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Biomedical subjects

J W Ramsay

Publications and source records attributed to J W Ramsay.

At least 19 recordsLinked to original sources
PubMed1995

Khat chewing and bladder neck dysfunction. A randomized controlled trial of alpha 1-adrenergic blockade.

OBJECTIVE: To assess whether the effect of chewing khat leaves (Catha edulis) on the urodynamics of healthy males is altered by the selective alpha 1-adrenergic blocking agent indoramin in a prospective randomized double-blind controlled trial. SUBJECTS AND METHODS: The urodynamics of 11 healthy males were studied before and during a khat chewing session preceded by indoramin or placebo. RESULTS: Khat chewing produced a fall in average and maximum urine flow rate. This effect was inhibited by indoramin. CONCLUSIONS: The urinary side-effects of khat chewing are probably mediated through stimulation of alpha 1-adrenergic receptors.

Adult↗
PubMed1993

Sham versus transurethral microwave thermotherapy in patients with symptoms of benign prostatic bladder outflow obstruction.

Transurethral microwave thermotherapy (TUMT) is a single-session, minimally invasive outpatient treatment for patients with symptoms of benign prostatic bladder outflow obstruction. We designed a prospective randomised trial to identify any placebo response. Patients with a Madsen symptom score over 8 for at least 6 months were eligible for study. Two measurements of urinary flow less than 15 mL/s and a residual urine of under 350 mL were also required for entry. Patients with renal dysfunction, upper urinary tract disease, co-existing bladder disease, and malignant prostatic change were excluded. 43 patients were studied: 21 were randomised to receive a sham treatment and 22 to thermotherapy. Sham treatments were done with the urethral applicator in situ. 40 patients were available for evaluation at 3 months. 2 patients had delayed follow-up and 1 patient randomised to TUMT has undergone transurethral resection. The thermotherapy group showed a 70% decrease (from 14.5 to 4.3) in the mean Madsen score, a 53% increase in flow-rate (8.5 to 13.0 mL/s), and 92% decrease in residual urine volume (147 to 12 mL). No significant change was seen in these mean indices in the sham group. There was no difference in the main complication of transient haematuria between the two groups. However, there was a 22% frequency of acute retention in the TUMT group. The results show little significant placebo component to the subjective and objective improvement that occurs in patients who have received TUMT.

Aged↗
PubMed1992

Endometriosis of the ureter.

Five patients with ureteric endometriosis are described. Extensive pre-operative investigation failed to reveal the aetiology of the unilateral upper urinary tract obstruction seen in all of these patients. Due to the dense fibrosis that invariably accompanies ureteric endometriosis, early surgical excision of the ureteric stricture permits effective resolution of upper tract dilatation and improved renal salvage.

Adult↗
PubMed1989

Irrigation and acute ureteric dilatation--as for ureteroscopy.

The effects of irrigation with sterile and infected saline after acute ureteric dilatation by graded Teflon dilators were evaluated renographically and histologically in minipigs. The minipig ureter was dilated from its normal calibre of 4 F to 10 F, and 100 ml of sterile or infected saline were then introduced from a height of 60 cm under gravity. One week after irrigation and dilatation the ipsilateral kidney was either functioning less than 10% or there was an obstructive nephropathy. Histology at 3 months suggested that extravasation of infected irrigating fluid was the most likely cause of ureteric stricture formation.

Animals↗
PubMed1989

Biofilms, bacteria and bladder catheters. A clinical study.

Biofilms were present on 16 of 33 urethral catheters examined. In 11 cases the catheter carried a different microbial flora from that of the bladder urine. The length of time the catheter was in situ did not influence biofilm formation, and all types of materials tested supported biofilm growth. Biofilms were seen on 2 of the 7 catheters where prophylactic antibiotics had been used.

Bacteria↗
PubMed1989

Plasma lignocaine levels during transurethral prostatectomy.

It has been reported that transurethral absorption of lignocaine may cause systemic toxicity when associated with mucosal damage within the urethra. We measured the serum levels of lignocaine in 30 patients after the transurethral administration of 400 mg lignocaine gel just before transurethral prostatectomy. In 11 patients additional lignocaine was given as part of the anaesthetic induction (Group A). In 19 patients no additional lignocaine was given (Group B). Two patients in Group A and three patients in Group B also underwent Otis urethrotomy. The mean peak plasma lignocaine concentration as measured by sequential venous samples was 1424 ng/ml in Group A and 72 ng/ml in Group B. We conclude that 400 mg lignocaine gel applied endourethrally before transurethral resection of the prostate results in plasma concentrations well below the toxic levels.

Aged↗
PubMed1988

The effects of double J stents on renal pelvic dynamics in the pig.

Intra-pelvic pressure and peristaltic activity were measured before and during diuresis in 26 minipigs, immediately, one week and three weeks following ureteric intubation with 5 and 6F polyethylene double J stents. Changes in these dynamic parameters were seen which indicate that these stents caused renal outflow obstruction. The severity of this obstruction appears dependent upon the size of the catheter and the temporal length of intubation. This study indicates that double J stents provide sub-optimal drainage of the renal pelvis and damaged ureter.

Animals↗
PubMed1988

Suprapubic endoscopy: a percutaneous approach.

We have assessed whether suprapubic endoscopic surgery can be helpful in situations where transurethral access is inadequate, difficult or likely to be associated with urethral damage and have applied a modified version of the well known techniques for creating and dilating a track for percutaneous renal access to the bladder. This method has been used in a series of clinical cases and in certain experimental studies. Assessment of the techniques has allowed their modification and the development of a specially designed access cannula--the St Peter's Hospital cannula.

Endoscopy↗
PubMed1988

Acute ureteric dilatation for ureteroscopy. An experimental study.

The effects of three methods of acute ureteric dilatation (by graded Teflon dilators, low and high pressure balloon dilators) were evaluated radiologically, renographically and histologically in minipigs. The minipig ureter was dilated from its normal calibre of 4 F to 10 F. All three methods caused upper urinary tract dilatation and an obstructive nephropathy which had not resolved 96 h after dilatation. Histology at 24 h showed destruction of the transitional epithelium, with inflammation throughout the ureteric wall. Four weeks after dilatation the ureter was still dilated and urothelial nests were seen in the lamina propria and in the muscle coats. There was no evidence of ischaemic necrosis or ureteric stricture formation. The implications of these findings for clinical practice are discussed.

Animals↗
PubMed1987

Tissue effects of an ultrasonic scalpel for clinical surgical use.

The effects of a new ultrasonic scalpel were studied in laboratory animals. Tissue heat conduction from the tip of the ultrasonic blade was measured. Tissue damage was assessed by light microscopy of histochemically stained sections. The ultrasonic scalpel incised nonfibrous tissue effectively, with minimal heat conduction, and the incisions healed with no evidence of fibrosis nor of tissue destruction.

Animals↗
PubMed1987

Extracorporeal shock wave lithotripsy. Is sessional access worthwhile?

One hundred and fifty-three patients with renal stones referred to one teaching hospital have received extracorporeal shock wave lithotripsy (ESWL) treatment as a result of a monthly sessional arrangement organised with a neighbouring lithotripter unit. The results of treatment, assessed 3 months after lithotripsy, showed results comparable with those from any lithotripter centre. Sessional access for lithotripsy may provide a satisfactory way of increasing the number of patients who are treated with lithotripsy by reducing the demand for beds at the hospitals where a lithotripter is sited.

Adolescent↗
PubMed1987

Urothelial reaction to ureteric intubation. A clinical study.

Urothelial biopsies from ureters intubated with silicone (11) and other polymer (13) double J stents revealed features of mucous metaplasia in 12/24 cases. These changes were associated with encrustation of the stents and occurred principally in stone-forming patients.

Epithelium↗