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Biomedical subjects

W F Hendry

Publications and source records attributed to W F Hendry.

At least 163 records · Page 9Linked to original sources

Life with an ileal conduit: results of questionnaire surveys of patients and urological surgeons.

Two questionnaire surveys were undertaken to investigate the problems experienced by patients and staff in coping with ileal conduits. A survey of 34 patients showed that the major problems were urinary leakage and skin excoriation. In 7 out of 13 patients, leakage was associated with contour problems due to abdominal hernias of recession of the stoma. Fifty-seven questionnaires were received from British urologists, who each constructed, on average, 7 ileal conduits per annum. Twenty of 57 surgeons had no stomatherapist. Leakage and skin reactions were once again the most commonly encountered problems. It was concluded that the most severe leakage problems could be prevented by careful surgical technique. However, most of the day-to-day problems could be handled by a competent stomatherapist.

Aged↗

The role of surgery in the combined management of metastases from malignant teratomas of testis.

Thirty-three patients with malignant testicular teratomas and para-aortic metastases exceeding 2 cm in diameter have been treated with radiotherapy, chemotherapy (vinblastine and bleomycin, with or without cis-platinum) or both, followed by surgical excision of the residual para-aortic mass. Removal of a poorly functioning ipsilateral kidney was necessary in 7 cases (21%) and a segment of vena cava was resected in 2 (12.5%) of 16 patients with primary right-sided tumours. Removal was incomplete in only one patient, who had femoral nerve root involvement, and he subsequently died of secondary haemorrhage (operative mortality 3%). Undifferentiated tumour was found in 8 (61%) of 13 patients (Group 1) after radiotherapy, compared with only 2 (15%) of 13 (Group 2) after chemotherapy and radiotherapy, and 4 (57%) of 7 (Group 3) who had chemotherapy only prior to surgery; however, 3 of the Group 3 patients were referred because of evidence of activity in the para-aortic region.

Adolescent↗

Bilateral germ cell tumours of the testis.

Between 1952 and 1976, 760 men with testicular tumours were seen at The Royal Marsden Hospital. Of this group 21 (2.75%) developed tumours of the contralateral testis, in 2 instances synchronously and in the remaining 19 at intervals from 4 months to 15 years. Of 15 men in whom adequate history has been obtained, 7 (46%) had a history of maldescent and in all 7 patients the pathology of both tumours showed the same histological subtype. Only one example of malignant teratoma undifferentiated (MTU) as first tumour was encountered; 13 of 19 (68%) patients had seminomas and the second tumour was a seminoma in 11 patients (58%). Of the group of 21 patients, 12 (57%) are alive and disease-free. Of 14 Stage I patients (second tumour), 12 (85%) are considered cured of their 2 tumours. However, patients with evidence of extratesticular spread did badly, even if the second tumour was a seminoma, and treatment for these patients should include chemotherapy. Similarly, both Stage I MTU second tumours did badly.

Cryptorchidism↗

Primary carcinoma of the female urethra.

Experience in the diagnosis and management of 39 female patients with primary carcinoma of the urethra is described. The condition presents to both gynaecological and urological units and has a relatively good prognosis provided that it is diagnosed quickly. There must be, however, a clinical awareness of the condition in those patients presenting with non-specific urological symptoms. Radiotherapy is the treatment of choice using interstitial implants for the superficial tumours and external beam for the deeper tumours. Surgery alone is possible in only a small number of cases, it being reserved mainly for recurrent or resistant disease.

Adenocarcinoma↗

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↗

Combined management of malignant teratoma of the testis.

Intensive chemotherapy with bleomycin and vinblastine was used as initial treatment in patients with advanced testicular teratoma and after relapse following lymph-node irradiation in patients with early-stage disease. Between January, 1976, and March, 1978, 84 patients, 28 with early disease and 56 with advanced disease, were treated. All 28 men with early-stage disease are alive and disease-free. Patients with advanced disease were divided into two groups. Patients with bulky multiple lung metastases and those with liver involvement did poorly, only 4 of 23 (17.4%) being disease-free. Conversely, patients with bulky abdominal nodes and those with limited lung disease did well, 17 of 21 previously untreated patients (80.9%) being alive and disease-free. Within the latter group, 16 patients were managed with chemotherapy and radiotherapy and/or surgery. Of these, 15 (93.4%) are disease-free.

Abdominal Neoplasms↗

Male infertility due to sulphasalazine.

Four young immigrants whose ulcerative colitis was controlled by sulphasalazine had oligospermia and infertility. No other cause for infertility was found in any of them nor in their wives. Findings on semen analyses rapidly improved in all patients on withdrawal of sulphasalazine, which resulted in four pregnancies in three of the wives. Reintroduction of sulphasalazine was followed by rapid deterioration in the semen of two patients. The frequency and importance of the effect of sulphasalazine on fertility requires further evaluation.

Adult↗

Obstructive nephropathy: successful evaluation with radionuclides.

A non-invasive test of nephron function, the renal parenchymal transit time (P.T.T.) index, is shown to be as accurate as antegrade pressure measurements in diagnosis of renal outflow obstruction. It is more sensitive than conventional methods of demonstrating the associated obstructive nephropathy. P.T.T. is useful in following the effects of surgery, or of temporising, in patients with confirmed or potential outflow tract obstruction. Renal radionuclide P.T.T. analysis gives the functional information essential for the management of patients in whom intravenous urography reveals a dilated renal pelvis.

Dilatation, Pathologic↗

The role of computed tomography in the management of testicular teratoma.

CT scans of the lungs, mediastinum and abdomen have been performed in 65 patients with malignant teratoma between August 1977 and June 1978. CT is superior to conventional radiology in detecting pulmonary metastases and mediastinal lymphadenopathy. It is a valuable technique for defining the full extent of para-aortic nodal disease and provides more information than lymphography alone. In this series sequential CT scans have been used to monitor treatment response to detect relapse and to assess operability of demonstrable residual disease.

Abdominal Neoplasms↗

The pattern of spread and treatment of metastases in testicular seminoma.

The results of treatment of 199 patients referred to the Royal Marsden Hospital with testiclar seminoma from 1963 to 1975 are described. Of 190 previously untreated patients 16 (8.4%) have died of seminoma, 3 (1.5%) of teratoma and 9 (4.9%) of intercurrent disease. Of 121 Stage I patients the only death was due to a second testicular tumour. In orchiectomy and volume of abdominal node metastases. This was not, however, prognostically significant. Death from seminoma occurred in 6 out of 38 patients (15.8%) with nodal metastases less than or equal to 5 cm in diameter and 3 out of 16 patients (18.7%) with metastases greater than 5 cm in diameter; 2 of 8 Stage III patients died of seminoma. Thus radiation controlled nodal metastases in more than 80% of Stage I, II and III patients. In Stage IV patients and patients referred with disease relapse, 12 out of 16 patients died of seminoma. Chemotherapy experience is briefly reviewed. Cyclophosphamide as a single agent has produced a 50% response rate. There is no evidence to suggest a radiation-related increase in mortality from the group of long-term tumour-free survivors.

Castration↗

An ultrastructural study on the effects of warm ischaemia on the inosine-protected kidney.

Unperfused, saline-perfused and inosine-perfused rat kidneys were subjected to various times of warm ischaemia with and without resumption of blood flow. Tissues were examined with a transmission electron microscope. Inosine has a protective effect on the epithelial cells of the proximal convoluted tubules, where microvilli are less damaged by ischaemia than those of the proximal convoluted tubular cells of the control animals. Three is also a much higher ratio of autophagic vacuoles to lysosomes present in cells of inosine-treated kidneys, reflecting their ability to sequester and digest organelles damaged during ischaemia and thus protect themselves from degradation products. A major effect of inosine seems to be the preservation of the organelles and rush border of the cells of the proximal tubule during warm ischaemia.

Animals↗

Intravenous inosine for ischaemic renal surgery.

The use of the intravenously administered nucleotide inosine is described for the protection of function in the human kidney undergoing ischaemic renal surgery. The treatment of 7 patients is described. The simplicity of the technique is emphasised.

Creatinine↗

The modified lumbotomy versus the oblique loin incision for renal surgery.

The time to full mobility and total analgesic requirements have been assessed in 40 patients undergoing renal surgery by the oblique loin incision or the posterior lumbotomy approach. By these criteria the lumbotomy group fared better than patients who had oblique incisions. We consider lumbotomy to be a valuable incision which should be in the repertoire of every urologist.

Analgesics↗