Ureteroscopy with and without safety guide wire: should the safety wire still be mandatory?

Background And Purpose: Although the evidence is sparse, most urologists advise the insertion of a safety guide wire (SGW) alongside the ureteroscope whenever performing ureteroscopy (URS). The aim of the study was to compare the results of ureteroscopic treatment for ureteral stones at the Oslo University Hospital (OUH), where the SGW is routinely used, with the results at the Haukeland University Hospital (HUH), where the SGW is routinely omitted. The primary goal was to evaluate the success rates of passing the ureteroscope through the orifice, the ability to access the ureteral stone, and the ability to place a ureteral stent when needed after the endoscopy.

A safety guidewire influences the pushing and pulling forces needed to move the ureteroscope in the ureter: a clinical randomized, crossover study.

Background And Purpose: It is generally advised to keep a safety guidewire (SGW) in the ureter alongside the ureteroscope during endoscopy of the upper urinary tract, but little is known of how the SGW influences the forces exerted on the ureteroscope in the ureter. The purpose of this study was to investigate whether the presence of an SGW during ureteroscopy (URS) in a normal clinical setting will influence the pushing and pulling forces exerted on a semirigid ureteroscope.

Patients And Methods: In a 1-year period (2010-2011), 40 patients admitted to Haukeland University Hospital for endoscopic treatment of renal pelvic stone disease were included in a clinical randomized crossover trial measuring the forces needed to move a semirigid ureteroscope during URS.

Diversity in urologists' personal preferences in the ureteroscopic management of ureteral calculi in Norway.

Objective: The aim of this study was to evaluate diversities in Norwegian urologists' personal preferences in the endoscopic management of ureteral calculi.

Material And Methods: A questionnaire exploring different items of importance for the ureteroscopic management of ureteral calculi was sent to the 124 specialists and residents in urology at the 24 hospitals treating urolithiasis endoscopically in Norway.

Results: A total of 92 physicians answered the questionnaire (response rate 74.

Metabolic evaluation and medical management of upper urinary tract stone disease. Guidelines from the Scandinavian Cooperative Group for Urinary Stones.

A set of simple guidelines for metabolic evaluation and medical/dietary management of patients with urolithiasis is presented. The evaluation scheme is based on the documented risk factors in the Nordic area and the results of controlled clinical trials, and takes its basis in the severity of the stone disease in the individual stone patient. The initial evaluation in all patients aims at diagnosing conditions with a definitive metabolic, infectious or anatomical/functional cause of stone formation (MIAF urolithiasis).

The long-term outcome in patients with superficial transitional cell carcinoma of the bladder: a single-institutional experience.

Objective: To determine the natural history of transitional cell carcinoma (TCC) of the bladder, and to identify factors which place patients at lifelong risk of developing progression and dying from bladder carcinoma.

Patients And Methods: The long-term outcome was evaluated retrospectively in 231 patients with superficial bladder TCC, assessed for the first time within a 6-year period from 1981 to 1986, with a median follow-up of 108 months. Of 231 patients, 217 (94%) were initially treated by transurethral or segmental resection.

Surgical management of chylous fistula after retroperitoneal lymph node dissection.

Conservative treatment with low-fat diet, medium-chain triglyceride or total parenteral nutrition, depending on the general condition of the patient, is the mainstay in the treatment of chylous ascites. In patients with persistent chylous fistula direct surgical closure is a valid treatment option.

Shock wave lithotripsy of urinary calculi with Lithocut C-3000 in a small center.

We report clinical results with the Lithocut C-3000 shock wave lithotriptor used in treatment of kidney and ureteral stones. The Lithocut C-3000 is a low-cost device. There is no need for anaesthesia.

Ureteroscopy in pregnancy.

Purpose: We report our experience with ureteroscopy in pregnancy.

Materials And Methods: From 1984 to 1994, 24 pregnant women with lasting symptoms of ureteral obstruction underwent diagnostic and therapeutic ureteroscopy. Most of the women were in the second or third trimester of gestation.

A new system for descriptive classification of stones in the upper urinary tract.

A descriptive classification is proposed to stratify upper urinary tract stones by their number, size and location. The system considers the minimal but most important factors regarding the choice of surgical treatment and its success. Its principle is adaptable to more complex staging systems already existing.

[Postrenal acute renal failure with deficient or minimal dilatation of the renal pelvis].

This article presents the clinical and radiological findings in three patients with acute obstructive renal failure. In a setting of typical clinical symptoms of acute postrenal obstruction, the lack of or only minimal ultrasonographic dilatation of the pelvicalyceal system should not lead to the conclusion that there is no obstruction until supplementary invasive procedures have demonstrated open urinary tracts. Minimal pelvic dilatation in acute obstructive renal failure is typically associated with malignant diseases encasing the distal parts of the ureters, retroperitoneal fibrosis, urinary calculi and urinary infections.

Lamellar germ cell processes: structures for possible interaction between germs cells and Sertoli cells during spermatogonial differentiation and early meiotic prophase.

The recent finding of a stage-dependent topographical relationship of basally located germ cells to Sertoli-Sertoli interspaces in the rat testis ( Ulvik 1983a ) has suggested a focal interaction between Sertoli cells and early germ cells at the sites where 2 Sertoli cells meet over a basal germ cell. Focal, stage-dependent interaction between Sertoli cells and germ cells may require specializations of the germ cell membrane. Therefore, in the present work the surface of spermatogonia and spermatocytes has been studied under the electron microscope throughout the cycle of the seminiferous epithelium.

Comparative pharmacokinetics of metronidazole and tinidazole used as single dose prophylactic agents.

The pharmacokinetic properties of metronidazole (M) and tinidazole (T) were studied in patients undergoing colorectal surgery after a single preoperative dose of 1500 mg infused during 50 minutes. High-pressure liquid chromatography was used to determine serum concentrations, which for M and T were almost identical during the first 12 hours. After 24 hours, the concentration of T were slightly higher.

Stage-dependent topographical relationship of spermatogonia and early spermatocytes to Sertoli-Sertoli interspaces in the rat testis.

In the rat seminiferous epithelium the Sertoli-Sertoli interspaces can be regarded as ending at the surface of basal germ cells as well as at the basement membrane. The relationship between these basal endings (BEs) of the Sertoli-Sertoli interspaces and the basal germ cells was examined using the electron microscope. The number of BEs in a given area of the seminiferous epithelium was counted and found to be constant throughout the cycle of the seminiferous epithelium.

Selective uptake by the Sertoli cells of cytoplasm from normal spermatogonia in the rat testis.

Electron microscopical examination of germ cells during their development from early type A spermatogonia to late pachytene spermatocytes showed that small, spherical pseudopodia emerged from type B spermatogonia and, to a lesser degree, from intermediate spermatogonia and early spermatocytes. Serial sections showed that the pseudopodia pinched off from the type B spermatogonia and were engulfed by the adjacent Sertoli cells. Groups of dense bodies were found in the Sertoli cells adjacent to the engulfed islands of germ cell cytoplasm.

Classification of plastic-embedded rat seminiferous epithelium prior to electron microscopy.

Systematic electron microscopic studies of the changes which take place during the cycle of the rat seminiferous epithelium require that each of the 14 stages of the cycle are identified in the light microscope in plastic-embedded material allowing each stage to be trimmed out separately before the electron microscopic study. The classification of the 14 stages has originally been based on the morphological characteristics seen in paraffin-embedded tissue after PAS-staining. PAS-staining is less effective in plastic-embedded material, and this may be a main reason why electron microscopic findings of the seminiferous epithelium relatively seldom are related to the stages of the cycle.

Stage-dependent variations in volume density and size of Sertoli cell vesicles in the rat testis.

Membrane-bounded spherical vesicles found in rat Sertoli cells have been examined quantitatively during the cycle of the seminiferous epithelium. Most of the vesicles were localized to the basal and columnar portions of the Sertoli cell cytoplasm. The thin lateral projections of the Sertoli cells contained very few vesicles.

Life-supporting first aid self-training.

The authors studied the acquisition of life-supporting first aid knowledge and skills by 230 lay people in self-training group instruction without qualified first aid instructors and self-training at home. The self-training course consisted of audiotape-recorded instructions, flipover charts, an instruction booklet, first aid materials and a "Resusci Anne" training mannikin. The same instruction booklet and first aid materials were used for self-training at home.

Mechanical small bowel obstruction due to adhesions.

During the years 1971-1975, 103 patients were operated on for adhesive small bowel obstruction, giving an incidence of 80 per 1 million inhabitants per year. Previous laparotomy caused the obstruction-provoking adhesions in 90% of the cases. Appendicectomy, gynaecological operations, and operations on the intestine were the three most common surgical procedures performed prior to the obstruction.