PubMed HealthSearch

Biomedical subjects

J McLoughlin

Publications and source records attributed to J McLoughlin.

At least 19 recordsLinked to original sources

Neuropathic urinary retention in the absence of neurological signs.

We present two cases of painless urinary retention secondary to central intervertebral disc prolapse. In neither case were there signs or symptoms suggesting an underlying neurological insult. Both patients voided spontaneously following neurosurgical intervention. The classical features of acute cauda equina compression may be absent in patients with central lumbar disc protrusion. Painless urinary retention may be the only physical sign.

Adolescent

Prospective study of hormonal and semen profiles in marathon runners.

OBJECTIVE: To investigate the effect of marathon training on hormonal and semen profiles in male athletes. DESIGN: Prospective longitudinal study over 1 year. SETTING: Department of Obstetrics and Gynaecology, University of Cape Town, South Africa. PARTICIPANTS: Twenty-four healthy male marathon runners, 25 to 54 years of age. MAIN OUTCOME MEASURES: Hormonal evaluation included determination of plasma concentrations of total T, LH, FSH, PRL, E2, and P. Semen analyses included an evaluation of count, motility, morphology, and volume. These profiles were correlated with training intensity. RESULTS: The intensity of training increased significantly in the first 5 months of the study. This was accompanied by a significant rise in serum PRL levels and a fall in P levels. No other significant hormonal changes were identified. The semen volume and sperm motility and morphology fell significantly during training, but there was no significant alteration in the sperm count. CONCLUSION: This longitudinal study demonstrates that endurance training can modify significantly hormonal profiles and semen parameters in long-distance runners.

Adult

Immunometric assays of luteinizing hormone (LH): differences in recognition of plasma LH by anti-intact and beta-subunit-specific antibodies in various physiological and pathophysiological situations.

Restricted immunoreactivity of plasma luteinizing hormone (LH) has been described in some subjects when assayed with certain methods involving antibodies against intact LH. We have compared the performance of the Amerlite LH-30 (A) and Delfia LHSpec (D) assays (which include anti-intact and beta-specific antibodies, respectively) in normal and pathological conditions. As shown previously, results of the two systems were highly correlated with each other and, as we show here, with those of a bioassay. We found eight outliers (results outside the 95% confidence interval of the regression) among 427 samples studied from 121 subjects. Of the outliers, five had Delfia results in a range (< 1 IU/L) that was associated with poor assay precision for that assay, and the ratios of their values by both methods (A:D ratios) were very low. This ratio was affected by endocrine status, e.g., was lower in postmenopausal women than in premenopausal controls, and varied intraindividually within the same menstrual cycle. The restricted immunoreactivity described previously for assays involving anti-intact LH antibodies may, in part, reflect these differences, which, in turn, may reflect the presence of isoforms (e.g., glycoforms) that are differentially recognized by assays that have different antibody configurations.

Antibodies

Accumulation of human chorionic gonadotrophin in the serum of patients during in-vitro fertilization treatment cycles with Pergonal.

We examined the possible contribution of human chorionic gonadotrophin (HCG) in Pergonal to the serum luteinizing hormone (LH)-like bioactivity in 10 patients (median age 32 years, range 28-38) with tubal infertility who were undergoing in-vitro fertilization (IVF), together with 19 controls (median age 30 years, range 21-43). IVF patients were treated with clomiphene (50 mg twice daily) over days 2-6 and Pergonal (150 IU i.m.) daily from day 5 until at least day 10. Serum LH was measured by fluoro-immunometric assay (I-LH) and in-vitro Leydig cell bioassay (B-LH). Serum HCG was measured by fluoro-immunometric assay. The data were analysed by paired two-tailed t-test, following logarithmic transformation. From days 1-5, there was an increase in serum B-LH (mean, 95% confidence intervals given in parentheses) from 8.3 (6.8, 10.2) IU/l to 11.7 (9.8, 13.9) IU/l [P = 0.004], and in serum I-LH from 4.5 (3.7, 5.4) IU/l to 5.4 (4.6, 6.3) IU/l [P = 0.002]. From days 5-8, there was a rise in B-LH to 16.6 (12.6, 21.9) IU/l [P = 0.023]. The rise in I-LH to 6.3 (5.1, 7.8) IU/l [P = 0.081] failed to reach significance. Furthermore, serum HCG was < 0.75 IU/l until after Pergonal was administered on day 5, then rose to a plateau on day 8 at 1.2 (0.8, 1.6) IU/l. Serum HCG in the controls remained < 0.75 IU/l throughout.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Evaluation of Ki-67 monoclonal antibody as prognostic indicator for prostatic carcinoma.

Prostate tissue containing either primary adenocarcinoma (45 patients) or benign hyperplasia (15 patients) was immunostained with the monoclonal antibody Ki-67, which recognises a human nuclear antigen expressed by human cycling cells. The percentage of cells staining positive was considered a measure of proliferation. This derived Ki-67 index was higher for carcinomas than for hyperplastic glands. Within the group of carcinomas, Ki-67 indices in patients with metastatic disease were significantly higher than in those without and there was a trend towards increasing Ki-67 indices with increasing Gleason grade. When patients with prostate cancer were prospectively followed up, the Ki-67 index did not predict either disease progression or hormone responsiveness. Ki-67 immunostaining may define a group of patients with prostate cancer of poor prognosis.

Adenocarcinoma

Comparison of nephrostomy drainage systems.

Forty patients undergoing nephrostomy insertion were randomised into 2 groups: those maintained on intermittently closed and those on permanently closed drainage systems. The average cost of managing a patient in the former group was one-eighth that of the latter and was not associated with any increase in morbidity.

Costs and Cost Analysis

Surgical treatment of venous leakage: medium-term follow-up.

Thirty-eight men aged 26-69 years (mean 58) who failed to achieve a full, sustained erection with intracavernosal injections of papaverine and phentolamine (PIPE) and who had evidence of a venous leak on digital subtraction dynamic cavernosography underwent penile vein ligation. Postoperative follow-up ranged from 7 to 44 months (mean 28). Nineteen patients regained spontaneous erections which would allow intercourse (mean follow-up on these men was 23 months). Of these 19 patients, 5 experienced recurrent loss of potency over a 6- to 17-month period (mean 9 months), 4 of these subsequently responding to intracavernosal therapy. Of the 19 without full erections after ligation, 8 obtained erections which would allow intercourse with intracavernosal injections. Two of these patients subsequently lost their response to injections at 2 and 6 months postoperatively. Eleven men had no benefit from surgery (either with or without injections). Of the total of 27 men with erections allowing intercourse, only 19 made an attempted coitus during the follow-up period. Of 9 men with treatment failure who had undergone repeat cavernosography, 8 had evidence of a persistent leak, usually arising from the cavernosal veins. At the time of this study, 4 men had been re-explored, following which 3 obtained erections with the aid of PIPE. Patients who fail to improve following ligation may benefit from re-investigation and repeat ligation using a different surgical approach.

Adult

Metoclopramide in the treatment of reflux oesophagitis: a comparison of normal and controlled-release formulations.

Twenty patients with reflux oesophagitis were recruited into a randomized, single (investigator)-blind, two-part crossover study of controlled-release metoclopramide ('Gastrobid Continus' tablets) 15 mg given twice daily, and normal-release metoclopramide ('Maxolon'), 10 mg given 4-times daily. Both treatment regimens were efficacious in reducing the severity of heartburn, the incidence of waking at night due to pain from heartburn and the severity of gastro-intestinal symptoms. The incidence of volunteered and sought side-effects/symptoms was similar on both treatments. More patients preferred the controlled-release than the normal-release formulation. It is concluded that 15 mg controlled-release metoclopramide twice daily and 10 mg normal-release metoclopramide 4-times daily are equally effective and well-tolerated treatment regimens, but that the controlled-release formulation has the advantage of a smaller dose and twice daily administration.

Administration, Oral

Markers of the metastatic phenotype in prostate cancer.

Metastatic malignant disease is the single most common cause of treatment failure and subsequent mortality of most human malignancies, including prostate cancer. Presently, cells expressing the metastatic phenotype cannot be identified within a primary tumor population. Hence, accurate assessment of the likely behavior of an individual primary malignancy cannot be made at the time of diagnosis. The studies now reported have been aimed at identifying some of the features that may be associated with the metastatic phenotype of prostatic cancer. Insight into those factors that may be involved in prostate cancer metastasis has been gained from a variety of experimental approaches as well as study of intact human prostate cancers.

Animals

Cerebellar manifestations of prostatic carcinoma.

We present two patients known to have prostate cancer who presented with acute cerebellar signs. The neurological deficit of the first patient was due to a paraneoplastic cerebellar manifestation and progressed, despite evidence of response of the primary prostate tumour to hormonal manipulation. The second case, resulting from a solitary cerebellar metastasis, was amenable to surgical intervention and subsequent hormonal manipulation. This latter patient has experienced no recurrent neurological signs after a period of 7 years follow-up. This is the first report of a paraneoplastic cerebellar deficit and, to our knowledge, only the sixth case of parenchymatous cerebellar metastasis of prostatic origin to appear in the literature.

Acute Disease

Impact of short-term oral steroid use upon children's school achievement and behavior.

Physicians need clarification of whether the temporary use of adrenal corticosteroids to abort acute asthma can adversely effect school achievement and behavior problems. Nineteen nonsteroid-dependent asthmatic children were given prednisone orally while all other medications were kept constant. Five days later, when they were seen in the physician's office, an academic achievement test was administered to the child; and the child, a parent, and a teacher completed behavior rating surveys. After 2 weeks off the steroids the child returned to the physician's office and the achievement test and rating scales were completed again. There was no significant difference between the achievement test scores and behavior ratings in school or at home under the two conditions. Short-term use of oral steroids does not impair children's basic academic skills nor their behavior at school or home.

Administration, Oral