PubMed HealthSearch

Biomedical subjects

C M Booth

Publications and source records attributed to C M Booth.

At least 19 recordsLinked to original sources

The benefits of a shared-care prostate clinic.

OBJECTIVE: To establish a hospital based shared-care clinic to investigate and manage benign prostatic hyperplasia (BPH) with general practitioners (GPs). PATIENTS AND METHODS: During one year, 330 patients referred with suspected prostatic obstruction were investigated in an outreach clinic in a rural cottage hospital by urology department nurses according to a protocol. After this, they were referred directly back to their GPs with recommendations for their management or seen in the urologist's clinic. A questionnaire was completed by the GPs to assess their satisfaction with and attitudes to the clinic. RESULTS: One-third of the patients were referred directly back to their GP, a third were seen routinely and a third seen urgently in the urologist's clinic, usually because a prostate-specific antigen assay indicated the possibility of latent prostatic cancer. A survey confirmed that GP support for the clinic was unanimous whilst patients were reassured by the thoroughness and sensitivity of the clinic's nursing staff. CONCLUSION: The clinic reduced the workload of the GPs and urologists whilst providing a speedy and comprehensive assessment of patients presenting with suspected prostatic obstruction.

Clinical Protocols

Cutting the cost of catheterization for acute retention--a hospital or domiciliary procedure?

OBJECTIVE: To report the views of General Practitioners (GPs) and patients on the most appropriate place and person to catheterize patients in acute urinary retention. PATIENTS AND METHODS: Two separate questionnaires were sent to 50 local GPs and 100 patients who had recently been referred with acute urinary retention. The questionnaires were designed to ascertain the most appropriate place and person to catheterize these patients. They also established the number of hospital admissions due to acute retention, the use of ambulances and the uptake of the district nurse services. RESULTS: Whilst 54% of GPs advocated domiciliary catheterization, only 20% of emergency catheterizations were carried out in the home. Nearly half the patients catheterized in the Accident and Emergency Department were admitted acutely and 41% of patients had travelled to hospital by ambulance. Patients were equally divided about where they would prefer to be catheterized, but 70% of patients stated that they were happy to be catheterized by a trained nurse; no GP opposed this concept. CONCLUSION: The cost/benefit analysis of these results strongly supports the case for establishing best-practice guidelines to promote an emergency domiciliary service led by GPs and trained district nurses and thus hasten the emergency care of acute retention and cut costs.

Acute Disease

Expression of GAP-43 mRNA in mouse spinal cord following unilateral peripheral nerve damage: is there a contralateral effect?

Two new oligonucleotide anti-sense probes and their corresponding sense probes specific for mouse GAP-43 mRNA were synthesized and end-labelled with digoxygenin. They were used to localize GAP-43 mRNA in the spinal cords of normal mice and in mice 3 and 7 days following unilateral sciatic nerve cut. GAP-43 mRNA was found to be expressed at low levels in motor and other neurons of the normal spinal cords. As expected from other studies, up-regulation occurred in the cell bodies of axotomized motor neurons but, in addition, up-regulation was also observed in the cell bodies of intact motor neurons contralateral to the lesion. Densitometer measurements showed that the up-regulation of GAP-43 mRNA was less in the intact, contralateral motor neuron cell bodies than in the axotomized motor neuron cell bodies and furthermore was transient, being higher at 3 days than at 7 days following axotomy. Both anti-sense probes gave the same result, although differences in cellular localization was observed, and the two sense probes were negative. Probe binding was abolished by pretreatment of the sections with ribonuclease and hybridization was carried out under different conditions of stringency in order to ascertain whether the contralateral expression of GAP-43 mRNA was a true reflection of its distribution in vivo. There is conflicting evidence on the presence or absence of contralateral effects following unilateral peripheral nerve injury in the literature, and it is suggested that these differences can be accounted for by the methodology and type of probe used.

Amino Acid Sequence

Delayed response to denervation in muscles of C57BL/Ola mice.

Muscle fibre areas and numbers, tetanic force, resident macrophage numbers and acetylcholine sensitivity were measured in normal and denervated soleus muscles of C57BL/Ola mice for comparison with data from outbred and other inbred strains. Serum creatine kinase levels were also measured. The muscles of normal C57BL/Ola mice had more fibres, generated more tension, had fewer resident macrophages and had a lower acetylcholine sensitivity than muscles of other strains. The normal level of serum creatine kinase was lower in C57BL/Ola mice than in Balb/c mice. Following denervation, the mean cross-sectional area of muscle fibres in Balb/c mice started to fall from day 1 but a fall was not seen in muscles from C57BL/Ola mice until day 5. The development of increased acetylcholine sensitivity was slower in the C57BL/Ola mice although the values in all mouse strains had converged by five days. The levels of serum creatine kinase also rose more slowly following denervation in C57BL/Ola mice. The differences between the data from C57BL/Ola mice and others are ascribed to the slow rate of Wallerian degeneration in that strain. The results support the view that the effects of denervation on muscle are due to both inactivity and an inflammatory effect contributed by nerve degeneration. The mutation that causes slow nerve degeneration may, however, also affect muscle directly, making it more resistant to catabolism.

Acetylcholine

An antibody to neural cell adhesion molecule impairs motor nerve terminal sprouting in a mouse muscle locally paralysed with botulinum toxin.

We have investigated the possible role of neural cell adhesion molecule, in promoting motor nerve terminal sprouting in the paralysed mouse gluteus maximus muscle, using a rabbit polyclonal antiserum to mouse brain neural cell adhesion molecule (donated by Dr C. Goridis). This antiserum recognizes neural cell adhesion molecule in the basal lamina and extracellular matrix of denervated mouse muscles (1988, Booth C. M. and Brown M. C., Neuroscience 27, 699-709). As a single dose of antibody injected in vivo over the surface of denervated gluteal muscles bound for 12-48 h to over 80% of fibres expressing neural cell-adhesion molecule, once daily injections were used to see if there was any action on terminal sprouting. Injections of antibody were made for four days, starting three days after muscles were paralysed with botulinum toxin. To avoid non-specific complement-mediated attack on neural cell adhesion molecule bearing motor nerve terminals, mice of the DBA/2 strain were used as these lack complement component C5. They were further complement depleted by daily intraperitoneal injections of colloidal inulin. The percentage of end plates bearing terminal sprouts (visualized in whole mounts of the gluteus maximus with zinc iodide-osmium staining) was reduced from a mean of 60.5% +/- 3.2 (n = 11) for mice treated with botulinum toxin alone and 61.5% +/- 1.2 (n = 8) for those treated with non-immune serum, to 37.3% +/- 3.6 (n = 8) in the anti-neural cell adhesion molecule injected series.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Localization of neural cell adhesion molecule in denervated muscle to both the plasma membrane and extracellular compartments by immuno-electron microscopy.

The location of neural cell adhesion molecule in mouse skeletal muscle has been investigated using two immuno-electron microscopical techniques. In the first method, 6-micron frozen sections of a normal and a hemi-denervated gluteus muscle were stained by an indirect immunoperoxidase method using a rabbit-derived polyclonal antiserum to neural adhesion molecule as the primary antibody. The stain was visualized with the electron-dense chromogen, diaminobenzidine and the sections fixed, osmicated and processed for electron microscopy whilst still on the slide. Ultrathin sections were cut and viewed in the electron microscope, where the reaction product appeared to be localized in the plasma membrane and on the basal lamina of the muscle fibres. The second method, using a 5-nm immunogold-labelled secondary antibody, confirmed and extended these initial observations. In these experiments, the primary antibody to neural cell adhesion molecule was applied in vivo to hemi-denervated mouse gluteus muscles. The muscles were dissected out 24 h later, divided into denervated and innervated halves and then into junctional and extrajunctional regions. Together with the junctional and extrajunctional regions of normal, control pieces of muscle which had not been incubated with anti-neural cell adhesion molecule, they were lightly fixed, and incubated with the secondary gold-labelled antibody, before further fixation and processing for electron microscopy. Semi-thin, 0.5-micron sections of each were cut and viewed at 20,000 x magnification. Randomly sampled fibres from the extrajunctional regions of the denervated and innervated halves of the hemi-denervated gluteus and the normal, control gluteus were photographed for quantitative analysis. Five micrographs were randomly selected from each group and in these, the numbers, density and position of gold particles were measured using a digitizing tablet. By far the highest number of gold particles was found in the denervated half of the gluteus muscle, there being much less in the innervated half and practically none in the control. The density of gold particles in the denervated muscles was maximal in the plasma membrane-basal lamina complex, but most were located in the extracellular spaces outside this region, where they usually occurred in clusters apparently in association with collagen fibres. We conclude that neural cell adhesion molecule in denervated skeletal muscle is present not only in the plasma membrane but also in the basal lamina and extracellular space.

Animals

Renal parenchymal carcinoma in children.

A series of 14 cases of renal parenchymal carcinoma in patients under 20 years of age is presented and reviewed with the best documented case reports from the literature. Unlike its adult counterpart the tumour has an equal sex ratio and minor trauma frequently precipitates presentation, otherwise its behaviour is similar. The treatment of choice is nephrectomy but, unlike adults, there is evidence to support the value of adjunctive radiotherapy and chemotherapy in the treatment of local spread. Prognosis is particularly worsened by cellular granularity, and vascular or direct extrarenal spread. The 5 year survival rate is 52 per cent.

Adolescent

Muscles of adult rats and mice express the Thy-1 glycoprotein on denervation.

Adult-skeletal muscles when denervated undergo extensive changes in biochemical and physiological properties. Many of these changes, for example the appearance of acetylcholine receptors along the length of the fibres, are characterized by a reacquisition of features normally found in developing muscles. This generalization can now be extended to the surface glycoprotein, Thy-1, which is expressed in myoblasts and transiently in newly fused myotubes in culture, for we have found that denervation leads to extensive production of Thy-1 in hindlimb muscles of adult rats and mice where its expression is normally very low. In addition, there is a slight transient rise in Thy-1 in muscles contralateral to the denervation.

Animals

Evaluation of screening tests for detecting sacral autonomic neuropathy in diabetes mellitus. A preliminary study.

In 6 patients with diabetes mellitus and 6 non-diabetic "controls" referred for urological assessment, sacral electromyelography (SER) and electrical stimulation of the anal reflex were compared with pressure/flow videocystourethrography (VCU) for the detection of sacral neuropathy, whilst electrocardiography (ECG) was used to screen for generalised autonomic neuropathy. Five diabetics had evidence of a neuropathic bladder on VCU and on electrical stimulation all 5 had an absent anal reflex, which may thus prove to be a simple, reliable, non-invasive screening test for sacral neuropathy.

Adult

Segregation of motor nerves on a segmental basis during synapse elimination in neonatal muscles.

The distribution of motor axons from segmental roots L4 and L5 entering the gluteus muscle of neonatal rats via the inferior gluteal nerve was determined by visual inspection of contractions when the muscle was pinned out in vitro. In both 0-2-day-old rats and in rats older than 11 days, there was overlap in the distribution. But in rats older than 11 days there was a clear tendency for the L4 root to avoid the muscle's posterior margin and for the L5 to avoid the anterior portion of the muscle innervated by the inferior gluteal nerve. This segregation was less sharp in 0-2-day-old rats. Hence synapse elimination does not occur randomly, but by a process which favours particular root distributions.

Animals

The structure of the bladder neck in male bladder neck obstruction.

A light microscope and neurohistochemical study is presented of full thickness biopsies from the bladder neck of 10 middle-aged males with urodynamically proven bladder neck obstruction. Apart from varying degrees of collagen deposition in seven cases, no abnormality was present in the detrusor and pre-prostatic components of the bladder neck muscles or in the distribution of cholinergic nerve fibres. The normal noradrenergic innervation to the pre-prostatic sphincter was absent in all specimens; this may be age-related.

Adult

Histological and urodynamic study of the bladder in enuretic children.

In a study of the bladders of 12 enuretic children by cystoscopy, light microscopy and urodynamics, cystoscopic trabeculation was found in 10 cases. Histologically, the trabeculation resembled adult trabeculation of obstructive aetiology, collagen infiltration being the characteristic hallmark. Using urodynamic measurements, the bladders behaved like those of adult enuretics; 10 out of 12 were unstable and voiding occurred at relatively high pressures. There was no correlation between symptoms and either cystoscopic or histological trabeculation.

Adolescent