Prolapsed single system ureterocele in a girl

Ureteroceles in childhood usually are associated with ureteral duplication. A 7-year-old girl with a single system ureterocele is described. The patient presented clinically with urinary infection and prolapse of the ureterocele, causing urinary retention.

Urological anomalies in the caudal regression syndrome

Two cases of unusual urological anomalies seen in association with the caudal regression syndrome are reported. One patient had bilateral single ectopic ureters with unilateral renal agenesis and the other a megalo-ureter secondary to a ureteric valve.

Fetal urinary tract abnormalities detected on maternal ultrasound

Twenty-one cases of fetal urinary tract abnormalities were detected on maternal ultrasound in a 5 year period. Six fetuses died and 13 of the 15 surviving cases have had corrective urological surgery, usually during the neonatal period. Maternal ultrasound provides advanced warning of major urinary tract abnormalities in the newborn. Therefore, appropriate investigations and medical management can be instituted early and potentially destructive urological lesions can be corrected as soon as possible. As yet, antenatal intervention does not seem to be warranted as the most common cause of bilateral upper tract dilatation in the surviving cases in this series was primary reflux, and in the cases that died the urinary abnormalities were not salvagable.

Repair of amino acid radicals by a vitamin E analogue

Free radicals derived from one-electron oxidation of the amino acids tryptophan, tyrosine, methionine and histidine have been found to be rapidly (k = 10(7) -10(9) dm3 mol-1 s-1) and efficiently repaired by Trolox C, a vitamin E analogue. The reactions form a relatively stable phenoxyl radical of Trolox C (lambda max = 440 nm; epsilon = 5.4 X 10(3) mol dm-3 cm-1). The radical cation of tryptophan is more rapidly repaired than the neutral tryptophan radical. Repair of tryptophanyl radicals in the enzyme lysozyme has also been observed. The results suggest that a function of alpha-tocopherol in membranes may be the repair of radicals of integral membrane proteins.

Superficial bladder cancer: progression and recurrence

The tumors in 249 patients presenting initially with stages Ta and T1 bladder cancer were analyzed for tumor progression and recurrence. Only transurethral resection and/or fulguration was used before the first recurrence. Patients who received intravesical chemotherapy after the first tumor recurrence were excluded from an analysis of progression. Progression according to stages Ta and T1, and grades I, II and III was 4, 30, 2, 11 and 45 per cent, respectively. All differences were statistically significant. Progression also correlated with nontumor dysplasia and size. High tumor grade, lamina propria invasion, atypia elsewhere in the bladder, positive urinary cytology, tumor multiplicity and large tumors were associated with shorter intervals free of disease.

Urethral ectopic ureter with a ureteric valve

An unusual case of a urethral ectopic ureter in a girl is reported. Only the upper half of the ureter was a megaloureter, the distal half being stenosed. The appearances were consistent with the presence of a ureteric valve.

The effect of beta-galactosides on the protonmotive force and growth of Escherichia coli

The effect of three beta-galactosides on the components membrane potential (delta psi) and pH gradient (delta pH) of protonmotive force and growth of Escherichia coli has been examined. A good correlation between the reduction of the protonmotive force and growth inhibition was observed. Thus some galactosides had little effect on either the protonmotive force or growth while lactose diminished the protonmotive force and caused growth inhibition. This effect of lactose was dependent on the ionic composition of the growth media. In Medium A (77 mM-Na+, 85 mM-K+) lactose diminished delta psi but had no effect on delta pH. Growth inhibition was transient at an external pH 6.0 but complete at pH 7.5. In medium KA (approximately 1 mM-Na+, 162 mM-K+) delta pH was diminished and delta psi was not affected and consequently growth inhibition was complete at pH 6.0. In medium NA (163 mM-Na+, 20 mM-K+) lactose had little effect on delta psi, delta pH or growth. These data support Skulachev's hypothesis of buffering of the protonmotive force by K+ and Na+ gradients.

The use of valinomycin, nigericin and trichlorocarbanilide in control of the protonmotive force in Escherichia coli cells

Valinomycin, nigericin and trichlorocarbanilide were assessed for their ability to control the protonmotive force in Escherichia coli cells. Valinomycin, at high K+ concentrations, was found to decrease the membrane potential delta phi and indirectly to decrease the pH gradient delta pH. Nigericin was found to have two modes of action. At low concentrations (0.05-2 microM) it carried out K+/H+ exchange and decreased delta pH. At higher concentrations (50 microM) it carried out a K+-dependent transfer of H+, decreasing both delta phi and delta pH. In EDTA-treated cells only the latter mode of action was evident, whereas in a mutant sensitive to deoxycholate both types of effect were observed. Trichlorocarbanilide is proposed as an alternative to nigericin for the specific control of delta pH, and it can be used in cells not treated with EDTA.

Application of the pull-through technique of transverse advancement ureteral reimplantation

In the pull-through technique of ureteral reimplantation the ureter is divided at the hiatus and pulled through into the bladder. It is then advanced transversely as described previously for megaloureter but the technique also may be used for routine cases. The technique is particularly suitable for ureteral reimplantation in patients with urethral valves and neurogenic bladder. Pull-through ureteral reimplantation also may be used to reimplant the orthotopic ureter in complete ureteral duplication with ectopic ureterocele or with orthotopic reflux.

Renal parenchymal injuries secondary to blunt abdominal trauma in childhood: a 10-year review

Sixty-six cases of renal parenchymal injuries secondary to blunt abdominal trauma in childhood are reviewed. Based on radiological findings, the injuries were classified into renal contusions, lacerations and transections. The clinical features were more acute in patients with renal laceration and transection. Complications were more common in patients with renal transection and led to partial or total renal loss in a significant number of cases. Renal contusions and most lacerations should be managed non-operatively but renal transections should in general be managed operatively.

The effects of partial and selective reduction in the components of the proton-motive force on lactose uptake in Escherichia coli

The relationship between the steady state lactose accumulation (delta plac) and the magnitude of the membrane potential (delta psi) and pH gradient (delta pH) has been studied at pHo5.5 and pHo7.5. An attempt has been made to differentiate between two possible means by which lactose accumulation may be reduced below the proton-motive force (delta p). Firstly, that delta psi and delta pH are not equivalent in driving lactose transport and secondly, that 'slip' reactions (beta-galactoside exit via the carrier without a proton) may reduce accumulation. The data support the latter; however, our conclusions are tempered by the observation that the apparent stoichiometry (delta plac/delta p) increases to a value of at least 2 at values of delta p below 130 mV.

Quantitative measurements of the proton-motive force and its relation to steady state lactose accumulation in Escherichia coli

The magnitude of delta psi (membrane potential), delta pH (pH gradient), lactose accumulation and cytoplasmic volume have been determined over a range of experimental conditions. A study of two probes of delta pH, benzoate and dimethyloxazolidene-2,4-dione (DMO), and four probes of delta psi, Rb+, K+, tetraphenylphosphonium (TPP+) and 3,3'-dipropylthiodicarbocyanine iodide, has been carried out. Benzoate and DMO are shown to be equivalent at pH values above the pK of DMO, but the latter may be less accurate below this pH. The cations TPP+ and Rb+ were found, by a number of criteria, to be equivalent, and TPP+ may be used in cells not pretreated with EDTA. These studies are an essential prerequisite to the use of TPP+ as a quantitative probe in untreated cells.

Uncrossed complete ureteral duplication with caudal orthotopic orifice and ureterocele

A case is reported of uncrossed complete left ureteral duplication with the orthotopic ureteral orifice opening caudal to the ectopic orifice. Whereas the caudal orthotopic orifice was associated with a ureterocele and megaloureter, the cranial orifice was associated with a small undilated ureter. The orthotopic kidney was hydronephrotic, and the ectopic kidney was small and non-functioning. The ureterocele was excised together with the megaloureter and the small ectopic kidney also was removed. The undilated ectopic ureter was transplanted to the orthotopic kidney by performing a ureteroneocystostomy distally and ureteropelvic anastomosis proximally.

Urinary undiversion in myelomeningocele patients with an ileal conduit diversion

Neurogenic bladder in myelomeningocele has been managed until recently by routine ileal conduit urinary diversion. Long-term complications are not uncommon after an ileal conduit and 23 of our patients required major surgical revision during the last 2 years. In 5 patients with an ileal conduit urinary undiversion was performed after excision of the conduit and direct ureteral anastomoses. Over-all progress of these patients has been satisfactory. We conclude that when major surgery is required to correct ileal conduit complications in myelomeningocele, urinary undiversion should be considered in selected cases.

Transverse advancement ureteral reimplantation: pull-through alternative in megaloureter

A modification of the transverse advancement ureteral reimplantation technique suitable for megaloureter operation is described. After dividing the ureter extravesically at or near the ureteral hiatus and after adequate mobilization or manipulation (tailoring), the ureter is pulled through into the bladder. A limited mucosal incision is then made and routine transverse advancement reimplantation is done. The technique is suitable for cases when extravesical exposure of the ureter is considered necessary and obviates the need for intravesical ureteral mobilization.

Revision of ureteral reimplantation by the transverse advancement technique

Antireflux ureteral reimplantation may be performed by a variety of techniques with consistently satisfactory results. Complications, such as persistent reflux and postoperative ureterovesical obstruction, may be encountered occasionally and, when significant, they will necessitate a revision operation. Herein 6 cases are described of failed ureteral reimplantation, which were revised successfully by performing a transverse advancement ureteral reimplantation.

Automated determination of total plasma cholesterol: a serum calibration technique

The automated (AutoAnalyzer II) determination of cholesterol in nine serum pools in the concentration range 3.465-8.871 mmol/l, gave results that were approximately 10% higher than reference values when the analyses were based on unesterified cholesterol standards containing the same amount of water as the sample extracts (1963 analyses in 12 laboratories during a 12 month period; automated value = 0.032 + 1.10 X (Reference value)). A serum calibration procedure was successful ilues, and was equally effective in correcting the values observed for aliquots of 368 fresh-frozen plasma samples analyzed in each of the 12 laboratories during a 38 month period.

Progressive effects of protein-calorie malnutrition on serum free amino acids in infant and young adult nonhuman primates

Serum amino acid profiles have been known to change when dietary protein restriction is instituted in animals and in man. In the present study, significant alterations were noted in infant monkeys observed over 14 weeks. Impressive but less dramatic changes were apparent in protein-restricted young adult monkeys observed over a much longer period. In general, essential amino acids were depressed (especially the branched-chain group) while nonessential amino acids tended to rise (especially glycine and alanine). Changes were most acute within the first 3 to 4 weeks of dietary restriction. Improvement in dietary protein content provided to young adults led to resumption of normal serum amino acid patterns. Level of available dietary protein and age of the animals clearly dictated the severity of amino acid imbalance observed.

External quality-control survey of cholesterol analyses performed by 12 lipid research clinics

We report accuracy and precision achieved in the automated analysis for cholesterol in a long-term multilaboratory study, presenting and evaluating the significance of data accumulated by 12 Lipid Research Clinics (LRC's) in the analysis of 18 unknown surveillance pools during three years. The average bias for all pools and for 13 autoAnalyzer II (Technicon Instruments Corp., Tarrytown, N.Y. 10591) instruments in the 12 clinics was -0.41% (range -1.2 to +0.3%), as compared to values established by reference methodology. The regression equation relating observed cholesterol values (y) to reference values (x) was: y = 0.35 + 0.977x. The bias varied from pool to pool (-2.3 to +5.3%), positive biases being observed for pools with cholesterol concentrations less than 1.4 g/liter, and negative biases for those pools with higher concentrations. Total standard deviations ranged between 25 and 75 mg/liter, and total CV's for most individual instruments were between 1 and 3%. Of the variability for a particular pool, less than 20% was due to differences among instruments, and within- and between-run variabilities were approximately equal. These trends were the same as those previously observed [Clin. Chem. 23, 1744 (1977)] in the analysis of bench control pools of known cholesterol concentration.

External quality-control survey of cholesterol analyses performed by 12 lipid research clinics

We report accuracy and precision achieved in the automated analysis for cholesterol in a long-term multilaboratory study, presenting and evaluating the significance of data accumulated by 12 Lipid Research Clinics (LRC's) in the analysis of 18 unknown surveillance pools during three years. The average bias for all pools and for 13 autoAnalyzer II (Technicon Instruments Corp., Tarrytown, N.Y. 10591) instruments in the 12 clinics was -0.41% (range -1.2 to +0.3%), as compared to values established by reference methodology. The regression equation relating observed cholesterol values (y) to reference values (x) was: y = 0.35 + 0.977x. The bias varied from pool to pool (-2.3 to +5.3%), positive biases being observed for pools with cholesterol concentrations less than 1.4 g/liter, and negative biases for those pools with higher concentrations. Total standard deviations ranged between 25 and 75 mg/liter, and total CV's for most individual instruments were between 1 and 3%. Of the variability for a particular pool, less than 20% was due to differences among instruments, and within- and between-run variabilities were approximately equal. These trends were the same as those previously observed [Clin. Chem. 23, 1744 (1977)] in the analysis of bench control pools of known cholesterol concentration.

Results of ureteral reimplantation in patients with intrarenal reflux

Intrarenal reflux was diagnosed in 6 male and 3 female children between 3 weeks and 11 years old, with 13 kidneys affected. One kidney was removed and 12 were managed successfully by antireflux ureteral reimplantation. Followup examination showed satisfactory growth of 10 of the 12 kidneys with intrarenal reflux.

Potential contribution of primary-school teachers to the health of a developing country

Like many other developing countries, Kenya gives higher priority to primary education than to health services. Thus, in rural areas primary schools are evenly distributed, well attended, and staffed by well-qualified teachers whereas health centres are thinly scattered, inaccessible to many, and staffed largely by people of low educational attainment. The public-health knowledge of school teachers exceeds that of many health workers. It is suggested that teachers of health science, in particular, represent a valuable resource for preventive and promotive medicine which can be exploited at little cost.

Ureteral reimplantation by the transverse advancement technique

When the transverse advancement technique of ureteral reimplantation is used the submucosal tunnel is made transversely across the base of the bladder. This method was used for reimplantation of 131 ureters in 92 children. The results indicate that the transverse advancement technique is adaptable to virtually any situation requiring ureteral reimplantation and is a simple, safe and reliable procedure for prevention of reflux.

Analytical performance and comparability of the determination of triglycerides by 12 Lipid Research Clinic laboratories

Twelve Lipid Research Clinic laboratories performed automated fluorometric triglyceride analyses on four control serum pools of known concentration by a modified Hantzsch reaction. The analyses were done during a two-year period, with use of common standards, methodology, and quality-control procedures. Estimates of analytical bias, variability, and short- and long-term trends for each instrument and for the entire group of LRC instruments are presented. High accuracy, precision, and interlaboratory comparability were achieved through rigorous standardization and control of the entire analytical procedure. Individual instrument biases varied from an average of 4.9% below to 1.0% above reference values. Between-run variability was often less than within-run variability and interlaboratory variation was substantially less than intralaboratory variation. The total standard deviation for all instruments ranged from 37 to 63 mg/liter. Only 5 to 14% of this variation was due to differences among instruments. The among-instruments standard deviation ranged from 12 to 17 mg/liter; the between-run, within-instrument standard deviation ranged from 29 to 46 mg/liter, and within-run standard deviation from 27 to 40 mg/liter. The significance of the results for long-term collaborative studies is discussed.

Analytical performance and comparability of the determination of triglycerides by 12 Lipid Research Clinic laboratories

Twelve Lipid Research Clinic laboratories performed automated fluorometric triglyceride analyses on four control serum pools of known concentration by a modified Hantzsch reaction. The analyses were done during a two-year period, with use of common standards, methodology, and quality-control procedures. Estimates of analytical bias, variability, and short- and long-term trends for each instrument and for the entire group of LRC instruments are presented. High accuracy, precision, and interlaboratory comparability were achieved through rigorous standardization and control of the entire analytical procedure. Individual instrument biases varied from an average of 4.9% below to 1.0% above reference values. Between-run variability was often less than within-run variability and interlaboratory variation was substantially less than intralaboratory variation. The total standard deviation for all instruments ranged from 37 to 63 mg/liter. Only 5 to 14% of this variation was due to differences among instruments. The among-instruments standard deviation ranged from 12 to 17 mg/liter; the between-run, within-instrument standard deviation ranged from 29 to 46 mg/liter, and within-run standard deviation from 27 to 40 mg/liter. The significance of the results for long-term collaborative studies is discussed.

Analytical performance and comparability of the determination of cholesterol by 12 Lipid-Research Clinics

Twelve Lipid-Research Clinic laboratories performed automated cholesterol analyses on four control-serum pools of known cholesterol concentration, using the Liebermann-Burchard reaction. The analyses were done during a two-year period, with the same standards, methodology, and quality-control procedures. Estimates of analytical bias, variability, and short- and long-term trends for each instrument and for the entire group of LRC instruments are presented. High accuracy, precision, and interlaboratory comparability were achieved through the rigorous standardization and control of the entire analytical procedure. The significance of these results for long-term collaborative studies is discussed. Individual laboratory biases averaged from 0.5 to 2.0% below Abell-Kendall reference values. Between-run variability was about equal to within-run variability and inter-laboratory variation was substantially less than intra-laboratory variation. The total standard deviation for all instruments was about 0.04 g/liter. Only 8-15% of this variation was due to differences between instruments. The between-instrument standard deviation ranged from 0.011 to 0.015 g/liter; the between-run, within-instrument standard deviation ranged from 0.023 to 0.030 g/liter; and within-run standard deviation ranged from 0.023 to 0.028 g/liter. The significance of the achieved results for long-term collaborative studies is discussed.

Analytical performance and comparability of the determination of cholesterol by 12 Lipid-Research Clinics

Twelve Lipid-Research Clinic laboratories performed automated cholesterol analyses on four control-serum pools of known cholesterol concentration, using the Liebermann-Burchard reaction. The analyses were done during a two-year period, with the same standards, methodology, and quality-control procedures. Estimates of analytical bias, variability, and short- and long-term trends for each instrument and for the entire group of LRC instruments are presented. High accuracy, precision, and interlaboratory comparability were achieved through the rigorous standardization and control of the entire analytical procedure. The significance of these results for long-term collaborative studies is discussed. Individual laboratory biases averaged from 0.5 to 2.0% below Abell-Kendall reference values. Between-run variability was about equal to within-run variability and inter-laboratory variation was substantially less than intra-laboratory variation. The total standard deviation for all instruments was about 0.04 g/liter. Only 8-15% of this variation was due to differences between instruments. The between-instrument standard deviation ranged from 0.011 to 0.015 g/liter; the between-run, within-instrument standard deviation ranged from 0.023 to 0.030 g/liter; and within-run standard deviation ranged from 0.023 to 0.028 g/liter. The significance of the achieved results for long-term collaborative studies is discussed.

Common skin diseases (analysis of 7,636 cases)

A total of 7,636 patients attending the Outpatient Clinic of the Skin and Venereal Disease Department, Medical College Hospital, Mymensingh, were analysed in relation to skin affection, place of residence, seasonal variation of skin diseases, age incidence and site involved with skin diseases. In over 70% of patients, the skin condition diagnosed was either pyoderma or scabies. Majority of these patients came from rural areas. Greater number of patients with pyoderma sought medical help during summer whereas more patients with scabies came during winter. Pyoderma was common in young children but incidence of scabies was distributed in all age groups.