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The third report continues with recommendations on procedures related to the evaluation of micturition. It covers pressure-flow relationships and residual urine. These recommendations were subject to discussion during the Seventh Annual Meeting of the International Continence Society in Portoroz, Yugoslavia, September 1977.
Urine chemical profiles were followed for three or nine days after intravenous injection of diatrizoate, iohexol, or saline in 30 rats, where a tubulointerstitial nephropathy was induced by gentamicin given over an eight-day period. Another ten rats injected with saline served as controls. Compared to injection of saline, both iohexol and diatrizoate induced dysfunction. The excretion of the cytoplasmic enzyme lactate dehydrogenase was significantly greater following iohexol than following diatrizoate. No significant differences between the two media were shown by the various serum components examined. Among the gentamicin-treated rats, light microscopy showed prolonged occurrence of tubular necrosis and a more intensive round cell infiltration following iohexol than following diatrizoate and saline. Both contrast media induced further temporary renal dysfunction in rats with gentamicin nephropathy; iohexol induced more morphologic changes than diatrizoate.
In the follow-up of low stage, low grade transitional cell carcinoma of the bladder, cystoscopy is used as a diagnostic standard. Because of the lack of well defined prognostic parameters, cystoscopic follow-up is based upon empirical grounds. In this study, 82 patients with a primary superficial transitional cell carcinoma of the bladder were studied with respect to the time interval before recurrence. The mean number of cystoscopies leading to detection of recurrence (i.e. the ratio of positive to negative cystoscopy) was reviewed. Eighteen cystoscopies had to be done to detect each recurrence. Because of this excessive number of cystoscopies, the diagnostic value of the combination of red cell count in urine, cytology and history of micturition symptoms and haematuria was assessed in a retrospective study of 86 recurrences of bladder carcinoma. The results indicated that the combination of these non-invasive diagnostic tests may constitute a sensitive procedure for the follow-up of bladder tumours. In the case of T1G3 and muscle-invasive recurrences (greater than T1), the sensitivity rate was 100%.
Using a severely complicated in vitro bladder model with a computer-controlled autosimulation system for antimicrobial concentration in urine, we examined the significance of the peak concentration value and time above MIC, and obtained the following results. 1. Regarding the initial bactericidal speed, the higher the peak concentration value was, the more quickly the bacterial concentration decreased. 2. Concerning the minimum value of bacterial concentration in the model bladder, the higher the peak concentration value was, the more the level tended to decrease. 3. Regarding inhibition of regrowth of bacteria (ERT) 1) When a particular antimicrobial agent had no PAE on bacteria, the viable bacterial count curve was similar in cases of peak antimicrobial concentration values of higher than 8 MIC. 2) On the other hand, when an antimicrobial agent had PAE on bacteria, regrowth of bacteria occurred quickly below a certain peak concentration (24 MIC or 64 MIC value), although there was some difference depending on the type of antimicrobial agents. Thus, it was suggested that the peak concentration above that level be attained and maintration above that level be attained and maintained for some time were in order to obtain PAE adequately. 4. It is concluded from the aforementioned facts that two factors, a certain high concentration and a certain continued time are necessary for both antimicrobial agent with metabolic disorder and antimicrobial agent with cell wall synthetic inhibition to obtain proper antimicrobial effect. The condition of their necessity differed slightly according to the two different agents.
During an epidemic-free period of nearly 2 years infections and illnesses were followed in a group of small children (2-3 1/2 years) in a day nursery. The incidence of illness was fairly low, 6.3 per child and year. The viral infections were followed by means of the inclusion reaction in the urine and isolation of virus, and the bacterial by culture of nasal secretion. In 60% of the cases the viral infection was accompanied by illness. In 57 cases of illness there were 27 (47%) with merely virus and/or inclusion reaction, 8 (14%) in which bacteria alone were discovered, and 22 (39%) with both. The viral infections were the decisive ones in about 80% of the illnesses. Enteric respiratory viruses of 10 types were detected. 16 (73%) of the 22 children had such an infection on at least one occasion, and spread within the group occurred on infection with echovirus 9, coxsackievirus B4 and reovirus. Enteric viruses accounted for 29% of the viral infections. Streptococci and Mycoplasma pneumoniae played no part in the bacterial infections, which were entirely dominated by pneumococci. Cytomegaloviruria was found in 13 (72%) of 18 children examined. No spread was detected within the group. Rotavirus was on no occasion found in faeces.
Urine samples from 28 donors with known blood group and secretor status were concentrated by three different procedures, and ABO typing on the concentrated samples was successfully performed after 12 weeks of storage. The effects of storage with or without sodium azide on ABO typing and on the pH values at several different temperatures were also studied.
A simple and high-yield purification procedure for urine protein 1 (UP1) using anti-UP1 immunoaffinity chromatography is described. Pure UP1 was obtained in a final yield of 60.2%, and observed as a single electrophoretic band and as a single peak on reversed-phase high-performance liquid chromatography. The N-terminal amino acid residue of UP1 was found to be glutamic acid, contrary to what was reported previously. Furthermore, the N-terminal sequence of UP1 up to 53 amino acids was confirmed to be identical with that of mature human Clara cell 10-kilodalton protein, which inhibits phospholipase A2 activity.
A capillary gas chromatographic-mass spectrometric method for the determination of [13C,15N2]theophylline and unlabelled theophylline (TP) and of 1,3-dimethyluric acid (1,3-DMU), a major metabolite of TP, is described. TP and the metabolite were extracted separately from serum or urine, purified by high-performance liquid chromatography and converted into alkyl derivatives (monoethyl-TP and dibutyl-1,3-DMU). The internal standards used for the respective determinations were [2H6]TP and [2H6]1,3-DMU. Detection was performed by monitoring the molecular ions of the alkyl derivatives. The method needed no complex corrections for contributions and provides good accuracy and precision.
Urine volume (UV), Glomerular filtration rate (GFR) and Fraction of reabsorption (FR) of water, Ca, IP, Na+, K+, Cl-, Glu and UN, which are significant in kidney function analysis, were investigated and compared in three rat strains (WI, SD and F344). UV/body weight ratios were higher in SD rats as compared to other strains. The GFR difference was not significant, but the FRH2O difference was significant in three rat strains. FR of Ca, K+ and Glu showed no significant differences in three different rat strains. SD and F344 were significantly lower than WI in FR of IP. FR of Na+, Cl- and UN were significantly different in three rat strains without Cl- between SD and F344, and UN between WI and SD.
Various surgical methods for the treatment of severe incontinence of urine II degrees can be used. The aim of the present study was to apply primarily in 255 cases of severe stress incontinence. II degrees the specific surgical procedure for treatment: 123 cases of cysto-rectocele repair including vaginal hysterectomy, 71 cases of puborectalis repair, 43 cases of urethrovesicosuspension operation with or without abdominal/vaginal supplementary procedures, till 1970 12 cases of combined operations and finally beginning in 1973 6 cases of dura-sling operation. Indications and principles of surgical intervention are described according to clinical intern procedures. Puborectalis repair (Franz operation) and pubococzygeus repair (Ingelman-Sundberg operation) in cases of missing prolapse combined with severe incontinence gave rather good results. The basis for optimum results after operative treatment of patients with stress incontinence is a detailed pre-operative diagnosis; The most specific operative procedure from the beginning seems to us more recommendable than routine cysto- rectocele repair including a second more specified operation in cases of relapse.
Using conventional clearance technique, the net renal clearance of diflunisal is very low, about 1% of glomerular filtration rate. Although net renal secretion is not demonstrable, probenecid significantly decreased renal clearance of the drug. Also, the renal clearance was increased by increases in urine flow or urinary pH. However, in contrast to acetylsalicylic acid, these effects would be expected to be minor, on the one hand to conserve drug or on the other hand in facilitating drug elimination in cases of overdosage.
Iodine research holds an increasing place in thyroid pathology, either to cover a radioisotopic investigation with paradoxal results or to find an iatrogenic cause to an unexplained hypo- or hyperthyroidism in new born children as well as in adults. To determine iodine overloads we may need a urinary iodine estimation, in addition to blood iodine determination (quickly eliminated products) or instead of it (difficult blood taking: new born children, etc.). Classically, the 24 hours urinary iodine estimation (total urinary iodine) covers this need but, in practice, as we generally deal with ambulatory patients, the risks linked to the obtention of a perfect 24 hours urine collecting make us abandon it. This article presents an original and simple way of getting round this difficulty: it demonstrates that an excellent iodine overload estimation can be obtained by measuring simultaneously from a simple miction: on one hand iodine concentration, on the other hand the urinary creatinine.
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