Biomedical subjects
Publications and source records attributed to A G Tulloch.
A multidisciplinary study group was established to assess impotent patients. One hundred and forty-eight patients were fully assessed and 25 potent volunteers underwent measurement of nocturnal penile tumescence (NPT). This report describes the selection process and results of surgical implantation of the American Medical Systems (AMS) inflatable and the Jonas silver-silicone prostheses.
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The effects of propantheline and imipramine on detrusor function and salivary gland secretion were studied in the dog. Both drugs caused a decrease in the rise of intravesical pressure following pelvic nerve stimulation in the anaesthetised dog. Propantheline had a profound effect on the salivary gland, whereas imipramine had very little effect on the volume of saliva produced after electrical stimulation of the chorda tympani. This suggests that the action of imipramine on the bladder is not anticholinergic. The significance for treatment of detrusor dysfunction is discussed.
Fifty new cases of carcinoma of the prostate were assessed prior to treatment to determine the incidence of bony metastases. The radioisotope bone scan was the most sensitive method of detecting metastases and of localising them. It was twice as accurate as the serum acid phosphatase estimation. Skeletal X-rays were the least accurate method. Forty-six per cent of patients had abnormal bone scans at presentation. The histological grade of the tumour correlated well with the bone scan. The higher the grade, the more likely was the bone scan to be abnormal. There is need for greater accuracy in detecting metastases, and the bone marrow acid phosphatase estimation, either alone or in conjunction with the bone scan, may provide this accuracy.
Pelvic nerve stimulation caused an increase in pressure in both the urethra and bladder of anaesthetised dogs. The increases were only partially blocked by intravenous injection of atropine and were not significantly reduced by phentolamine, propranolol or methysergide. Quinidine produced some reduction in the bladder but not the urethral response. Hexamethonium reduced but did not abolish the responses to pelvic nerve stimulation. Close arterial injection of acetylcholine and 5-hydroxytryptamine increased the bladder and urethral pressures; noradrenaline produced a biphasic increase in urethral pressure but had no effect on the bladder; ATP increased bladder pressure but the response of the urethra was variable. The results indicate that some fibres in the pelvic nerve to the urethra as well as to the bladder are atropine resistant and suggest that transmission does not involve 5-hydroxytryptamine or noradrenaline and probably not ATP. The significance for treatment of detrusor dysfunction is discussed.
Pressure recordings within the bladder, proximal (U1) and middle (U2) thirds of the urethra have been monitored in anesthetized female mongrel dogs before and just after being made paraplegic, i.e., during the period of spinal shock. In the intact animal, parasympathetic stimulation produces uninhibited waves whereas U2 pressure remains unchanged; during spinal shock, it produces a small rise of intravesical pressure, without uninhibited waves but with a marked increase in U2 pressure. This may explain why bethanechol chloride is not effective in producing bladder emptying during spinal shock. Stimulation of the beta-receptors of the synpathetic nervous system and blockade of the alpha-receptors both singly and in combination produce urethral "sphincter" relaxation during spinal shock. This might allow bladder evacuation during spinal shock with the Credé maneuver or abdominal straining.
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In an experimental canine model, topical application of phenylephrine hydrochloride (Neo-Synephrine) to the urethral mucosa was demonstrated to cause a rise of intraurethral pressure which persisted for over 2 h without any rise of arterial pressure. There was no intraurethral pressure change after the topical application of phentolamine (Regitine) or phenoxybenzamine (Dibenzyline). No effect was observed on the intraurethral pressure following isoprenaline (Isuprel) application, but a marked fall in arterial pressure was observed.
The sympathetic activity was investigated by recording the fall of internal sphincter pressure produced by a dose of phentolamine (Regitine) which completely abolished all alpha adrenergic sympathetic activity. It was found that when the bladder was empty, the mean fall of internal sphincter pressure was 7.1 cm, water; but when the bladder was partially filled, the mean fall was 17.6 cm. water. After use of reserpine, which creates a "pharmacologic sympathectomy," no sympathetic activity was demonstrated.
During experimental spinal shock, the urethral muscle responded to drugs earlier than the detrusor muscle. Stimulation with parasympathomimetic drugs caused some rise in intravesical pressure, but an unexpected and much greater rise of intraurethral pressure. Bladder evacuation was achieved with the Credé manoeuvre during spinal shock with the combined effect of alpha adrenergic blockade and beta adrenergic stimulation.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.