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Biomedical subjects

R C Pugh

Publications and source records attributed to R C Pugh.

At least 19 recordsLinked to original sources
PubMed1986

Evaluating control of breathing utilizing an on-line microcomputer.

This paper describes a system that was designed to evaluate ventilatory responses to hypercapnia, airway occlusion pressure (P100), as well as measuring ventilatory drive and timing. Parameters measured include minute ventilation (VE), breathing rate (f), tidal volume (VT), inspiratory time (TI), fractional inspiratory time (TI/TTot), mean inspiratory flow (VT/TI), and end tidal partial pressure of carbon dioxide (PETCO2). These measurements allow for a thorough analysis of abnormalities of neural and neuromuscular ventilatory drive. The system's architecture was based primarily on currently available microcomputer components designed for the IEEE 696 bus.

Computers↗
PubMed1983

Urothelium and the Specific Red Cell Adherence Test.

The Specific Red Cell Adherence Test (SRCAT) has been modified to produce clearer, more consistent, permanent preparations. Normal urothelium, inflammatory lesions, squamous metaplasia, papillomata, flat in situ and papillary tumours and invasive neoplasms of the bladder have been studied. Inflammatory and squamous changes did not corrupt the test results. The SRCAT was found to be a highly significant test for identifying those patients at risk from invasive bladder tumour. ABH antigens in carcinoma in situ appeared to be non-uniformly distributed throughout the bladder urothelium; it is suggested that all subsequent biopsies from these patients should be tested.

ABO Blood-Group System↗
PubMed1982

Sympathetic orchiopathia--an experimental and clinical study.

An experimental and a clinical study have been performed to elucidate the nature of contralateral testicular damage following unilateral testicular injury--sympathetic orchiopathia. In an experimental study significant impairment of sperm production was produced by contralateral testicular damage which did not seem to be immunologically mediated or to involve the breakdown of the "blood-testis" barrier. In 5 subfertile patients with oligozoospermia and unilateral testicular damage, removal of the damaged testicle did not result in an improvement in their semen analysis.

Animals↗
PubMed1981

Testicular testosterone concentration, interstitial cell density and spermatogenesis in infertile men.

The concentration of testosterone was estimated in testicular biopsies taken from infertile men under general anaesthesia and was found to vary between 0.77 and 9.87 nmol/g wet tissue (median 3.41 nmol/g). Spermatogenesis was assessed by the Johnsen scoring technique but there was no evidence of a deficiency of intratesticular testosterone being associated with dysfunction of the seminiferous tubules. Similarly, there was no direct relationship with testicular size, clinical diagnosis, or the concentration of testosterone found in peripheral plasma taken at the same time as the testicular biopsy. These negative findings were not explained by variation in the volume densities of the Leydig cells assessed in 10 biopsies selected to the representative of the range of testosterone concentrations found in entire series. A retrospective comparison between the concentration of testosterone in peripheral plasma at the time of surgery and the available preoperative levels found in 10 patients provided further evidence for the previously reported lowering of testosterone levels by general anaesthesia. It is suggested that future studies of testicular androgens should be conducted on tissue obtained under local anaesthesia in order to eliminate this effect.

Adult↗
PubMed1981

The role of N-nitrosamine in carcinogenesis at the ureterocolic anastomosis.

Seven cases of colonic tumours occurring at the ureterocolic anastomosis (UCA) in patients diverted for benign disease are presented and comparisons made with existing literature. There appears to be a definite increase in the incidence of colonic malignancy in patients with this diversion. A theory of carcinogenesis involving bacterial activation of endogenously formed N-nitrosamine is suggested. Preliminary results of rectal urine analysis support this theory in that high concentrations of N-nitrosamine have been found mutagens demonstrated.

Adenocarcinoma↗
PubMed1981

Conservation surgery of renal carcinoma: the EIRSS experience.

Seventy-two patients with renal carcinoma (RC) in a solitary kidney or bilateral synchronous tumours underwent parenchyma-sparing excision of their neoplasms. This was performed in situ in 51 and extracorporeally in 21 kidneys, with a complication rate respectively of 17 and 43%. The 5-year survival rates were 78% for unilateral disease, 48% for bilateral synchronous and 38% for bilateral asynchronous disease. Survival correlated with P category, grade and diameter of the tumour. Vascular invasion and spindle cells indicated a poor prognosis; the position of the tumour, oncocytic elements, calcification, lymphocytic infiltration or the predominance of clear cell or granular cells did not influence survival.

Adult↗
PubMed1980

Urothelial carcinoma of the kidney and ureter.

Two hundred and three patients with upper tract urothelial tumours were reviewed. Eighty had pelvicaliceal tumours, 90 ureteric tumours, and 33 multifocal tumours of both pelvis and ureter. Two hundred patients had transitional cell carcinomas and 3 had squamous cell carcinomas. The overall corrected 5-year and 10-year survival rates were 59.7% and 41.1% respectively. Widespread multifocal occurrence poor differentiation, penetration of the muscle coat and conservative resection of tumours predisposed to a poorer prognosis.

Adult↗
PubMed1979

Steroid treatment of male subfertility caused by antisperm antibodies.

47 subfertile men with significant titres of antisperm antibodies were treated with one of two steroid regimens. The results were assessed by changes in sperm-counts and in serum antibody titres and by subsequent pregnancies. 15 oligozoospermic men were treated with prednisone 5 mg three times a day for 3--12 months. Sperm-counts became normal in 10 men and 4 of their wives became pregnant. 14 men with normal sperm-counts received the same treatment: antibody titres fell slightly and 3 of their wives became pregnant. 18 other men with normal sperm-counts were given one or more courses of methylprednisolone 96 mg/day for 7 days. There was a more pronounced fall in antibody titres in these men, and 7 of their wives became pregnant. Testicular biopsies in 3 men with high titres of antibodies and very low sperm-counts which became normal with prednisone showed adequate spermatogenesis; however, focal round-cell infiltration of seminiferous tubules was observed in 1 case. It is suggested that a steroid-responsive immune orchitis can occur spontaneously in man, and may contribute to the infertility of men with antisperm antibodies.

Autoantibodies↗
PubMed1978

Idications for testicular biopsy or exploration in azoospermia.

Investigation of 311 azoospermic males has shown that the combination of estimation of testicular size and plasma FSH allows the spermatogenic function of the testes to be accurately assessed by non-invasive methods. Patients with small testes and grossly elevated levels of plasma FSH have absent, or grossly impaired spermatogenesis, and do not require surgical exploration. They should be advised with regard to adoption or artificial insemination. Patients with large testes (5 cm) or an FSH level which is not grossly elevated require operation and should undergo a surgical exploration and the possible correction of an obstructive lesion. A testicular biopsy is essential if no obstructive lesion is found as the histology of these patients may show a spermatogenic arrest.

Biopsy↗
PubMed1978

Prostate carcinoma: intratumor BCG immunotherapy.

Two groups of patients with advanced cancer of the prostate received adjuvant immunotherapy by direct intra-tumor injection of BCG. The first group had advanced metastatic disease that was failing to respond to conventional hormone therapy. The second group were new cases of stages III and IV tumor who were previously untreated and who had had a transurethral resection of the prostate and orchiectomy followed by BCG immunotherapy. The clinical and pathologic findings for both groups of patients are described.

BCG Vaccine↗
PubMed1977

Adjuvant immunotherapy with B.C.G. in carcinoma of the prostate.

8 previously untreated patients with Stage III and Stage IV prostatic cancer who had had the bulk of their primary tumour removed by transurethral resection, and residual tumour suppressed by bilateral total orchidectomy, were given adjuvant immunotherapy by direct injection of B.C.G. into the prostate. The pyrexial reaction to, and the histological changes from B.C.G. have been more marked in the patients whose disease is no longer controlled by conventional therapy. Granulomas have been found in the lungs, liver, myocardium, spleen and bone marrow. Granulomas in carcinomatous areas have been associated with tumour cell degeneration.

Aged↗
PubMed1977

Early diagnosis of prostatic carcinoma: the role of transurethral resection.

The exclusion of prostatic carcinoma in TUR specimens represents a considerable problem for the histopathologist. A technique for the separation of tissue on an anatomical basis which has been carried out on 50 patients is presented. It permits more representative histological sampling of TUR specimens and more accurate characterisation of prostatic carcinoma, but further refinement is recommended.

Adult↗
PubMed1977

Perceptions of urban versus rural hospital patients about return to their communities.

During a two-month period in 1976, male patients scheduled to be discharged from two Veterans Administration Hospitals, who were aged 55 or older, chronically ill, able to communicate rationally, and had been hospitalized at least a week for the current illness, were interviewed prior to discharge. Information was sought regarding their feelings about admission and discharge, the availability of and their need for 13 related health-related services at home, and the informal support systems available to them in their local communities. Comparisons were made between patients from distinctly rural settings (communities with less than 5,000 population) and those from larger towns or cities. Both urban and rural patients were modest in assessment of their own health-related needs, especially their need for social and ancillary health services. In almost all instances, the perceived availability exceeded perceived needs. Rural dwellers reported somewhat less apprehension about entering the hospital; they also reported more social contact in their home communities despite the fact that in this sample the rural dwellers were more likely to be older, widowed, and living alone. Rural dwellers were slightly more likely to have their own family doctor.

Aged↗
PubMed1976

Plasma gonadotrophic hormones, testicular biopsy and seminal analysis in the men of infertile marriages.

The first step in the investigation of infertile men is to obtain 2 seminal analyses 3 days after the previous ejaculation. Clinical assessment of testicular size is an unreliable means of assessing spermatogenesis and is best done by performing bilateral testicular biopsies. Azoospermic men with grossly elevated FSH levels should be advised to consider AID or adoption. Those with normal or mildly elevated FSH levels should undergo testicular exploration in an attempt to correct an obstructive lesion. Azoospermic men with subnormal FSH levels may have an isolated hormone defect which will respond to treatment with Pergonal. Different treatment programmes for oligozoospermic men depending on the results of the FSH and LH assays may lead to a more rational approach to therapy. Infertility associated with varicocele may possibly be associated with a local disturbance of "inhibin" and FSH concentrations.

Adult↗
PubMed1976

Experimental cellular allergic reactions in normal canine and malignant human prostate.

This paper describes the histopathology of chronic tuberculin-type hypersensitivity reactions in the normal canine and malignant human prostate. Seven dogs were sensitized by injection of Freund's complete adjuvant and the histological response to the subsequent intra-prostatic injection of 6 mg tuberculin PPD was documented. A chronic mononuclear cell prostatis persisted for 4 weeks and was accompanied by paracortical distension and follicular hyperplasia in regional lymph nodes. Six patients with carcinoma of the prostate were given multiple intraprostatic injections of BCG, which induced a chronic mononuclear cell prostatitis with some evidence of tumour-cell necrosis. The study indicated that the prostate can support chronic cell-mediated allergic reactions to extrinsic antigens and that intra-prostatic injections of BCG can be administered without harmful effects to patients with malignant prostatic disease.

Adenocarcinoma↗
PubMed1975

Flat carcinoma in Situ of bladder.

36 patients with flat carcinoma in situ of the bladder have been reviewed. Those with widespread disease usually presented with dysuria or obstructive outflow tract symptoms and radical surgery appeared to give better results than radiotherapy. However, when the lesion was confined to small areas of the bladder mucosa, haematuria or pain were the main presenting symptoms and a conservative approach seemed justified. It is suggested that the term flat carcinoma in situ be used for this lesion whose behavior differs significantly from that of the commoner papillary or invasive tumours. The pathological appearances are to be reported elsewhere in full.

Adult↗