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Biomedical subjects

M G Lucas

Publications and source records attributed to M G Lucas.

14 recordsLinked to original sources
PubMed1992

Identification of metastatic disease by T category, gleason score and serum PSA level in patients with carcinoma of the prostate.

Pre-operative serum prostate specific antigen (Tandem-R assay), T category, Gleason score and the metastatic (M1) status of a consecutive series of 60 patients with newly diagnosed carcinoma of the prostate were studied prospectively. The results revealed that, of these variables, pre-operative serum PSA (greater than 100 ng/ml) was the single most important indicator of metastatic disease, with 100% predictive value. With this alone, 83.3% of M1 disease could be correctly identified. For the remaining 17%, however, we advocate a high index of suspicion if the tumour is T3-T4 category on digital rectal examination (predictive value = 71.4%) and has a high grade with a Gleason score 8-10 (predictive value = 81%).

Aged↗
PubMed1991

Sperm retrieval by electro-ejaculation. Preliminary experience in patients with secondary anejaculation.

Twelve patients with spinal cord injury and 2 diabetics with secondary anejaculation underwent 26 sessions of electro-ejaculation, using a technique which has previously been popular only in veterinary medicine. Ejaculate was obtained on 21 occasions. Semen quality was adequate for cryostorage on 9 occasions (8 patients); on 8 occasions (5 patients) it was used for immediate artificial insemination of the partner. To date, there has been 1 pregnancy resulting in a live birth.

Adult↗
PubMed1990

Lumbosacral evoked potentials and vesicourethral function in patients with chronic suprasacral spinal cord injury.

Persistent detrusor acontractility despite normal somatic reflex activity in some patients with high spinal cord injury is an enigma. Previous work has suggested disordered integration of afferent activity in sacral roots or the sacral spinal cord. Forty male patients with chronic stable suprasacral cord lesions were studied by filling and voiding videocystometrography, and recording lumbosacral evoked potentials from posterior tibial nerve stimulation. Only five of 15 patients with decreased detrusor contractility had abnormal lumbosacral evoked potentials. Similar abnormalities were found in four of 11 patients with efficient hyperreflexic bladders. The finding of normal lumbosacral evoked potentials in the majority of patients with suprasacral cord injuries and decreased detrusor contractility supports the argument that the pathophysiology of this specific form of neurogenic bladder dysfunction is multifactorial.

Adolescent↗
PubMed1989

Idiopathic constipation associated with impaired urethrovesical and sacral reflex function.

Sixteen chronically constipated women (age range 20-66 years) and 29 healthy control subjects (age range 22-53 years) underwent neurophysiological assessment of the integrity of pelvic spinal reflexes. The results were compared with videourodynamic studies and multiport anorectal manometry combined with external anal sphincter electromyography. The neurophysiological assessment consisted of electrical stimulation of the dorsogenital nerve, while recording any evoked reflex activity in the external anal and urethral sphincters with concentric needle and surface electrodes. Of these constipated women, 75 per cent had absence of one or more evoked sacral reflexes (compared with 20 per cent of healthy controls, P less than 0.05). Sensory thresholds and motor unit potentials in the external anal sphincter were similar in healthy and constipated women. Nine (56 per cent) constipated women displayed urodynamic abnormalities (increased bladder capacity, acontractile bladder and genuine stress incontinence). Only 38 per cent of constipated women perceived a desire to defaecate during rectal distension with up to 100 ml, compared with 95 per cent of normal subjects (P less than 0.0005). Moreover, 73 per cent of constipated women did not relax the external anal sphincter during defaecation, compared with 12 per cent of controls (P = 0.001). Taking into account the possible significance of our data in relation to previous findings it is suggested that the integration of sensory information within the sacral cord may be impaired in chronic idiopathic constipation.

Adult↗
PubMed1989

Lack of relationship of conus reflexes to bladder function after spinal cord injury.

A series of 20 patients with acute complete suprasacral cord lesions underwent serial urodynamic assessment of vesicourethral function and serial measurement of sacral reflex latency times (SRL) and reflex threshold throughout a follow-up period of 42 to 83 weeks (mean 50). No correlation was found between any pattern of SRL latencies or reflex thresholds and subsequent bladder behaviour. The reproducibility of sacral reflex latencies was found to be poor (mean variation of serial measurements from initial reading 21%) and could not be explained on the basis of "dynamic" neurological recovery. Studies using the bladder as a stimulus site were unreliable. The value of SRL studies in detecting subtle neurophysiological changes is discussed.

Adolescent↗
PubMed1989

Characterization of the serum In(Lu)-related antigen: identification of a serum protein related to erythrocyte p80.

The In(Lu) gene has been shown previously to downregulate expression by erythrocytes and by a subset of leukocytes of an 80-Kd protein antigen defined by monoclonal antibody (MoAb) A3D8. A3D8 antibody has also been shown by inhibition studies to recognize a serum antigen; this serum antigen is present in reduced amount in serum from In(Lu) donors. The present study demonstrates that the serum antigen recognized by A3D8 antibody also resides on a protein similar in size to the protein present in erythrocyte membranes. Studies using chromatographically purified protein have further shown that this antigen shares many epitopes with that present in RBCs and is therefore likely to be extremely homologous or identical to the erythrocyte In(Lu)-related p80.

Animals↗
PubMed1988

Long-term follow-up of selective sacral neurectomy.

Between 1976 and 1981, 22 patients underwent selective, complete sacral root section as a treatment for severe detrusor overactivity. Eighteen were followed up for more than 4 years (mean 6.2). Thirteen of the 22 patients had significant symptomatic improvement lasting for more than 4 years post-operatively (59%), 8 of whom had stable bladders. It was concluded that this operation still has a place in the treatment of detrusor overactivity.

Adolescent↗
PubMed1987

Endoscopic bladder transection for detrusor instability.

Eighteen patients with intractable detrusor instability were treated by endoscopic bladder transection. In two patients there was complete symptomatic relief. Two more were rendered continent but continued to complain of urgency and nocturia. The remaining 14 patients were not improved by the procedure. These results have caused us to abandon this operation as a treatment for detrusor instability.

Adult↗
PubMed1986

Urography prior to prostatectomy.

As part of the pre-operative assessment for prostatectomy, the routine intravenous urogram continues to be requested by many practitioners. One hundred and ten patients being considered for prostatectomy underwent, prospectively, intravenous urography and trans-abdominal ultrasound. This paper specifically examines the respective contribution to management of these investigations. In 34% of patients, management was influenced in some way. This could have been achieved by ultrasound and plain abdominal radiograph alone. Additional intravenous urography would not have affected the clinical management of any patient.

Aged↗
PubMed1985

Idiopathic sclerosing peritonitis.

A girl of 12 years old presented with acute small bowel obstruction nine weeks after an uncomplicated appendicectomy. The obstruction was found to be due to the development of sclerosing peritonitis. Previous reports of this rare condition have suggested that it is predominantly found in adolescent girls residing in subtropical climates.

Child↗