Biomedical subjects
P J Paterson
Publications and source records attributed to P J Paterson.
In situ hybridisation of albumin mRNA in normal liver and hepatocellular carcinoma with a digoxigenin labelled oligonucleotide probe.
AIMS: To study the localisation and distribution of albumin mRNA in normal liver and hepatocellular carcinoma by in situ hybridisation with an oligonucleotide probe. METHODS: A 51 base oligonucleotide was synthesised from a sequence at the 5' end of the human albumin gene and the probe was labelled at its 3' end with digoxigenin 11-dUTP. Formalin fixed, wax embedded sections of liver biopsy specimens were used to study the localisation and distribution of albumin mRNA. After in situ hybridisation the bound probe was visualised using a digoxigenin antibody conjugated with alkaline phosphatase. RESULTS: In normal liver albumin mRNA was detected in hepatocytes and no positive signal was observed in biliary epithelium, vascular endothelium, or Kupffer cells. In 75% (9/12) of the hepatocellular carcinomas studied a positive hybridisation signal was observed in tumour cells. CONCLUSIONS: Albumin mRNA can be detected in sections of formalin fixed, wax embedded liver, a digoxigenin labelled probe is ideally suited for in situ hybridisation of liver because there is no background from the detection system. The identification of albumin mRNA may be a useful marker of hepatocellular carcinoma, and the demonstration of albumin mRNA by in situ hybridisation overcomes the potential background problem associated with albumin immunohistochemistry.
Management of submucous uterine fibroid with buserelin, gemeprost and hysteroscopic resection.
A 19-year-old virgin presented with severe menorrhagia and a haemoglobin level of 76 g/L as a problem of management. A 5 cm diameter submucous fibroid was identified at hysteroscopy and biopsied but was unable to be removed. The luteinising hormone releasing hormone agonist, buserelin, was used in an attempt to produce symptomatic relief. One week after commencing buserelin therapy, severe menorrhagia occurred and the patient was admitted to hospital with a haemoglobin concentration of 24 g/L. Buserelin treatment was continued and no further menstruation occurred over the following year. As the patient was now well, hysteroscopic submucous fibroid resection was contemplated. Due to cervical rigidity in this teenager, a 1 mg gemeprost pessary was inserted into the posterior vaginal fornix three hours before surgery. This allowed an operative hysteroscope to be inserted into the uterus and a fibroid resection to be performed. Menstrual blood loss has been normal for six months after hysteroscopy. A combined medical and surgical approach may avoid hysterectomy in such problem patients.
Relationship between outlet obstruction constipation and obstructed urinary flow.
Ten women with symptoms and radiological features of outlet obstruction constipation underwent urodynamic bladder studies. The results were compared with ten age- and sex-matched controls. The mean (s.e.m.) peak flow rate for patients was 19.4 (6.4) ml/s compared with 32.1 (7.2) ml/s for controls (P less than 0.05). The mean (s.e.m.) voiding time for patients was 62.9 (23.7) s against a corresponding value of 15.6 (6) for controls (P less than 0.05). The mean (s.e.m.) bladder volume in patients was 482 (80) ml compared with a control value of 254 (112) ml (P less than 0.03). The mean (s.e.m.) detrusor pressure during the voiding phase was 53.3 (12) cmH2O. These results demonstrate that patients with outlet obstruction constipation have a generalized pelvic floor disorder resulting in obstructed urinary flow.
Urological manifestations of HIV-related disease. A case of AIDS-associated testicular seminoma, Kaposi's sarcoma and possible intracranial lymphoma.
A wide variety of pathologies afflicting the genitourinary tract can be displayed by patients infected with the human immunodeficiency virus (HIV), including both infective and neoplastic conditions. Treatment can often be offered for such conditions using a combination of therapeutic approaches. These conditions should be looked for specifically in patients with HIV infection as treatment may improve their quality of life. A case is presented of a testicular seminoma (appearing in association with an intracranial mass and Kaposi's sarcoma) in a male patient with the acquired immune deficiency syndrome (AIDS); he made a good response to orchiectomy and radiotherapy for his seminoma. A short review is also given of the range of HIV-associated genitourinary pathologies which have been described to date.
Renal artery embolism: a rare cause of renal colic.
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Corporeal plication for surgical correction of Peyronie's disease.
A retrospective study was done on 30 patients who underwent surgical correction of the penile deformity secondary to Peyronie's disease between 1983 and 1988. Mean followup was 31 months (range 9 to 72 months). Nine patients (30%) underwent Nesbit's operation, 8 (27%) had incision and transverse closure of the tunica albuginea and 13 (43%) had corporeal plication. Over-all, 19 patients (63%) improved postoperatively, which implied erection free of pain with minimal or no deformity and the ability to perform normal sexual intercourse. Presence of pain with deformity was an important factor that influenced the surgical result and should be regarded as a contraindication to surgical intervention. The results of corporeal plication were as good as the other 2 methods. The advantages of this procedure over the other 2 methods are discussed. We recommend this procedure for patients in whom surgical correction of the deformity is indicated.
Granulomatous orchitis. Review of 15 cases.
Granulomatous orchitis is a rare lesion of the testis which can clinically simulate malignancy. The clinical, radiological and pathological features of 15 patients are presented and discussed.
Phenoxybenzamine in prostatic hypertrophy. A double-blind study.
Forty-five patients awaiting prostatectomy participated in a double-blind study of phenoxybenzamine 10 mg/day for 5 weeks. Objective measurements of peak urine flow, voided volume, residual urine and frequency of micturition and nocturia showed no significant difference between phenoxybenzamine and placebo. Patients taking phenoxybenzamine had a significantly greater improvement in hesitancy and flow symptoms than those on placebo. Side effects occurred in 47.6% of patients on phenoxybenzamine and 22.2% of those on placebo. In this study phenoxybenzamine 10 mg/day was ineffective in patients with benign prostatic hypertrophy.
Intravesical formalin in intractable haematuria.
Eleven patients with bladder tumours classified T2 (2 cases), T3 (6 cases) or T4 (3 cases) - and 3 patients with radiation cystitis - were assessed as being beyond the scope of even palliative surgery, severe haemorrhage being present in all cases. One patient was treated by total cystectomy and urinary diversion 21 months after intravesical formalin installation. Palliative haemostatic treatment was instituted in all cases by intravesical instillation of a 10% formalin solution under general anaesthesia. Two patients received 3 and 5 instillations respectively, the former over 3 weeks and the latter over 9 months. The bladder was filled completely and an indwelling catheter introduced, the formalin solution being left in the bladder for from 3 to 20 minutes (mean: 13 minutes). Haematuria was absent after from one to 21 days (mean: 5.3 days) in 13 cases. The 14th patient died before arrest of haemorrhage. Survival after instillation was from 3 days to 32 months (mean 6.8 months). The outcome was fatal within 3 months or less in 8 cases and 6 patients died within 2 months of acute renal failure, one within 3 days of instillation. In 5 cases the treatment with formalin reduced bladder capacity to less than 100 ml. Other complications included acute infection of thigh, ruptured bladder, retroperitoneal fibrosis and severe frequency and nocturia (1 case each), and this procedure should therefore be reserved for terminal cases unable to support more aggressive therapy.
The effects of treatment on the hypercalciuria of chronic cadmium poisoning.
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Allopurinol and urinary stones.
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Reduction in urinary oxalate values by allopurinol.
A variety of substances have been used to prevent recurrence of stone disease. Recently there has been considerable interest in the ability of allopurinol to prevent stone recurrence. This article discusses the effect of allopurinol on the urinary oxalate in a group of stone formers. A significant reduction was obtained especially in subjects in whom the blood urate levels exceeded 300 mumol./L. Possible mechanisms explaining the mode of action of the drug are discussed.
The effect of allopurinol on urinary oxalate excretion in stone formers.
Allopurinol is a drug which could be valuable in the treatment of stone patients. In 29 subjects treated with 300 mg of the drug per day it has been found that there was a significant fall in urine oxalate excretion if the blood urate was above 330 mumol/l. In 10 subjects followed for 1 year the urine oxalate was significantly reduced and maintained at a lower level than the original.
Clinical and biochemical abnormalities in coppersmiths exposed to cadmium.
5(18.5%) of a group 27 coppersmiths exposed to cadmium fume had stone disease. When compared with a control group of assembly workers in the same factory they had evidence of renal impairment as shown by blood biochemistry and proteinuria. A greater tendency to liver damage was found in the coppersmiths. There was evidence that restrictive airways disease was more common in the coppersmiths than in the control group. Blood-cadmium concentrations were significantly higher in the coppersmiths and in the assembly workers than in a reference population.
ABH secretor status in patients with bladder tumours.
The ABO blood groups and secretor status of a group of patients with bladder tumours were investigated and compared with those of a group of patients of a similar age suffering from a variety of genito-urinary diseases. Some of the control patients were known to have been exposed to potential carcinogens, and the findings in this group were analysed separately. No significant differences were found when comparisons of these three groups of patients were made.
Sterilization--tubal approach or hysterectomy?
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