Importance of early tumour exacerbation in patients treated with long acting analogues of gonadotrophin releasing hormone for advanced prostatic cancer.
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Aged↗
Biomedical subjects
R C Tiptaft
Publications and source records attributed to R C Tiptaft.
Perineal nerve damage in genuine stress urinary incontinence. An electrophysiological study.
Twelve patients with genuine stress incontinence of urine were investigated using manometric and electrophysiological techniques. All were shown to have slowed conduction in the perineal branch of the pudendal nerve which innervates the periurethral striated sphincter muscle. The mean perineal nerve terminal motor latency in these patients was 3.9 +/- 0.8 (ms) and in 20 age and parity matched control subjects was 2.0 +/- 0.2 (ms) (P less than 0.001). These results are consistent with a neurogenic factor in patients with genuine stress incontinence of urine which may have implications regarding selection of patients for surgery to restore urethral competence.
Adult↗
Mazindol for nocturnal enuresis.
Sixteen adult enuretics who had failed to respond to simple conventional treatment of their symptoms have been investigated and treated with mazindol. Sixty-three per cent have been made dry and improvement achieved in a further 31%.
Adolescent↗
Squamous cell carcinoma of bladder.
Examination of the histology of all bladder tumors presented to the London Hospital over a ten-year period revealed a surprisingly low incidence of squamous bladder carcinoma. We would support the view of other workers that this tumor usually presents at an advanced stage and carries with it a poor prognosis. However, when no evidence of metastatic disease is evident, treatment with standard protocol of radiation therapy and cystectomy should achieve the same results as for the transitional cell tumor. Squamous cell carcinoma of the bladder would appear to be as radiosensitive as its transitional cell counterpart.
Carcinoma, Squamous Cell↗
Mazindol in the control of micturition.
The appetite suppressant mazindol has been compared with a placebo in the control of incontinence in a double-blind cross-over trial. Twenty-five patients were entered; 4 were withdrawn for protocol violations. The underlying diagnoses were determined; 19 had stable detrusors and 6 unstable. Seventeen patients made a complete response to mazindol for a 68% overall response rate.
Adolescent↗
The impact of optical urethrotomy on the management of urethral strictures.
The introduction of optical urethrotomy by Sachse has reduced the need for urethroplasty: 261 urethroplasties were performed between 1964 and 1983, of which 87 were performed in one stage on patients who would today have undergone urethrotomy as the procedure of first choice. The results in this group are compared with those in 151 patients treated between 1978 and 1983 by 265 internal optical urethrotomies. At 5 years 50% of those treated by urethrotomy needed no further treatment, compared with 83% of those treated by urethroplasty. Nevertheless, the ease and safety of urethrotomy makes it the procedure of first choice, and urethoroplasty should be reserved either for cases where urethrotomy is unsuitable or where it has been tried on several occasions without success.
Adolescent↗
Fistulae involving rectum and urethra: the place of Parks's operations.
Twenty-five rectovesical and rectourethral fistulae were treated over an 18-year period in which various methods for closing the rectal side of the fistula were developed, ultimately with two techniques using the full thickness of intestine. As a result of these operations the management of the urethral and vesical side of the fistulae became a relatively simple problem to which standard techniques could be applied.
Adult↗
HLA antigen expression on urothelial cells: detection by antibody-dependent cell-mediated cytotoxicity.
Antibody-dependent cell-mediated cytotoxicity (ADCC) was used to detect HLA-A, -B and -C antigens on in vitro-cultured urothelial cells of normal or malignant derivation. Alloantisera induced specific lysis of 51Cr-labelled targets by effector lymphoid cells from non-immune donors. HLA antisera were routinely titred to dilutions greater than or equal to 10(-3) on urothelial cells in primary or long-term culture. The HLA phenotype was compared for lymphoid cells and urothelial cells from eight individuals. HLA antigens detected by complement mediated lymphocytotoxicity were also detected on urothelial cells. No deletions or gains in HLA antigens were found on normal or malignant urothelial cultures as compared with donor lymphocyte HLA typings. The results show that the established urothelial cells lines J82, TCCSuP and SCaBER have retained their donor HLA phenotype. The established cell lines T24 and RT4 derived from transitional cell carcinomas and HCV-29 from urothelium were found to have distinctive HLA profiles although donor lymphocytes were not available for comparison. The serological crossreactions seen in complement mediated lymphocytotoxicity were clearly observed in ADCC. In particular, HLA-Cw5 was found to crossreact with HLA-Cw8. HLA-Cw5 was detected on 6/8 cultures of transitional cell carcinomas and this was confirmed by absorption analysis.
Antibody-Dependent Cell Cytotoxicity↗
The long-term follow-up of idiopathic retroperitoneal fibrosis.
In a series of patients with idiopathic retroperitoneal fibrosis followed for up to 22 years, 21 were treated after ureterolysis of 36 ureters by wrapping the ureters in omentum. Recurrent fibrosis was noted in 2 patients involving 2 ureters. Earlier in the same period 3 patients with 4 ureters were treated by intraperitoneal placement after ureterolysis: in these, recurrence was noted in 2 patients involving 2 ureters. Steroids were used as an adjuvant when ureterolysis was incomplete or for relapse. The omentum appears to afford long-term protection against return of the fibrosis around the ureter.
Adult↗
A critical appraisal of the Boari flap.
Sixty-two ureters were reimplanted in 54 patients using the Boari flap between 1967 and 1982. The indication was mainly for operative injury to the ureter, but other causes of obstruction to the lower ureter were also found. There was one death from post-operative pulmonary embolism. With attention to details of operative technique--notably to the avoidance of tension and to the provision of adequate splinting and drainage--the procedure may be adapted to a wide variety of difficult surgical problems encountered in the pelvis.
Adolescent↗
The diagnosis of testicular swellings using water-path ultrasound.
Water-path ultrasound was used to investigate 29 patients with swellings of the testicle. When the swelling contained fluid, such as a hydrocele or a cyst of the epididymis, it was accurately depicted in the ultrasound scan. Seminomas appeared as anechoic areas which could not be distinguished from granulomatous orchitis, but were clearly different from the homogeneous echo pattern of the normal testis. The depiction of the epididymis was less clear. Water-path ultrasonography is a promising addition to our diagnostic armamentarium.
Dysgerminoma↗
The early and aggressive repair of iatrogenic ureteric injuries.
Sixty-two iatrogenic injuries of the ureter in 52 patients have been studied over a 15-year period. A plea is made for early recognition in post-operative urinary fistulae and early operative repair. The results of 41 cases treated by the Boari-Ockerblad method are reported without post-operative obstruction or failure.
Adult↗