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Biomedical subjects

F J Allen

Publications and source records attributed to F J Allen.

At least 19 recordsLinked to original sources
PubMed1996

Oral surgery at St. Mary's Hospital, Chapelizod. A quarter century experience of day-case oral surgery.

To mark the first quarter century of the existence of the Oral Surgery unit at St. Mary's Hospital, Chapelizod, an audit was undertaken. Twenty-nine thousand, three hundred and seventy-four (29,374) entries in the operations register were analysed, examining annual totals, categories of operation, the changing patterns of anaesthesia, including cancellations on the day, and the evolution of a true day-case service. The results showed a decline in total numbers and in some operation categories. The most striking reductions were in extractions of carious teeth and in preprosthetic surgery. The most marked increase was in surgery for impacted teeth. While general anaesthesia remains the most commonly used form of anaesthesia, there has been an increased utilisation of sedation. Since the earlier years the number of patients requiring admission post-operatively has steadily decreased but more patients have been cancelled on the day of operation. Most of the changes described reflect the influence of health care economics and the effects of fluoridation.

Ambulatory Surgical Procedures↗
PubMed1995

Are neuroendocrine cells of practical value as an independent prognostic parameter in prostate cancer?

OBJECTIVE: To assess whether the presence of neuroendocrine (NE) cells is of value as an independent indicator of poor prognosis in patients with prostate carcinoma. PATIENTS AND METHODS: A series of 160 consecutive patients with prostate carcinoma was studied retrospectively. In 120 there was sufficient tissue for review and to perform immunoperoxidase stains for neuron specific enolase (NSE) and chromogranin A (CGA). All patients had a potential follow-up of at least 5 years. RESULTS: Five-year survival was poorer for patients with a high tumour grade and stage at presentation compared to those with a lower grade and stage. NE cells were more common in higher grade and stage disease, but 5-year survival did not differ significantly between patients with NE cell positive and negative tumours. CONCLUSION: NE cells are of no practical value as an independent prognostic indicator in patients with prostatic adenocarcinoma.

Adenocarcinoma↗
PubMed1993

Leydig cell tumor of intra-abdominal testis.

A patient with bilateral cryptorchidism and gynecomastia due to Leydig cell tumor involving the left intra-abdominal testis is described. Raised serum estrogen, low serum testosterone, and ultrasonic demonstration of a tumor in the left testis allowed the diagnosis to be suspected preoperatively. The relevant literature is reviewed.

Adult↗
PubMed1993

Genito-urinary tuberculosis--experience with 52 urology inpatients.

The current trend in South African health services is toward primary care. Pulmonary tuberculosis is well understood by the majority of primary care doctors and nurses, whereas genito-urinary tuberculosis may not be as easy to diagnose and treat. We reviewed our experience with this condition in 52 patients, who represented 0.74% of urology admissions between 1986 and 1991. There was a 3:2 male/female ratio, the age range was 7-76 years (mean 43 years), and the disease was more common among blacks and coloureds than among whites. Multiple sites of involvement were fairly common. Seventy-five per cent of patients had renal involvement and 17% epididymal involvement. The commonest presenting complaints were urinary frequency and haematuria, although flank and scortal pain were also reported by a number of patients. Physical examination seldom helped to suggest the diagnosis. On microscopic examination and culture of the urine, sterile pyuria was present in only 50% of our patients and 29% had positive cultures for a 'normal' coliform organism. Fifty patients underwent excretory urography and the findings were very varied. Patients were treated primarily with antituberculosis drugs, but 58% also required some form of surgery; nephrectomy was the commonest operation. Ureteral strictures developed in over 50% of cases with renal involvement. We conclude that the diagnosis of genito-urinary tuberculosis is not simple, and that treatment must include regular follow-up at a specialist institution.

Adolescent↗
PubMed1992

Intravenous urography in patients with transitional cell carcinoma of the bladder. The incidence and implications of ureteral obstruction.

In order to study the value of excretory urography in the diagnosis of transitional cell carcinoma of the bladder, and also the incidence and implications of ureteral obstruction, 100 consecutive patients were studied. Of 73 patients with superficial tumours (stages Tis, Ta, T1) only 1 (1,4%) had hydronephrosis as a result of the bladder tumour. However, 2 further patients had hydronephrosis secondary to synchronous ureteral tumours. Of the 27 patients with muscle-invasive tumours, 10 (37%) had hydronephrosis at the time of diagnosis. Four patients who had normal upper tracts initially, developed hydronephrosis during follow-up: 1 due to progression of a superficial tumour to stage T3, 1 due to the development of an ureteral tumour, and 2 due to fibrosis of the intramural ureter after transurethral resection of superficial tumours. The presence of ureteral obstruction at the time of diagnosis most often implies a muscle-invasive tumour, but the possibility of a synchronous ureteral tumour must also be considered. Fibrous strictures of the distal ureter can occur after transurethral resection of superficial bladder tumours.

Carcinoma, Transitional Cell↗
PubMed1991

Prostate carcinoma--the value of T stage and grade in predicting metastases and prognosis. A cost-effective approach to clinical staging.

In order to evaluate the initial T stage and tumour grade as predictors of metastatic disease and prognosis in adenocarcinoma of the prostate, 963 patients were reviewed. Of the patients, 41% presented with metastatic disease. Stage T4 tumours were associated with a consistently poor prognosis, and 70% of such patients had demonstrable distant metastases. No patient with TOf local disease had metastases or died of prostate cancer during follow-up. The incidence of metastases was also low in stages T1 and T2. High tumour grade correlated strongly with more advanced disease. Using this information a more cost-effective approach to the staging of prostate carcinoma is proposed.

Adenocarcinoma↗
PubMed1990

A case of adult mesoblastic nephroma: ultrastructure and discussion of histogenesis.

A benign fibromyomatous kidney tumor with deep seated tubular structures in a 20-year-old woman is reported as a case of adult mesoblastic nephroma. Ultrastructural examination confirmed the fibromyomatous nature of the stroma and the tubules appeared to be an integral part of the tumor. The histogenetic relationship to congenital mesoblastic nephroma, Wilms tumor and other tumors is discussed. Radical nephrectomy was performed and the patient remained well 1 year later.

Actin Cytoskeleton↗
PubMed1990

Immunosuppressive therapy for pemphigus vulgaris complicated by malakoplakia of the bladder.

Pemphigus vulgaris is an uncommon auto-immune disease which responds well to treatment with corticosteroids and azathioprine. Malakoplakia is a rare granulomatous disease associated with coliform infections and an altered cellular immune response. We report a 68-year-old female patient with pemphigus vulgaris who, after 2 years on maintenance prednisone and azathioprine immunotherapy, developed malakoplakia of the bladder associated with chronic E. coli urinary-tract infection. The malakoplakia responded well to treatment with cotrimoxazole, bethanechol chloride and ascorbic acid, combined with tapering of the corticosteroid dosage. Our patient presents an uncommon but interesting complication of long-term immunosuppressive therapy for pemphigus vulgaris.

Aged↗
PubMed1989

Guidelines for the treatment of urethral strictures.

Over a period of 12 years 467 patients with urethral stricture were treated surgically at Tygerberg Hospital. The following surgical guidelines were developed: visual cold-knife urethrotomy should be the first line of treatment; urethroplasty is indicated when urethrotomy fails or is unfeasible; the urethroplasty of choice should be a single-stage operation; and staged procedures should be reserved for complicated cases.

Adolescent↗
PubMed1981

Dental fragments in the lips.

Fifteen successively presenting cases of dental fragments in the lips were analyzed as to cause, site of injury and relationship to groups of anterior teeth. In each case a lip laceration extended from mucosa to skin. This finding supported the hypothesis that a tooth, having transfixed the affected lip, fractured on emergence from the skin surface on contact with a hard object. Skin wounds were often repaired in general hospitals without detecting the foreign body and prior to seeking a dental opinion.

Adolescent↗