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Biomedical subjects

W W Bonney

Publications and source records attributed to W W Bonney.

At least 19 recordsLinked to original sources

Preliminary report: detrusor hyperreflexia in schizophrenia.

The object of this study was to demonstrate detrusor hyperreflexia (DH) in schizophrenic patients. Twelve consecutive schizophrenic patients were evaluated by DSM-IIIR diagnostic criteria and other standard psychiatric measures, urological history and examination, and urodynamic study. All were referred for clinical indication, voiding dysfunction, or incontinence. Two patients were excluded for confounding variables, mental retardation and benign prostatic hypertrophy. Of the ten evaluable patients, four had DH. Detrusor hyperreflexia does occur in a subset of schizophrenic patients, even in the absence of other recognized disease to explain the occurrence. This relationship, previously unreported, warrants further investigation.

Adult

Basis of severity grade in detrusor hyperreflexia.

For both treatment and research it is useful to classify detrusor hyperreflexia/instability according to degree of severity, because it relates to symptomatic impact. However, there has been no systematic evaluation of criteria for severity assignment. This report compares patient classification by urodynamic data according to 3 methods: arbitrary criteria, a severity index, and an empirical cluster analysis. Within the primary urodynamic data there were no natural groupings as a basis for division into discrete patient groups. By all three methods, however, severity level did relate to symptoms.

Adolescent

Crypt cell thymidine incorporation in ileal urinary pouch. Preliminary report.

This is a brief communication about mucosal change in ileal urinary reservoirs, the earliest reported observations to date. Previous authors described early villous atrophy and crypt elongation, late panmucosal atrophy and metaplasia. Crypt cell proliferation should be a forerunner of these events and therefore warrants quantitative measurement. We studied continent pouches in dogs on postoperative days 42 and 43 using in vivo tritiated thymidine incorporation into crypt cell DNA, a novel application of autoradiography for urinary reservoirs. Adjacent normal ileum provided the internal control. Increased crypt cell thymidine incorporation was confirmed at this early time.

Animals

Topical effect of intravesical oxybutynin.

Intravesical oxybutynin was instilled into rat bladders in graded doses by repeated catheterization to study the local bladder effects of drug concentration and incidental urinary infection. On the thirteenth day, after 5 doses, bladders were recovered for measurement and histological study. In the highest dose group, systemic absorption from the bladder caused weight loss and cachexia. However, in no group was there any clear evidence of drug-related mucosal or bladder wall change. Instead, the two high dose groups seemed somehow protected from the combined adverse effects of catheterization and infection.

Administration, Intravesical

Absorbable staples in continent ileal urinary pouch.

Continent ileal urinary reservoirs were created in dogs to study absorbable surgical staples. Within each pouch, certain controlled observations were possible. The staples and chemically similar polyglactin absorbable sutures caused almost identical tissue reactions. The staples outlasted the sutures, probably because of greater size. Inverted and everted staple closures worked equally well. It appears feasible to consider clinical urinary diversion with absorbable staples, a time-saving method.

Animals

Yield of cancer tissue from prostatic needle biopsy.

This study concerns the quality of human prostatic cancer needle biopsy specimens for routine diagnosis and for bioassay. We examined routine hematoxylin and eosin-stained microscopic sections from 20 prostatic cancer patients, 159 needle cores in all, 71 positive for tumor. Linear core measurements were made with a calibrated ocular micrometer, each segment counted positive if it contained any tumor. Among all subjects there were 35.5 cm of tumor-bearing core length, 26 per cent of the total core length but 60 per cent of the length if completely negative cores were excluded. From these data we calculate a 91 per cent probability of detecting any cancer present if at least 4 cores are taken.

Adenocarcinoma

Stability of sublines in the R3327-H rat prostatic tumor.

Over several years of in vivo maintenance passage the R3327-H rat prostatic tumor has given rise to nine unique sublines in our laboratory. Some have emerged under selective treatment pressure while others apparently represent spontaneous or random modulation. Each new subline embodied an altered histology, growth rate, metastatic pattern or treatment sensitivity in comparison to its parent subline. However, each has been subsequently passaged enough times to provide evidence of considerable phenotypic stability, a notable point in view of the R3327 tumor's well known potential for modulation.

Animals

Cryotherapy.

Since 1969 cryosurgical perineal destruction of the prostate has been developed at the University of Iowa for treatment of patients with prostatic cancer. The technique of this procedure has been the subject of previous reviews. This is a summary of our experience of patient survival and the effect on local prostatic cancer growth in those patients with various stages of the disease subjected to perineal cryosurgical destruction of their cancer. We also report briefly on our experience in the laboratory where the Dunning tumor model is used to study the effect of cryosurgery as well as combinations of immunological modifications.

Adult

Cryosurgery in prostatic cancer: elimination of local lesion.

From 1969 through 1976, we performed cryosurgery in 229 cases of prostatic cancer. Most of these patients had bulky, locally extensive primary tumors, and one-half had disseminated disease. Through the open perineal approach, which gives exposure for an adequate freeze, cryosurgery has been well tolerated. The primary surgical goal has been to reduce or eliminate the local lesion to minimize subsequent cancer-related lower urinary tract problems and to cure those patients with truly localized disease. In every case cryosurgery produced dramatic shrinkage of the local lesion. After four to eight weeks a local recurrence was suspected in 13 per cent, and 41 per cent eventually had some evidence of a recurrent cancer nodule or persistent cancer in the bladder neck. In a series of statistical analyses we have related these recurrences to other clinical factors. Cryosurgery has been a safe, effective way to reduce or eliminate the primary prostatic cancer, even in patients with large local lesions.

Aged

Cryosurgery in prostatic cancer: survival.

From 1969 through 1976 we performed cryosurgery in 229 cases of prostatic cancer. This article presents survival in cryosurgery and other treatment groups. In every stage, despite a preponderance of large primary tumors and poor-risk patients, cryosurgery matched total prostatectomy and compared favorably to other modalities, including radiation therapy, at our center and elsewhere. According to previous authors, and in view of the present data, eradication of the local lesion is associated with better survival even in advanced cases. Cryosurgery provides a safe, effective method.

Aged

Penile prostheses for the treatment of impotence.

Eighty-nine patients were treated for impotence with penile prostheses. The Small-Carrion prosthesis was used in 56 patients, the inflatable prosthesis in 27 and Pearman's prosthesis in 6 patients. The overall functional results with the Small-Carrion and inflatable prostheses were comparable.

Adult

Urinary cytology and bladder biopsy in patients with bladder cancer.

Two hundred fifty patients with bladder tumor were evaluated over a three-year period. Cystoscopy, cytology, and random bladder and tumor biopsy were part of the workup. The follow-up of these patients resulted in a total of 509 cystoscopies, 772 specimens of bladder washings and urinary cytologies, and 503 tumor or selected mucosal biopsies. The value of cytologic study of bladder washings and cystoscopic urine samples as well as the importance of selected site mucosal biopsies in detecting "field changes" in the bladder epithelium associated with bladder tumors are discussed.

Biopsy

Biopsy and clinical course after cryosurgery for prostatic cancer.

Open perineal cryosurgical prostatectomy has been reported previously in 154 consecutive prostatic cancer patients at our center. In 37 of these patients post-cryosurgery biopsies of the prostate were obtained. In the present report we compare this tissue to the preoperative biopsies. The data suggest that well differentiated cancers are associated with advantageous survival in cryosurgery patients. Lymphoid and eosinophilic cell infiltrates may represent post-cryosurgical local immune responses, with improved survival. Estrogen therapy seems to suppress this local immune response. One month or more after cryosurgery cancer in the biopsy correlates with palpable local recurrence but prior to 1 month it does not correlate. Cryosurgery by the open perineal approach has been an effective method to eliminate the primary lesion in localized and extensive prostatic cancer.

Biopsy

Computed tomography of the pelvis.

The computed tomography scan has revealed the location and size of abnormal pelvic masses as an adjunct to other diagnostic studies. We have extended its usefulness by air distension of the bladder, which accommodates to adjacent structures and, therby, highlights abnormalities in its own wall and in other organs. The patients are prepared according to a simple routine. As we attempt further economy and efficiency the cost of each study becomes justified by the information gained.

Adenocarcinoma

Immunostimulation by cryosurgery: an orthotopic model of prostate and bladder cancer in the rat.

In patients with prostate cancer, cryosurgery has been highly effective in eradication of the primary tumor. Certain clinical observations have suggested the presence of an additional systemic anticancer effect, presumably immunologic in nature, but proof is lacking. To study this problem further, we developed two animal tumor models. Instead of using the classical subcutaneous site, we transplanted the 11095A and R-3327 prostate tumors into rat prostate, the 4909 bladder tumor into rat bladder. In these respective orthotopic locations, the 3 tumors displayed favorable growth characteristics with good accessibility for cryosurgery. This model should be considered for studies involving any localized treatment of an established urologic tumor.

Adenocarcinoma

Rat prostate carcinoma 11095-A: profile of organ- and tumor-specific antigens.

The 11095-A squamous cell tumor is a transplantable prostate carcinoma of the F344 rat. No tumor-specific antigens could be demonstrated for this carcinoma by serologic tests or in host protection experiments. Preliminary data from two other assay systems indicate that tumor-specific antigens may be weakly expressed in this model.

Animals