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At least 919 records · Page 51Linked to original sources
PubMed1991

Bowel perforation and interstitial cystitis in childhood systemic lupus erythematosus.

A 13-year-old girl presented with abdominal pain, fever, dysuria, incontinence and pyuria and was subsequently diagnosed as having systemic lupus erythematosus (SLE) with extensive gastrointestinal involvement and an associated interstitial cystitis. Despite aggressive therapy with high dose prednisone and cyclophosphamide she developed a small bowel perforation and subsequently died. The combination of bowel symptoms and interstitial cystitis seems unique to the population with SLE, while the separate complication of bowel perforation carries an extremely poor prognosis in this group of patients.

Adolescent↗
PubMed1991

[Clinical evaluation of the bladder tumor marker "Tu-MARK-BTA"].

Bladder tumor antigen (BTA) is a tumor marker isolated from the urine of individuals with TCC of the bladder. This antigen can be detected by the Tu-MARK BTA test, a simple and rapid slide latex agglutination test performed on freshly voided urine. Sensitivity and specificity of BTA were calculated, and the correlation with pathological grade, histological stage, and urinary findings were statistically evaluated (chi 2-test) in 110 patients (72 male, 38 female; age: 16-91, mean age 54.4) examined between September, 1989 and April, 1990 including 46 TCC of the bladder (primary 28, secondary 18; grade 1:10, grade 2:27, grade 3:9, pTis: 2, pTa: 2, pT1: 23, pT2: 5, pT3: 4, pT4: 2), and 64 benign diseases. Sensitivity was 45.6%, specificity was 60.9%. In bladder tumor cases a correlation was seen between BTA and stage (p less than 0.02), and between BTA and grade (P less than 0.05). The positive ratio was higher in T1-T4 (55.9%) than in Tis.Ta (p less than 0.02). A high positive ratio of BTA was seen in bladder tumor cases with hematuria (70%, p less than 0.01) and pyuria (86.7%, p less than 0.01). This method is easy and rapid and the values are highly correlated with stage. Therefore, it should be useful for not only screening but followup of bladder tumor. Furthermore, BTA in combination with urine cytology is a more useful way for diagnosing TCC of the bladder.

Adolescent↗
PubMed1991

[Renal cell carcinoma in a horseshoe kidney].

A 65-year-old man with pyuria visited our hospital. Physical examination had revealed a mass in the left upper quadrant of the abdomen. Intravenous pyelogram, ultrasonogram, computerized tomography and selective renal arteriogram suggested a hypervascular renal cell carcinoma on the left side of the horseshoe kidney. A left radical nephrectomy with division of the isthmus was performed. The pathological diagnosis indicated renal cell carcinoma consisting of clear cell type without invasion of the capsule or renal pelvis. Treatment with alpha-interferon was started and has continued for six months with no evidence of recurrence. Only 35 cases of horseshoe kidney with a renal tumor have been reported in the Japanese literature. Among them, adenocarcinoma was present in 54.3% of the cases, renal pelvic tumor in 17.1%, and nephroblastoma in 14.3%. While adenocarcinoma in horseshoe kidney is seen less often than normal kidney, there is an increased incidence of both renal pelvic tumor and nephroblastoma.

Aged↗
PubMed1991

Neurogenic urinary tract infection.

Even though renal failure secondary to the urologic complications of chronic or recurrent urinary tract infection has decreased markedly due to advances in diagnostic, preventive, and therapeutic measures, infection and its sequelae continue to be major problems in patients with spinal cord injury regardless of the bladder emptying method employed. Although lower urinary tract complications have decreased with intermittent catheterization, the effects of increased intravesicular pressure, inflammation, and chronic bacterial colonization or invasion of the urinary tract on long-term renal function are still undetermined. Thorough evaluation of the urologic status on a regular basis in all patients with spinal cord injury is encouraged. Treatment of urinary tract infection should be guided by scientific data and drug susceptibilities of etiologic bacteria. The general consensus is that the presence of asymptomatic bacteriuria, particularly in the absence of pyuria, usually does not warrant antibiotic treatment, and that prophylaxis or suppression of infection with systemic antibiotics is not effective for any considerable length of time. Preservation of renal function is the ultimate goal of all bladder management strategies.

Humans↗
PubMed1991

[A case report of eosinophilic cystitis complicated with transient vesicoureteral reflux].

A case of eosinophilic cystitis complicated with transient vesicoureteral reflux in an 11-year-old girl with allergic disorders is reported. She was suffering from pollakisuria, painful urination, vesical irritability, and gross hematuria for about 2 months. Urinalysis showed aseptic pyuria. White blood cell count was 9,700/mm3 with eosinophils of 10%. Eosinophils were also found on urine cytology. Intravenous pyelography revealed bilateral hydronephrosis and apparently contracted bladder. Tumorous lesion and edematous mucosa were observed in the retrotrigonal region on cystoscopy. The multiple bladder biopsy uniformly revealed eosinophilic cystitis. Following antiallergic treatment, practically all symptoms subsided in steps, and normal cystoscopic appearance and histological structure were restored in 3 months. The vesicoureteral reflux markedly diminished in 10 months.

Asthma↗
PubMed1991

[Organization of early diagnosis of urinary tract tuberculosis at general medical institutions].

Out-patient records of 1006 patients representing urologic tuberculosis risk groups and those of 104 persons never treated for urologic diseases before were analysed. Subjects with multiple and long-term aggravations of a urologic process and persistent pyuria were at higher risk for urinary tuberculosis. This group of patients made up 20-25% of those registered as having nonspecific diseases of the urinary system. A high risk group should also include patients who are observed and treated for different nonurologic conditions. At the same time their clinical urinalyses indicate stable abnormalities, including leukocyturia, albuminuria and hematuria.

Diagnosis, Differential↗
PubMed1991

[Flucytosine in the treatment of urinary fungal infections. Clinical efficacy and background factors].

Flucytosine (5-FC), an oral antifungal agent, was used in the treatment of 37 patients with urinary tract infections due to fungi. Criteria for treatment included pyuria of greater than or equal to 5 WBCs/HPF, fungal colony counts in urine greater than 10(3) CFU/ml and the presence of candiduria in 2 consecutive urine culture with interval of 7 days. Patients received 2 approximately 8 g/day of 5-FC for 7 to 14 days. The clinical efficacy was evaluated in 27 patients with 14 day-treatment and overall efficacy rate was 77.8%. In patients with indwelling catheter, overall efficacy rate was lower than that in patients without catheter. Twenty-two of 30 strains (73.3%) were eradicated by the treatment. The MIC of 5-FC for isolates was less than 0.78 micrograms/ml except for 5 strains. The secondary resistance during 5-FC treatment was observed in early phase in 6 patients whose clinical efficacy was poor. The loss of appetite and mild leukocytopenia were observed as adverse effects. From the results of our study, 5-FC appears to be effective and safe in the treatment of urinary tract infection due to fungi.

Adult↗
PubMed1991

Intestinal parasitoses and other infections in a college community.

In order to assess the health status of students doing their teaching diploma course at the Siriba Teachers College, Maseno, a study of their blood slides, their stools for ova and cysts and their urine samples for urinary tract infection was carried out. A total of 298 students were investigated: 27 (6%) had intestinal parasites, 96 (32.2%) had urinary tract infection, i.e., pyuria, bacteria and epithelial cells in their urines, most of them being females (55/96 or 57.3%). The peak occurrence of urinary tract infections was in the 22-23 year age group. There were four female students who were found to have Trichomonas vaginalis giving a prevalence rate of 1.3%.

Feces↗
PubMedDate not supplied

Urolithiasis in children.

A retrospective study of childhood urolithiasis was performed from July 1978 to December 1989 in the National Taiwan University Hospital. During the eleven years, fourteen patients aged from 1 to 16 years were enrolled. The male to female ratio was 10:4, but no sex predilection was found in seven children with bladder stone(s) (M:F = 4:3), Hematuria and pyuria were the commonest symptoms and signs. Bladder stone was the most frequently encountered stone while renal stone was the second. The underlying factors included urinary tract anomalies, and surgical intervention of the urinary tract and trauma. Proteus species was the most common bacterium isolated from the urine of stone patients. However, half of the patients' urine specimens were sterile. Calcium oxalate and struvite were the two main components of the stones irrespective of renal, ureteral, or bladder stone origin. Lithotomy, endourological removal, and extracorporeal shock wave lithotripsy were the major therapeutic procedures, but the last procedure might replace the others.

Adolescent↗
PubMed1990

Acute interstitial nephritis in adolescents and young adults.

We have reviewed our experience with acute interstitial nephritis (AIN) in pediatric patients over the 3-year period from 1985 to 1988. We encountered 7 new cases of AIN in this interval and it was seen in 7% of kidney biopsies performed during this time of study. The clinical presentation was very nonspecific and included fever (100%), gastrointestinal complaints (57%) and rash (28%). Laboratory findings on admission included elevated erythrocyte sedimentation rate (100%), anemia (70%), pyuria (57%) and abnormal renal ultrasound (86%). Associated systemic diseases were observed in 4 patients. AIN was severe enough to necessitate treatment with hemodialysis in 42% of the cases. Corticosteroid therapy was used in 6 patients with a favorable response in all but 1 case. While 6/7 patients manifested complete recovery, 1 adolescent who may have had pre-existing renal disease had persistent chronic renal failure (estimated GFR, 25 l/min/1.73 m2). We have concluded that: (1) AIN is a relatively common disease in pediatric practice; (2) it can be severe enough to necessitate dialysis therapy, and (3) AIN often occurs in children with systemic disorders that may be associated with immunologic disorders.

Adolescent↗
PubMed1990

Routine admission urinalysis examination in pediatric patients: a poor value.

The urinalysis has long been considered an important screening test for hospitalized children. The value of the admission urinalyses, required by hospital bylaws, was assessed for detecting urinary tract disease in children admitted to a day-care unit or impatient medical or surgical services during the months of June and November 1987. Of 2695 admissions, urinalyses were considered essential for diagnosis or therapy in 543 patients (excluded from analysis). In the remaining 2152 patients eligible for screening, urinalyses were obtained in 145 (30%) of day-care unit and 587 (35%) of inpatient admissions. The results of 149 (20%) of screening urinalyses were abnormal (23% abnormal in inpatient and 10% abnormal in day-care unit admissions). The numbers of urinalyses with abnormal results were similar in surgical and medical admissions and between the months of June and November. Pyuria (90 patients) and hematuria (66 patients) were the most common abnormalities in initial urinalyses. Follow-up urinalyses and other diagnostic studies were obtained in 38% of patients with abnormal admission urinalysis results. In subsequent urinalyses, 58% showed persistent abnormalities; however, most subsequent abnormal results were not pursued with additional tests. Urinary tract infections were diagnosed in 6 patients. No other additional diagnoses were determined. The cost of initial urinalyses and subsequent diagnostic studies in these 732 patients during the 2 months was $23,465. The cost per diagnosis of urinary infection was $3911. It is concluded that when hospital bylaws require routine urinalyses at the time of admission, this requirement is frequently ignored and, in addition, abnormal results are often unappreciated or not pursued.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1990

[Autosomal dominant polycystic kidney disease clinical analysis in VGH--Taipei].

Autosomal dominant polycystic kidney disease (ADPKD) is the commonest hereditary nephropathy. We collected 92 cases in VGH. Diagnosis was confirmed by intravenous pyelogram, renal sonogram, or renal CAT scan. The incidence of having positive family history was just only 28.3%. Patients were diagnosed at the mean age of 54 +/- 11 years (26-74 years). The common clinical findings were hypertension (73.9%), abdominal mass, proteinuria, anemia, azotemia, abdominal or back pain and pyuria in orders. Hypertension might present in the early stage with normal renal function (near 40%). Polycystic liver was the major extrarenal lesion (57.6%), but the incidence of abnormal liver function was only 10.1%. Enlarged kidneys were not always palpable, even at end stage of renal function (mean age 56 +/- 9 years, 89.4% kidney palpable). Patient's urine amount was usually nonoliguric, even in uremic stage (82.9%). Sepsis was the first cause of death. Cardiovascular disease and uremia were followed in sequence. Their expired mean age was 61 +/- 7 years (53-74 years).

Aged↗
PubMed1990

[A case report of emphysematous pyelonephritis].

A 51-year-old male patient with diabetes mellitus consulted his home doctor because of high fever and right flank pain. Urinalysis showed marked pyuria. Treatment with antibiotics was not completely effective, and he was referred to our hospital for further examination and treatment. CT scan showed an abnormal gas shadow in right renal parenchyma. He was diagnosed with emphysematous pyelonephritis and right subcapsular nephrectomy was done after the control of diabetes mellitus. We reviewed 57 cases of emphysematous pyelonephritis including our case in the Japanese literature, and we discussed about its etiology, symptomatology, choice of treatment and prognosis.

Diabetic Nephropathies↗
PubMed1990

[Duplication of the urethra in a young girl. Apropos of a case].

Duplication of the female urethra is quite uncommon. A case of complete urethral duplication is reported in a 2.5 year old girl seen for pyuria. Physical examination showed and epispadiac meatus with dribbling urine just above a bifid clitoris associated with an orthotopic meatus. The two urethras were patent and situated on the same sagittal plane as seen on the cystography. The treatment consisted of excising the whole epispadic urethra using a combined perineal and suprapubic approach enlarged by symphyseal section for a better repair of the bladder outlet. Postoperatively, the patient was content and free of symptom. The main features of urethral duplication in girl are reviewed.

Child, Preschool↗
PubMedDate not supplied

[Ureteropelvic junction obstruction presenting with abdominal pain: a analysis of fourteen cases].

During the past three and half years (Jan, 1984-Jun. 1987), 14 cases of ureteropelvic junction obstruction presented with abdominal pain were encountered in the Department of Pediatrics, Mackay Memorial Hospital. Eight cases were male and six female. Their ages ranged from 4 years old to 12 years old. The duration of abdominal pain lasted for several days in 5 cases, several months in 4, and several years in another 5 cases. The abdominal pain was usually recurrent. It occurred once every 2 to 6 months. The location of pain was predominantly in the left abdomen and the periumbilical area. Cramping was the most characteristic symptom. Besides abdominal pain, several cases also had vomiting or abdominal mass. Laboratory examination showed some cases to have microscopic hematuria and others pyuria. All were proved by renal ultrasonography to have varying degrees of hydronephrosis. Intravenous pyelography or retrograde pyelography also confirmed the diagnosis of ureteropelvic junction obstruction. In 9 of the 14 cases, surgical intervention was performed to correct abnormalities. Six cases were followed up regularly; all showed improvement, however, one developed ureteropelvic junction obstruction on the contralateral kidney one year later. The remaining five cases who did not receive surgical treatment continued to have recurrent abdominal pain.

Abdominal Pain↗
PubMed1990

Medical dissolution of feline struvite urocystoliths.

The efficacy of a diet designed to facilitate dissolution of feline magnesium ammonium phosphate (struvite) uroliths was evaluated in 30 cases of urolithiasis, sterile struvite uroliths dissolved in a mean of 36 days after initiation of dietary treatment. In 5 cases of urolithiasis, struvite urocystoliths associated with urease-negative bacterial urinary tract infection dissolved in a mean of 23 days after initiation of dietary and antimicrobial treatment. In 3 cases of urolithiasis, struvite urocystoliths associated with urease-positive staphylococcal urinary tract infection dissolved in a mean of 79 days after initiation of dietary and antimicrobial treatment. Dissolution of uroliths in cats fed the treatment diet was associated with concomitant remission of dysuria, hematuria, and pyuria, and reduction in urine pH and struvite crystalluria. In one case, a urocystolith composed of 100% ammonium urate, and in another case, a urolith composed of 60% calcium phosphate, 20% calcium oxalate, and 20% magnesium ammonium phosphate did not dissolve.

Amoxicillin↗
PubMed1990

Urachal anomalies: acquired patent urachus and giant urachal cyst--2 cases report.

Two cases of rare urachal anomalies in the adult are described, including one acquired patent urachus and one giant urachal cyst. The presenting symptoms and signs included pyuria, fever, lower abdominal pain and palpable abdominal mass. The correct preoperative diagnosis was made after sonography. The clinical and radiographic features and magnetic resonance imaging are presented. Stone formation and the huge capacity of the urachal cyst are first reported. Excision of the urachal tract with resection of the bladder dome and cauterization of the cystic wall with stone removal were performed in that order. When a young adult presenting with a wet umbilicus, acute abdominal pain or a lower midline abdominal mass, the possibility of an infected urachal anomaly should be considered in the differential diagnosis.

Adolescent↗
PubMed1990

[Long-term follow-up results of TUL (transurethral ureterolithotripsy)].

We experienced 112 cases of urolithiasis treated with transurethral ureterolithotripsy (TUL) between December, 1985 and September, 1988. We analyzed 35 patients treated with TUL and who had come to our hospital to be examined by cystography, renal ultrasonography, plain X-ray, and urinalysis more than 3 months later. The follow-up term ranged from 3 to 30 months after TUL. The patients were treated using a 12Fr Stortz rigid lithotripter or flexible uretero-fiberscope with electrohydraulic lithotripter. Urinalysis, kidney-ureter-bladder X-ray (KUB), ultra-sonography and cystogram were the main disciplines for follow-up. Urinalysis revealed 4 cases of hematuria, 3 cases of hematopyuria and 2 cases of pyuria. KUB showed no newly formed stones, but 2 cases of ureteral stones had moved from the kidneys. Renal ultrasonography demonstrated no hydronephrosis of operated side, except for 1 case of mild hydronephrosis, who had had severe hydronephrosis preoperatively. We searched for vesicoureteral reflux (VUR) in 34 of the long-term follow-up patients after TUL, but no VUR was seen on their cystograms. No significant late complications of TUL were observed. No harmful effects of ureteral dilation during transureteral operation were found even in long-term follow-up patients.

Adult↗