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Biomedical subjects

T F Ford

Publications and source records attributed to T F Ford.

18 recordsLinked to original sources
PubMed1997

Local staging of prostate cancer with 0.2 T body coil MRI.

This study was undertaken to evaluate the accuracy of low field strength body coil MRI in the staging of clinically localized prostate cancer. Fifty-three patients with prostate cancer were examined on a 0.2 T body coil system before undergoing radical prostatectomy. Of the 20 cases with unconfined stage T3 disease on histology, 12 were correctly staged, whilst three cases were overstaged by MRI. (Accuracy 79.2%, sensitivity 60%, and specificity 90.9%.) The accuracy, sensitivity and specificity for the detection of capsular penetration were 77.3%, 55% and 90.9%, respectively, whilst those for seminal vesical invasion were 94.3%, 83.3% and 95.7%, respectively. It is concluded that a high level of staging accuracy, comparable to that obtained in some published studies using high field strength endorectal coil MRI, can be obtained using 0.2 T body coil MRI.

Aged↗
PubMed1985

Intramucosal activation of pepsinogens in the pathogenesis of acute gastric erosions and their prevention by the potent semisynthetic amphipathic inhibitor pepstatinyl-glycyl-lysyl-lysine.

This study was designed to test the proposal that a critical event in the formation of acute gastric erosions is the intramucosal activation of pepsinogens. Gastric erosions were induced in rats by controlled haemorrhagic shock. Free acid proteinase activity in homogenates of gastric mucosa taken to include erosions increased progressively throughout the period of hypotension. Free enzyme activity in homogenates of apparently normal mucosa between erosions remained substantially unchanged. Luminal pepstatin, the potent but hydrophobic specific acid proteinase inhibitor which does not penetrate gastric mucosa, did not prevent the development of erosions. The equally potent but amphipathic water-soluble analogue pepstatinyl-gly-lys-lys, which does penetrate gastric mucosa, substantially reduced mucosal ulceration in this system. These findings suggest that focal intramucosal pepsinogen activation at the site of acute experimental erosions is causally related to their development, and suggest the inclusion of potent water soluble acid proteinase inhibitors of appropriate molecular structure in their clinical prevention and treatment.

Animals↗
PubMed1985

Endoscopic management of upper urinary tract stones.

Since 1981, 525 renal and ureteric calculi have been removed with percutaneous nephrolithotomy (PCN) or transurethral ureteroscopy as the primary modalities of therapy. Successful extraction of the stone at the first attempt was achieved in 92 per cent of cases by PCN and 70 per cent of cases by ureteroscopy, whilst further endoscopic surgery improved the overall success rates to 98 per cent and to 80 per cent respectively. Complication rates from these procedures have both been low as has the morbidity, with most patients leaving hospital within 4 days and returning to work within 2 weeks. The successful development of endoscopic lithotomy and the use of in situ destruction techniques has meant that we now reserve open surgery for difficult multibranched staghorn calculi and ureteric stones embedded in the urothelium. With the advent of extracorporeally generated shockwave lithotripsy it is likely that even these types of stone will be amenable to minimally invasive procedures.

Adolescent↗
PubMed1985

A preliminary in vivo assessment of acrylic acid graft-copolymers in the urinary tract.

Polymers such as polyethylene, polytetrafluorethylene and polypropylene may be copolymerized with acrylic acid by radiation initiation to produce copolymers which are cationic hydrogels and thus possess physical properties different to the base polymers from which they are derived. The present preliminary study was undertaken to determine whether this class of material may have potential application for use within the urinary tract. Inserts of such copolymers in sheet form (5 mm. square) and their corresponding base polymers were placed in the bladders of male Wistar rats as free floating grafts and left in situ for 3 months. Stone formation and/or encrustation occurred on 12 of the 16 radiation graft copolymers and on 9 of 11 of the corresponding base polymers. The altered physical properties of the tested acrylic acid graft copolymers appear to offer no additional resistance to encrustation although their plasticity and ability to swell in water may provide some advantages over more conventional polymeric materials.

Acrylates↗
PubMed1985

Adenomatous metaplasia (nephrogenic adenoma) of urothelium. An analysis of 70 cases.

A retrospective analysis of 70 cases of adenomatous metaplasia seen in the St Peter's Hospitals over a 15-year period has been carried out. The lesions occurred at all ages (7-81 years) and in both sexes (51 males, 19 females) and were found throughout the urinary tract from pelvis to urethra. In the pelvis and ureter the finding was usually an incidental one in association with stones or chronic inflammation; ulceration was a frequent accompaniment. Most vesical and urethral lesions followed a surgical procedure months or years previously, the patients re-presenting with haematuria or irritative bladder symptoms. The endoscopic appearances varied but there was often a striking correlation between the location of the lesions and the site of previous surgery. The association of adenomatous metaplasia with ulceration and previous surgery leads us to suggest that it is merely an unusual response to wound healing and attempts to treat it by diathermy resection are, therefore, likely to meet with limited success. Cystoscopic follow-up of persistent lesions gives no reason to suppose they are pre-malignant.

Adenoma↗
PubMed1985

The undescended testis in adult life.

The management of the undescended testis in the adult patient presents problems in terms of locating the impalpable gonad, the risk of malignancy and prognosis with regard to fertility. CT scanning has been used to locate four intra-abdominal testes. The risk of malignancy has been assessed by determining the incidence of carcinoma in situ after orchiectomy or testicular biopsy in 90 patients (112 testes). Carcinoma in situ was found in 4 of 16 abdominal, 3 of 44 inguinal and none of 52 scrotal testes following orchiopexy in childhood. Seventy per cent of undescended testes in adult patients had no evidence of spermatogenesis. This fact, together with the risk of malignancy in those testes in which germ cells are present, suggests that orchiectomy should be performed in unilateral cases. Testicular biopsy is essential if an undescended testis is to be preserved for androgenic function.

Adolescent↗
PubMed1985

Serum and tissue tumour markers in seminomas.

The serum expression of the tumour markers hydroxybutyric dehydrogenase (HBD), beta human chorionic gonadotrophin (beta HCG), alphafetoprotein (alpha FP) and placental alkaline phosphatase (PLAP) has been assessed in a consecutive series of 50 patients with pure seminoma. In pre-orchiectomy sera from 15 patients with stage I disease, HBD was elevated in 5, beta HCG in 3, alpha FP in 1 and PLAP in 1 (of 3 only). In 27 patients with stage 2 or 3 disease, prior to chemotherapy, serum HBD was elevated in 19, beta HCG in 11, alpha FP in 2 and PLAP in 10 (of 18). The presence of beta HCG was investigated immunocytochemically in primary tumour tissue from 39 patients. It was demonstrated in 6 of 21 tumours from patients with stage I disease and 5 of 18 with stage 2 or 3 disease.

Alkaline Phosphatase↗
PubMed1985

Immunocytochemical localisation of prostate-specific antigen: specificity and application to clinical practice.

An immunocytochemical method to localise prostate-specific antigen (PSA) in paraffin sections was used to establish the prostatic origin of both primary and metastatic tumours. The specificity of the technique was confirmed in 65 known primary (63 PSA-positive) and 17 metastatic prostatic carcinomas (16 PSA-positive). Thirteen non-prostatic primary carcinomas and a series of benign proliferative and malignant conditions which might be considered in the morphological differential diagnosis of prostatic adenocarcinoma were PSA-negative. The technique has now been applied diagnostically to tumour tissue resected from 21 patients. These neoplasms of the base and neck of the bladder could not be categorised as prostatic or urothelial in origin by clinical and endoscopic assessment or by conventional histopathology. In 11 patients such tumours were PSA-positive, indicating a prostatic origin. In two further patients, the prostatic origin of lymph node secondaries was confirmed in the absence of a clinically apparent primary. The technique is a valuable adjunct to conventional histopathology.

Adenocarcinoma↗
PubMed1984

Transurethral ureteroscopic stone extraction.

Transurethral ureteroscopy has now been used for stone retrieval in 31 patients with ureteric calculi. Four stones were located in the upper third, nine in the middle third and eighteen in the lower third of the ureter. The stones varied in size from 4 to 10 mm in diameter. Successful retrieval of the stones was achieved at the first attempt in 17 and at a second attempt in 3. Of the 11 failures (due to impaction, dislodgement into the pelvis or failed instrumentation), 4 have required open ureterolithotomy, 2 percutaneous nephroscopy and 2 ureteric meatotomies; 3 have been successfully disintegrated in situ. There have been no significant complications to date. Transurethral ureteroscopy appears to offer an alternative to existing therapeutic options.

Adult↗
PubMed1984

The impact of transurethral ureteroscopy on the management of ureteric calculi.

Transurethral ureteroscopy has now been used in an attempt to retrieve ureteric calculi in 48 patients. Six stones were located in the upper ureter, 11 in the middle and 31 in the lower third of the ureter. Successful retrieval was achieved in 27 patients at the first attempt and in 4 at a second ureteroscopy. Of the 17 failures, 7 patients have required open ureterolithotomy, 3 percutaneous nephrolithotomy and the remainder passed their stones either after in situ disintegration or ureteric meatotomy. There have been no serious complications to date. Transurethral ureteroscopy should now be regarded as the procedure of first choice in the management of ureteric calculi.

Adult↗
PubMed1984

Incidental carcinoma of the prostate: treatment selection by second-look TURP.

Twenty consecutive patients, aged under 70 years, with an incidentally diagnosed (TONXMO) carcinoma of the prostate were studied to determine the value of a repeat (second-look) TURP in assessing the accuracy of the estimates of tumour grade and volume following a first resection and in selecting patients for deferred or definitive treatment. In 8 of the 20 cases no tumour was present in the second specimen and in three cases the quantities were insignificant. All patients were treated expectantly and none has developed disease progression. Appreciable residual tumour was still present in nine patients, four of whom have developed local progression despite treatment (radiotherapy or stilboestrol). It is concluded that a second-look TURP adds to the accuracy of the definition of the T-category and as such is a valuable adjunct in determining appropriate therapy in such patients.

Aged↗
PubMed1984

Clinical and experimental evaluation of ureteric dilatation.

The present study was designed to evaluate the effect of ureteric dilatation (performed as a prelude to rigid ureteroscopy) on the vesicoureteric mechanism in experimental animals and man. Through a vesicotomy the left ureteric orifices of 10 anaesthetised male New Zealand White rabbits were dilated approximately 3-fold (to 4-5F) using Seldinger wires and gradated cannulae. Serial intravenous urograms and histological examination of the excised vesicoureteric junctions were performed at intervals of 2 weeks. Histologically, acute inflammatory changes were noted at 24 h, but at 2 to 8 weeks the histological appearances were normal. Radiologically, transient upper tract dilatation was noted in three animals. In 10 patients, intravenous urograms and micturating cystograms were performed 3 months after ureteric dilatation to 14F (prior to ureteroscopy). One asymptomatic patient had grade 1 vesicoureteric reflux but no other radiological abnormalities were found. It is concluded that ureteric dilatation is a safe procedure which merits reassessment as a urological technique.

Animals↗
PubMed1983

Transurethral ureteroscopic retrieval of ureteric stones.

This report documents our initial experience in the transurethral retrieval of ureteric stones using the rigid ureteroscope. Ten patients are included. Half of the stones were located in the lower one-third of the ureter and half in the upper two-thirds. They varied in size from 5 to 10 mm in diameter. Seven were successfully extracted at the first attempt using stone baskets under direct vision. Of the remaining 3, one was retrieved at a second ureteroscopy, one was fragmented and subsequently passed and one required percutaneous nephroscopy for its removal from the renal pelvis. It is concluded that transurethral ureteroscopy offers a safe alternative to both open ureterolithotomy and blind manipulation.

Adult↗
PubMed1983

Carcinoma in situ in testicular biopsies from men presenting with infertility.

This study concerns 2043 male partners of infertile marriages who underwent testicular biopsy in the 28 years from 1955 to 1982. In a review of the pathological material carcinoma in situ (CIS) was diagnosed in 8 men (0.39%). Six of these men were later found to have invasive germ cell tumours; one has remained tumour-free and one is lost to follow-up. The implication of these findings in relation to the selection of patients for biopsy and the treatment of CIS when diagnosed is discussed.

Adult↗
PubMed1982

A sensitive fluorometric assay for the simultaneous estimation of pepsin and pepsinogen in gastric mucosa.

An assay for pepsin has been developed based on the fluorometric measurement of trichloroacetic acid-soluble peptides released from casein at pH 5.3. The increase in relative fluorescence was most sensitive in the range 10-50 micrograms pepsin/l and casein hydrolysis was not affected by the addition of up to a 1000-fold molar excess of pepsinogen. This assay has been used to measure the free and total acid proteinase content of biopsies (less than 5 mg) from different areas of the gastric mucosa of rat and man. Interference by the major lysosomal acid hydrolase, cathepsin D, could be eliminated by the differential stability of pepsin and cathepsin D at acid and neutral pH. The free acid proteinase activity of biopsies from the corpus were almost identical in these species whereas the total acid proteinase activity was approximately 5-fold greater in man.

Animals↗
PubMed1982

Distribution of pepstatin and statine following oral and intravenous administration in rats. Tissue localisation by whole body autoradiography.

The distribution in rats of two radiolabelled derivatives of the potent pepsin inhibitor, pepstatin A, has been monitored by whole-body autoradiography. There was a very poor absorption of pepstatinyl-[14C]glycine and N-[3H]acetylstatine across the gastric and intestinal mucosae after oral administration. Both inhibitors were rapidly cleared from the blood by the liver and kidneys after intravenous administration. Neither inhibitor was localised in the gastric mucosa at a concentration that could be expected to be effective in inhibiting intracellular pepsin activity.

Administration, Oral↗