography and serum creatinine estimations. Three of the 10 patients have now been followed for over a year. The results with inosine perfusion are comparable to those obtained with hypothermic protection.

Adult↗