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Biomedical subjects

P B Clark

Publications and source records attributed to P B Clark.

8 recordsLinked to original sources
PubMed1979

End-to-end ureteroileal anastomosis for ileal conduits.

In the "Y" anastomosis, both ureters are spatulated and joined together to form a single tube which is anastomosed to the proximal end of the ileum. This technique has several theoretical advantages which appear to be borne out in practice when the results of its use in 101 patients followed for up to 12 years are reviewed. Only 2 anastomotic leaks needed operative treatment and only 4 patients developed ureteroileal stenosis. Renal function remained unchanged or improved in 84% of the patients, and definite hydronephorsis or pyelonephritis developed in only 4% of the kidneys. These results show that this method of ureteroileal anastomosis is at least as good as, and possibly better than, other techniques.

Adolescent↗
PubMed1979

Should recurrent calcium oxalate stone formers become vegetarians?

The hypothesis that the incidence of calcium stone disease is related to the consumption of animal protein has been examined. Within the male population, recurrent idiopathic stone formers consumed more animal protein than did normal subjects. Single stone formers had animal protein intakes intermediate between those of normal men and those of recurrent stone formers. A high animal protein intake caused a significant increase in the urinary excretion of calcium, oxalate and uric acid, 3 of the 6 main urinary risk factors for calcium stone formation. The overall relative probability of forming stones, calculated from the combination of the 6 main urinary risk factors, was markedly increased by a high animal protein diet. Conversely, a low animal protein intake, such as taken by vegetarians, was associated with a low excretion of calcium, oxalate and uric acid and a low relative probability of forming stones.

Calcium↗
PubMed1978

Risk factors in calcium stone disease of the urinary tract.

The concept that calcium stone formation may be explained on the basis of a number of risk factors is developed. The main risk factors involved are shown to be calcium, oxalate, pH, acid mucopolysaccharides and uric acid. A method is described for calculating and combining the individual risk factors into a measure of the "relative probability" of forming stones (PSF). PSF values are generally lower in normal subjects than in stone-formers. Amongst the normals, PSF values are lower in children and women than in men. Recurrent stone-formers have the highest PSF values and these correlate well with the severity of the diseases as defined by the stone episode rate of the patient. Single stone-formers have PSF values intermediate between those of normal men and those of recurrent stone-formers.

Adult↗
PubMed1978

Radical cystectomy for carcinoma of the bladder.

A personal series of 50 radical cystectomies has been reviewed to decide whether it is a justifiable operation and, if so, when it should be performed. In spite of the fact that radical cystectomy had a higher operative mortality than simple cystectomy and was sometimes followed by lymphoedema, in patients with invaded iliac lymph nodes it was followed by a 25% 5-year survival. It appears, therefore, to be a justifiable procedure. It is recommended that simple cystectomy should be performed for patients with papillomatosis, carcinoma in situ, and as a salvage procedure after radiotherapy has failed, and that radical cystectomy should be reserved for elective cases in of invasive vesical tumours, and for those patients who are found at exploration to have obvious metastic deposits in the iliac lymph nodes.

Adult↗
PubMed1978

Urethral tumours.

A series of 33 patients with urethral tumours has been studied to assess the risk of dissemination by endoscopic diathermy. This risk is less than that of cystourethrectomy. Urethral tumours should be treated like the vesical tumours they follow and so closely resemble: by endoscopic treatment while they remain small, sparse and superficial; by cystourethrectomy as soon as they become larger and more extensive. Recurrence of tumour in the urethral stump following cystectomy should always be treated by urethrectomy.

Aged↗
PubMed1975

Sarcoidosis of the penis treated by radiotherapy.

A case of sarcoidosis of the penis is reported which initially caused ulceration around the external urethral meatus. After an immediate response to steroid therapy, the disease recurred locally in spite of continuing therapy and involved other parts of the penis. Partial amputation of the penis was performed but further ulceration occurred at the cut ends of the corpora cavernosa in the penile stump. This ulceration healed after radiotherapy.

Biopsy↗