PubMed Health⌕ Search

Biomedical subjects

J E Newsam

Publications and source records attributed to J E Newsam.

At least 19 recordsLinked to original sources
PubMed1990

Morbidity following cystoscopy: comparison of flexible and rigid techniques.

Recent reports on the value of local anaesthetic flexible cystoscopy have emphasised excellent tolerance and preference for the technique over general anaesthetic rigid cystoscopy. However, no study has yet compared the post-operative morbidity rates of these procedures. Tolerance, preference and post-operative symptoms in 100 patients undergoing local anaesthetic flexible cystoscopy were compared with those in 100 patients undergoing general anaesthetic rigid cystoscopy. On initial questioning, 89% of patients found flexible cystoscopy painless and 92% expressed a preference for the same procedure on a future occasion; 98 patients who underwent flexible cystoscopy and 87 who underwent rigid cystoscopy returned a questionnaire on symptoms 1 week after the procedure. The incidence of post-operative symptoms was 33% following flexible cystoscopy and 76% following rigid cystoscopy. Patients in both groups who were undergoing check cystoscopy had a lower incidence of morbidity than those undergoing cystoscopy for other reasons. The results suggest that flexible cystoscopy was well tolerated and preferred by most patients. The morbidity associated with the procedure was also significantly less than that associated with rigid cystoscopy under general anaesthesia.

Adolescent↗
PubMed1986

Superficial bladder cancer: intravesical chemotherapy and tumour progression to muscle invasion or metastases.

Of 299 patients who presented with superficial bladder cancer (Ta, T1), 60 were treated by intravesical chemotherapy (Epodyl, methotrexate or mitomycin C). The rate of tumour progression to muscle invasion or metastases was identical for each intravesical regime. There was no evidence that mitomycin C promoted tumour progression. Carcinoma in situ in non-tumour-bearing urothelium was the most significant predictive factor for progression to muscle invasion or metastases.

Administration, Intravesical↗
PubMed1986

Results of surgery following radical radiotherapy for invasive bladder cancer.

Five hundred and ninety-one of 889 patients with T1 to T4 transitional cell carcinoma of the bladder had persistent or recurrent cancer after radical radiotherapy. Durable local control was significantly poorer for patients with grade 1 or T4 cancer before radiotherapy. Three hundred and twenty-two patients received additional surgical treatment: 211 were endoscopically managed and 111 had secondary cystectomy. The survival of patients with residual or recurrent cancer after radiotherapy was significantly improved by secondary local treatment (P less than 0.0001). A comparison was made between endoscopic treatment and cystectomy after radiotherapy. Patients having secondary cystectomy were younger (mean age 60.0 years) than those managed endoscopically (66.8 years). The 5-year actuarial survival rate (from the date of radiotherapy) for patients who had endoscopic treatment was 47.1% compared with 62.5% for those who had cystectomy (P = 0.16). After both treatments survival was significantly correlated with the T category of the tumour before radiotherapy. Local tumour control was better after cystectomy; 85.6% of patients were locally tumour-free at the end of follow-up compared with 44.5% of those managed endoscopically. There was no overall difference in the subsequent risk of metastases between the two forms of surgery. However, seven of 12 patients managed endoscopically prior to secondary cystectomy died of their cancer. Five of these patients died from metastases even though they were locally disease-free. There was a significantly increased risk of metastases in patients managed endoscopically who were not locally disease-free after treatment (P = 0.0003). Caution is advised in persisting with endoscopic treatment after radiotherapy if local control is not readily achieved.

Aged↗
PubMed1985

The role of endoscopic treatment after radical radiotherapy for invasive bladder cancer.

In a 6-year period 232 patients were treated by radical radiotherapy for transitional cell cancer of the bladder. Fifty-eight patients had secondary surgical management to control either locally persistent or recurrent tumour. Endoscopic treatment alone was used in 31 patients with down-staged tumours and the survival of this group compared favourably with that of 27 patients selected for salvage cystectomy (5-year survival rate 88% cf. 44%). A group of patients with favourable prognostic factors may be identified in whom cystectomy can be avoided without prejudice to survival.

Carcinoma, Transitional Cell↗
PubMed1983

Prognostic significance of biopsy results of normal-looking mucosa in cases of superficial bladder cancer.

Quadrant biopsies of normal-looking mucosa were used as part of the assessment of cases with superficial Ta,T1 transitional cell cancer of the bladder. Patients with one or more abnormal biopsies were shown to have a significantly greater chance of developing recurrent tumour compared to patients with normal mucosal biopsy findings. Other factors noted at the time of initial assessment, such as size, number of tumours, Ta,T1 category or grade of tumour did not predict recurrence, although recurrences that invaded muscle were associated with G3 histology in the primary tumour. The results of mucosal biopsy identified patients at risk for recurrence and it is possible that this group would derive particular benefit from adjuvant chemotherapy.

Carcinoma, Transitional Cell↗
PubMed1983

Incidental carcinoma of the prostate: selection for deferred treatment.

Fifty-one of 212 consecutive patients with prostatic cancer presented with incidentally diagnosed (TO) cancer. The average age at presentation was 73 years and follow-up ranged from 1 to 62 months. Deferred treatment was selected in 39 cases, 10 of which progressed. Of 15 deaths only 3 were related to prostate cancer and these were patients who had presented with metastases. Histological grading by the Gleason system demonstrated a significant correlation with metastatic stage at presentation and tumour bulk, but not with age or progression in deferred treatment cases. It is concluded that there is a need to subdivide patients presenting with incidental carcinoma, that tumour bulk correlates with histological grade and that future treatment protocols for TO disease should stratify for histological grade.

Aged↗
PubMed1981

Transitional cell carcinoma involving the prostate.

Transitional cell carcinoma involving the prostate gland was studied in 27 patients. Three different groups were recognised on the basis of the clinical pattern and histological findings. Each group has a different prognosis and merits a different approach to treatment. Thus, stromal involvement of the prostate by transitional cell carcinoma is a sinister finding that requires radical treatment, whereas ductal involvement by either carcinoma in situ or non-invasive papillary tumours can be managed less aggressively. This study emphasises that the present classification for these tumours is unsatisfactory and that adequate histopathological information is essential for their management.

Carcinoma in Situ↗
PubMed1980

TNM (1978) in bladder cancer: use and abuse.

Modifications to the TNM classification for bladder cancer, introduced in 1979, are described. The use of this classification was evaluated in 106 new patients. It proved to be satisfactory for in situ and papillary tumours but major problems occurred in attempting to separate superficially invasive from deeply invasive tumours. Several aspects of this classification require further consideration and modifications are proposed.

Humans↗
PubMed1979

The role of multiple mucosal biopsies in the management of patients with bladder cancer.

The results of multiple biopsies from apparently non-tumour bearing bladder mucosa were studied in 154 patients with bladder cancer; 33% of the biopsies from apparently normal mucosa showed histological abnormalities including 4.5% with carcinoma. When the mucosa appeared red but flat, 52% of the biopsies showed histological abnormalities including 14% with carcinoma. Biopsies from mucosa that had a granular or mossy appearance showed carcinoma in 42%. A more aggressive management policy was adopted in 12 patients (8%) as a direct result of the biopsy findings.

Adult↗
PubMed1975

Hyperthermic perfusion of the distended urinary bladder in the management of recurrent transitional cell carcinoma.

The clinical and histological changes following hyperthermic perfusion of the distended urinary bladder have been studied in 13 patients with transitional cell carcinoma, persistent after radical radiotherapy. Continuous epidural anaesthesia was necessary to achieve a constant state of bladder relaxation during irrigation of the distended bladder. This form of hyperthermic perfusion of the bladder was effective in arresting uncontrollable haemorrhage from bladder tumours and may be of value in the treatment of this complication. Perfusion at an outflow temperature of 44 degrees C for 4 hours caused tumour necrosis. It was, however, associated with damage to the vasculature of the bladder and frequency of micturition which persisted after mucosal recovery. Perfusion at 43 degrees C also caused tumour necrosis and the after effects were less severe.

Carcinoma, Transitional Cell↗
PubMed1970

The small kidney.

Explore the source record for details and available documents.

Age Factors↗