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Biomedical subjects

P K Hegarty

Publications and source records attributed to P K Hegarty.

7 recordsLinked to original sources

Priming prostate carcinoma cells for increased apoptosis is associated with up-regulation of the caspases.

BACKGROUND: The potential to prime prostatic carcinoma cell lines for apoptosis represents an exciting strategy for the treatment of patients with this disease. The ability and the underlying molecular mechanisms involved in sensitizing both androgen-sensitive and androgen-insensitive cell types to a range of apoptotic-inducing agents are investigated by the authors. METHODS: Primary and secondary cell lines were pretreated with diethyl-maleate (DEM) prior to the induction of apoptosis by Fas antibody (1 microg/mL), cycloheximide (1 microg/mL), etoposide (62.5 microM), and radiation (5 grays). It was demonstrated previously that DEM (50 microM) increases the sensitivity to apoptosis induced by these agents. The effects of DEM on both protein and RNA expression was determined by Western blot analysis and a ribonuclease protection assay, respectively. The effects of DEM on intracellular glutathione (GSH) levels and its intracellular distribution also were assessed. RESULTS: DEM did not affect the expression of the caspases at the transcriptional level but was associated with increased procaspase-3 and caspase-8 protein levels. DEM preincubation restored sensitivity to Fas antibody and radiation-induced apoptosis in cells from the LNCaP-bcl-2 transfectant cell line that, normally, are resistant to these apoptotic stimuli. It is that DEM chemically depletes intracellular thiol levels. Although no depletion in total intracellular thiol GSH was observed at these concentrations of DEM, trafficking of GSH from the nucleus to the cytosol was demonstrated. CONCLUSIONS: Identification of the caspases as a potential target for chemical manipulation may serve as an effective, adjuvant-based approach in the treatment of patients with prostate carcinoma and, in particular, for immunotherapy and radiation-based strategies that rely on the activation of these death-effector proteases.

Antineoplastic Agents, Phytogenic↗

Sexual function in patients with benign prostatic hyperplasia.

Sexual health has significant impact on quality of life among men with benign prostatic hyperplasia (BPH). The degree of sexual dysfunction matches the severity of lower urinary tract symptoms (LUTS). Treatment of BPH affects not only LUTS, but sexual function as well. Medical, surgical, and minimally invasive therapies differ in their effect on erectile function, ejaculation, and sexual satisfaction. Choice of treatment modality takes into account baseline sexual function and patient expectations. This review outlines the relationship between LUTS and sexual function and how they change with the currently available treatments.

Humans↗

Longevity of the Marshall-Marchetti-Krantz procedure.

BACKGROUND AND AIMS: The Marshall-Marchetti-Krantz procedure (MMK) is a vesico-urethral suspension, for the correction of urethral hypermobility in women with stress urinary incontinence. This study aims to describe the long-term outcome of the procedure. MATERIAL AND METHODS: 40 women with stress incontinence underwent the MMK. All operations were performed by one surgeon. Analysis of patients' notes yielded the early continence rate and perioperative morbidity. Long-term outcome was measured by means of a postal questionnaire with telephone contact to ensure maximum uptake. RESULTS: The immediate continence rate was 82%. Continence rates at up to 22 years follow-up (mean 8.5 years) is 61%. All failures occurred within 2 years of the operation. CONCLUSION: Patients still continent two years after the MMK will maintain continence in the long-term.

Adult↗

Prevention of postsplenectomy sepsis: how much do patients know?

INTRODUCTION: Asplenia causes a deficiency in immunity with a long-term risk of fulminant infection, associated with significant mortality. Patient compliance requires an understanding of risks of infection and its prevention. The impact of patient education has been little studied. MATERIALS AND METHODS: To ascertain the degree of knowledge held by patients who have undergone splenectomy, a comprehensive survey was designed. This also aimed to determine which group of health professionals was most successful in conveying information to patients. Patients who had undergone total splenectomy were interviewed by telephone, using a standardised list of questions to assess their understanding of the post-operation risks. RESULTS: Of 40 consecutive patients, 32.5% had a good knowledge of the risks of asplenia and their prevention, 52.5% had a fair knowledge and 15% a poor knowledge. Haematologists were most successful in initially conveying information to patients, and general practitioners also played a critical role in patient education. In this survey, it appears that surgeons were not effective at educating patients. CONCLUSION: Patient education postsplenectomy is poor. Measures to prevent infection in the asplenic patient are not being adequately implemented.

Adolescent↗

One-stage Fowler-Stephens orchidopexy for impalpable undescended testis.

BACKGROUND: The Fowler-Stephens orchidopexy (FSO) is a well-described treatment for high maldescended testes where the limiting factor for successful placement in the scrotum is short testicular vessels. The operation involves division of these vessels. The testicular blood supply is then dependent on collaterals from the vasal artery. AIMS: To assess the long-term outcome of patients who underwent this procedure in our institution. METHODS: The medical records of 20 patients who underwent 22 FSO from 1978 to 1999 by one urologist (HB) were reviewed. Outcome was assessed in terms of testicular position and size. RESULTS: Age at operation ranged from 2 to 14 years (mean 5.8 years). All patients had a one-stage FSO and in two of them the procedure was bilateral. In five patients, FSO was preceded by a diagnostic laparoscopy. Mean follow up was 22 months (range 0-121 months). Overall, results were considered good in 18 of 22 testes (82%). CONCLUSION: Our results for the one-stage FSO are comparable with other procedures for the management of high maldescended testis.

Adolescent↗

Exploration of the acute scrotum: a retrospective analysis of 100 consecutive cases.

BACKGROUND: Acute scrotal pain is a common urological emergency. Urgent exploration is the standard means of management, as no investigation can confidently exclude torsion of testis from the differential diagnoses. In our department, all patients up to the age of 40 years, presenting with acute scrotal pain undergo emergency scrotal exploration. AIM: This study assesses the outcome of such a policy in one unit. METHODS: The notes of 100 consecutive males who underwent exploration of scrotum have been reviewed. RESULTS: Testicular torsion was diagnosed in 33% of patients, with torsion of the appendix testis being the next most common entity. In the group with testicular torsion 12% required orchidectomy, and all had presented at least 24 hours after the onset of pain. The perioperative morbidity of scrotal exploration was very low. CONCLUSION: These data justify the policy of emergency exploration for all cases of acute scrotal pain up to the age of 40 years.

Acute Disease↗