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Biomedical subjects

M A Rose

Publications and source records attributed to M A Rose.

At least 55 records · Page 3Linked to original sources
PubMed1986

Effect of haemorrhage on hepatic glutathione concentration: an experimental study in the pig.

Depletion in the hepatic concentration of reduced glutathione (GSH) may potentiate liver injury resulting from toxic metabolites. Patients who have had severe haemorrhage frequently develop hepatic dysfunction and we have shown that the hepatic GSH level is decreased in these patients. The present study has examined the time-course effect of a 30% haemorrhage on the hepatic GSH level by sequential biopsies of the liver. Acute and chronic experiments were performed and, in both, the hepatic concentration of GSH fell during the first 6 h after haemorrhage; this fall was followed by a significant rebound elevation at 24 h. In the chronic haemorrhage experiment the hepatic GSH level was normal at 1 week after haemorrhage. Thus, the susceptibility of the liver to toxic metabolite injury after haemorrhage persists for less than 24 h in this experimental model and haemorrhage appears to have no long term effect on the hepatic GSH concentration.

Animals↗
PubMed1985

Bladder cancer. The selection of patients for treatment by full-dose irradiation.

Cure of muscle-invading bladder carcinoma in 20% to 39% of patients using full-dose external beam irradiation has been reported by many institutions in the last 10 years. Local failure occurs in 50% of patients so treated, however, and successful selection criteria for bladder-sparing radiotherapy are necessary. Prognostic factors which have been identified to be associated with a relatively successful outcome using full-dose irradiation include (1) the clinical stages T2 and T3, (2) the absence of ureteral obstruction on initial intravenous pyelogram, (3) a visibly "complete" transurethral resection having been achieved, and (4) complete response of the local tumor to radiation. In addition, local tumor control appears to be related to total dose administered. Analysis of the results of precystectomy radiation therapy, where papillary tumor histology and small tumor size yielded improved survival, suggests that these characteristics also may prove to be beneficial in patients selected for full-dose irradiation. The four-field box technique has become accepted as the best method to treat patients using beams from linear accelerators or betatrons. The bladder and pelvic lymph nodes should be treated to 50.4 Gy in 1.8 Gy fractions, 5 days/week. A cone-down boost to the tumor volume only then is given for a total dose of 64.8 Gy to 68.4 Gy in 7.5 weeks. The posterior rectosigmoid should receive less than 60 Gy, and the anus and femoral head and neck should be limited to 45 to 50 Gy to avoid toxicity. Innovative approaches to treatment of muscle-invading bladder cancer now are being explored and include the use of intravesical misonidazole combined with fractionated external beam irradiation, and systemic cisplatin administration in combination with radiation. Techniques which have yielded good results in superficial bladder cancer include open interstitial implantation, intraoperative single-dose electron beam irradiation, and trans-Foley radium applications. Further prospective evaluations of clinical and histologic tumor characteristics, treatment techniques and doses reviewed here will be necessary before definitive selection criteria for treatment with full-dose irradiation are established.

Brachytherapy↗
PubMed1985

Full-dose irradiation for patients with invasive bladder carcinoma: clinical and histological factors prognostic of improved survival.

We reviewed the outcome of 55 patients treated from 1974 to 1982 by full-dose radiation therapy (6,400 to 6,800 rad) to identify factors associated with tumor radioresponsiveness and patient cure. All patients had histological proof of muscle invasion by tumor. Of the patients 8 (14 per cent) had clinical stage T2, 29 (53 per cent) stage T3 and 18 (33 per cent) stage T4 disease. Thirteen patients are alive, all but 2 without evidence of cancer. Survivors include 1 of 9 patients who underwent salvage cystectomy for a local recurrence. The actuarial 5-year survival rate for the entire group was 28 per cent, with a corrected survival of 33 per cent. Median survival was 2.3 years. Corrected survival for patients with stages T2 and T3 disease was 45 per cent versus 9 per cent for those with stage T4 cancer (p equals 0.009). Within the group with stages T2 and T3 cancer (all with proof of muscle invasion) the most striking prognostic factor was papillary surface histological findings, with local control by radiation therapy alone of 63 per cent versus 20 per cent in the group with solid or flat tumors (p equals 0.01), and corrected 5-year survival of 62 per cent (papillary) versus 0 per cent (flat or solid) (p equals 0.002). Other significant prognostic factors for 5-year survival in this group were extent of transurethral resection (54 per cent complete versus 17 per cent incomplete, p equals 0.009) and ureteral obstruction on excretory urography (47 per cent without versus 14 per cent with, p equals 0.01). Our results suggest that full-dose radiation therapy can be offered to patients with muscle-invading bladder cancer, with a relatively higher probability of success in those with less advanced tumors by clinical stage, papillary surface histological findings and no ureteral obstruction, and in whom a complete transurethral resection is possible.

Aged↗
PubMed1980

Experimental evaluation of the urethral response to section of the spinal cord or cauda equina and to the electrostimulation of the bladder in non-human primates.

Studies of urethral function in 32 female monkeys indicate a dual innervation of the mid-urethra from sympathetic and somatic supply. The resting urethral pressure profiles were preserved after low level section of the spinal cord or division of the cauda equina. They had lowered amplitude after overstretch or electrostimulation of the autonomous bladder.

Animals↗