No abstract

SummaryA study of the effect of bladder lavage with isotonic fluid at 450 C on proliferative transitional celi carcinoma has shown definite cancericidal changes. These early studies suggest that further investigation of hyperthermia on a larger scale would be worth while.

Seventy-two samples of human urothelium have been examined by scanning electron microscopy (SEM) and the appearances compared with those of conventional light microscopy. Six main SEM cell types were recognised. None was diagnostic of malignancy; in particular, the presence of surface pleomorphic microvilli was not pathognomonic. However, the relation of the SEM appearance to malignancy and the accepted histological grades and clinical stages of malignancy was such as to warrant further examination.

The purpose of this study was to clarify the role of the conduit in the development of upper tract dilatation after ileal conduit urinary diversion. Twenty-seven patients with a normal upper tract were compared with 17 who had developed upper tract dilatation. Patients were studied by means of a technique to measure pressure and flow under "steady-state" conditions. Pressure activity was classified into two types. Type I pressure activity (frequency 6.2 +/- 3/min; amplitude 4.7 +/- 3 cm H2O) resulted in to-and-fro movement of contrast and the escape into the appliance of small volumes of contrast. In controls, most of the output from the conduit occurred during type I activity (73 +/- 14%). Type III/IV pressure activity resulted in vigorous aboral peristalsis and occurred infrequently in controls (frequency 5 +/- 4/h). In patients with upper tract dilatation, in contrast, type III/IV peristaltic activity occurred frequently (frequency 37 +/- 30/h; P less than 0.001: amplitude 72 +/- 34 cm H2O) and was responsible for most of the output (70 +/- 17%; P less than 0.001). The findings support the hypothesis that high pressure activity in the conduit is an important factor in the aetiology of upper tract dilatation, and they are compatible with the presence in such patients of functionally important obstructions of the distal conduit.