Spontaneous retroperitoneal hemorrhage.
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Adrenal Gland Diseases↗
Biomedical subjects
M Caine
Publications and source records attributed to M Caine.
Antispasmodic effects of flavoxate, MFCA, and REC 15/2053 on smooth muscle of human prostate and urinary bladder.
The antispasmodic effects of the flavone compounds flavoxate hydrochloride, 3-methylflavone carboxylic acid (MFCA), and REC 15/2053 (and in the case of the detrusor, oxybutynin), on the human detrusor, prostatic adenoma, prostatic capsule, and bladder neck, were studied by the in vitro isometric method. All the compounds inhibited, in different orders of potency, potassium-induced contractions of the tissues. Flavoxate showed a slightly greater activity than the other two compounds in the prostatic and bladder neck tissues. However, REC 15/2053 displayed greater activity in the detrusor than in the other tissues. The relaxant effect on the prostatic tissues suggests a potential use for these compounds in benign prostatic obstruction.
Adenoma↗
Triorchidism--a reconstructive approach.
Testicular duplication is a relatively rare condition. A case is described in which conservative surgery was performed with reconstruction to produce a single testis.
Adult↗
Alpha-adrenergic blockers for the treatment of benign prostatic hyperplasia.
There seems little doubt that alpha-adrenergic blockers can afford a measure of relief to many sufferers from BPH. The exact role this treatment has to play in the overall management of these patients has yet to be clearly defined. A continuing search is being made for more effective drugs, with the hope of finding one that will be more specific in its action on the prostate and produce fewer generalized effects. Whether this will prove possible may depend on whether any further subgroup of alpha receptors more specific to the prostate can be found or whether some method of targeting the drugs to the required region can be devised. If a drug treatment that reduces the size of the prostate can be found, perhaps a combination of the two forms of medical treatment will have a place. At present, it seems reasonable to conclude that there is good justification for using the alpha-blocking drugs available when employed in the manner and for the indications outlined herein.
Adrenergic alpha-Antagonists↗
Carcinoma of colon after ureterocolic anastomosis: implantation on calyceal mucosa.
Two cases are reported of the development of mucoid adenocarcinoma of the colon in young patients, nineteen and thirty-four years after ureterocolic anastomosis for benign conditions. One patient showed implantation of the colonic neoplasm on the mucosa of an upper calyx in the obstructed kidney. Patients who have undergone ureterocolic anastomosis have a greatly increased risk of the development of large-bowel neoplasms. When suspected, radiologic examination of the colon using a water-soluble contrast material, together with rectosigmoidoscopy or colonoscopy, is essential. Because of the serious nature of this complication, it is suggested that the recent trend to return to the use of large bowel in urinary diversion may be hazardous, especially in the young patient with a benign disease.
Adenocarcinoma, Mucinous↗
Phenoxybenzamine for benign prostatic hypertrophy.
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Dose-Response Relationship, Drug↗
Partial nephrectomy in surgical treatment of calculous disease.
Of a total of 158 partial nephrectomies, a detailed follow-up for up to sixteen years was obtained in 131. The rate of true ipsilateral recurrences was 26 per cent. Computer analysis of various parameters indicated that a previous history of a stone in the same or the contralateral kidney, or the presence of multiple or scattered stones in the affected side, were associated with a particularly high recurrence rate. Urinary infection at the time of or prior to operation was not of prognostic significance. The importance of complete excision of the calyceal neck was confirmed. It was concluded that the operation is logical for removal of a diseased segment of kidney, but generally cannot be recommended in the hope of removing a stone-bearing area of kidney and hence reducing the recurrence rate.
Adolescent↗
A placebo-controlled double-blind study of the effect of phenoxybenzamine in benign prostatic obstruction.
A double-blind placebo-controlled study of phenoxybenzamine for the symptomatic treatment of benign prostatic obstruction is reported. Statistically significant evidence of an improvement in both the peak and mean flow-rates was found. Both diurnal and nocturnal frequency were significantly diminished. Residual urine was unaffected, and the possible reasons for this are discussed. Urethral pressure recordings confirmed the reduction in the closure pressure in the prostatic segment of the urethra. It was concluded that there was good evidence that the treatment is effective.
Clinical Trials as Topic↗
Dynamics of acute retention in prostatic patient and role of adrenergic receptors.
The dynamic changes in the lower urinary tract associated with acute retention in the prostatic patient were investigated by pressure studies. These revealed that the site of maximal urethral pressure was in the prostatic segment, the bladder neck was not tightly closed, and the normal tone of the external sphincter was inhibited. Bladder decompression altered these findings, and alpha-adrenergic blockade produced a reduction in all pressure parameters in the posterior urethra. The significance of the findings is discussed in relation to present-day knowledge of lower tract urodynamics. It is concluded that certain cases of acute retention in the prostatic patient may be initiated by stimulation of the prostatic alpha-adrenergic receptors, and may then be perpetuated by a secondary fall in intravesical pressure together with a supplementaty "feed-back" stimulation of these receptors due to the bladder overdistention itself. Decompression and/or alpha-adrenergic block may sometimes reverse this process.
Biomechanical Phenomena↗
Specific attachment of T-lymphocytes from cancer patients to tumor cells.
The present study describes a new approach for detecting the immune reaction of peripheral blood lymphocytes of cancer patients against tumor antigens. T-lymphocytes from patients with carcinoma of the urinary bladder were found to attach specifically to monolayers of cells of urinary bladder carcinoma line (T24). The attached T-cells were identified by their capacity to form E-rosettes with sheep red blood cells. The number of rosette forming--target attached lymphocytes (RF--TAL) was 6 times higher in bladder carcinoma patients than in healthy controls or in patients bearing other types of cancer.
Antigens, Neoplasm↗
The importance of adrenergic receptors in disorders of micturition.
A review is presented of the adrenoreceptors in the lower urinary tract, and their relationship to disorders of micturition. It is suggested that they may be of importance of neurogenic bladder disease, bladder neck obstruction, benign enlargement of the prostate, and certain drug and hormonal effects on the lower urinary tract, and that modification of their activity can be of benefit in the management of these conditions.
Female↗
The use of alpha-adrenergic blockers in benign prostatic obstruction.
As a result of previous in-vitro studies on the alpha-adrenergic receptor activity of the human prostate and prostatic capsule a trial was made of alpha-adrenergic blockers for the relief of obstructive prostatic symptoms. Considerable benefit was obtained in several groups of patients, as demonstrated either by the relief or prevention of complete retention, or by diminution in residual urine or improvement in urinary flow-rate recordings. A number of illustrative cases are described, and the indications for the use of this treatment are suggested. It is emphasised that this treatment provides symptomatic relief only, and in no sense purports to be a treatment of the enlarged prostate itself.
Aged↗
Some clinical implications of adrenergic receptors in the urinary tract.
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Adrenergic Agonists↗
The treatment of benign prostatic hypertrophy with flutamide (SCH: 13521): a placebo-controlled study.
A double-blind, placebo-controlled study using the antiandrogen compound flutamide in 30 patients with benign enlargement of the prostate is reported. The potency of the compound was indicated by the large percentage of patients suffering from gynecomastia or nipple pain. Flow rate recordings are probably the most reliable and useful examination in this type of investigation, and statistical analysis of the results showed evidence of significant improvement in patients receiving flutamide. No evidence of an effect as compared to the placebo was found when the residual urine, prostate size or histological changes in prostatic biopsies were examined. Subjective effects, when carefully analyzed, provided some evidence of a preference for the flutamide group, especially in the early weeks of treatment, but the fallaciousness of subjective observations is stressed. The various problems associated with the choice and measurement of parameters to be used in this type of investigation are discussed, and the absolute necessity of proper controls and statistical analysis in such a clinical study is illustrated.
Anilides↗
Adrenergic and cholinergic receptors in the human prostate, prostatic capsule and bladder neck.
The adrenergic and cholinergic receptors of the human prostatic capsule, prostatic "adenoma", and bladder neck, were investigated by the in-vitro isometric technique. The prostatic capsule was found to be very rich in both alpha-adrenergic receptors and cholinergic receptors. The prostatic adenoma was moderately rich in alpha-adrenergic receptors, but cholinergic receptors were absent. Beta-adrenergic receptors were absent in the prostatic adenoma, and there was an equivocal response in less than half the specimens of the prostatic capsule. An attempt was made to distinguish between the trigonal component at the posterior bladder neck, and the true bladder neck muscle both posteriorly and antero-laterally. The results indicat that the "posterior bladder neck" seen at operation is predominantly trigonal muscle, and is poor in cholinergic receptors. The adrenergic response is variable in the true bladder neck muscle, but is present and strong in the trigonal muscle. This response is characteristically gradual in its development. In view of the findings in this investigation, it is suggested that certain instances of acute retention of urine in prostatic patients are due to over-stimulation of the alpha-adrenergic receptors, particularly those in the prostatic capsule. Similarly, the accepted clinical contraindication to the use of cholinergic drugs for retention in the prostatic patient is supported by the distribution of the cholinergic receptors in the tissues examined.
Acetylcholine↗