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Biomedical subjects

A W Bruce

Publications and source records attributed to A W Bruce.

At least 73 records · Page 4Linked to original sources
PubMed1980

Skin flap technique in formation of urinary conduit stoma.

Stomal stenosis following ileal loop diversion is a significant complication to warrant attention. One of the predisposing factors remains the circular nature of the stoma itself, often in conjunction with chronic skin irritation. Surgical revisions predispose one not only to the usual hazards of operation, but also tend to be multiple or involve extensive surgical reconstruction. A skin flap technique in the initial formation of the stoma avoids the incidence of stenosis related to the circular nature of the stoma. The procedure is simple and does not increase the surgical time. No significant stomal complications developed in 28 patients who had urinary diversions, followed for a mean of 30.6 months.

Adolescent↗
PubMed1980

Immunohistochemical evaluation of prostatic carcinoma before and after radiotherapy.

Immunohistochemical procedures were applied to the examination of human tissues for prostatic acid phosphatase. With antisera against purified human prostatic acid phosphatase 173 normal and neoplastic tissues were tested. Samples of 45 non-prostatic carcinomas and their respective normal tissues were negative. Of 4 seminal vesicles studied 2 showed weak reactivity. The epithelial cells of normal prostatic acini were uniformly positive in 25 patients studied. In contrast to normal prostatic tissue the malignant acini in 53 of 55 patients with prostatic carcinoma had variable but positive reactivity. Of 27 patients receiving radiotherapy for adenocarcinoma of the prostate variable staining was observed in the neoplastic cells of 24, 8 to 52 months after treatment. The continued production of prostatic acid phosphatase in the malignant cells after radiotherapy suggests that they also may maintain metabolic activities necessary for growth and metastasis.

Acid Phosphatase↗
PubMed1980

Frequency of micturition and urinary tract infection.

Introital swabbing was done on each of 19 patients with a history of lower urinary tract infection. The swabs were collected during a 5-day period, with 2 swabs being collected each day. We found that 1) introital flora varied in nature and in number from hour to hour and from day to day, 2) repetitive qualitative swabbing was the most accurate method to determine the presence of pathogens in the introitus and 3) there was a relationship between the frequency of micturition and the presence of introital pathogens: a) normal controls became colonized with pathogens as frequency of voiding was increased and b) pathogen carriage was found more commonly in the patient group as compared to the controls and the patient group voided more frequently than the control group. The theoretical implications of this relationship are discussed.

Female↗
PubMed1980

The role of the radioimmunoassay for prostatic acid phosphatase in prostatic carcinoma.

Considerable controversy exists as to the exact role of prostatic acid phosphatase in the investigation of patients with adenocarcinoma of the prostate. In order to compare different clinical trials, consistent standards of patient selection and staging criteria must be applied on a prospective basis. Other variables which can lead to discrepancies in the results include sources and purification of antigen as well as the analytic accuracy of the immunologic method used. The statistical approach has illustrated the futile outcome of screening an unselected population. On the other hand, if appropriate criteria must be stressed that these estimates have been based on the best possible data available; we have not been able to reproduce either the high sensitivity or specificity reported using three different radioimmunoassays. Therefore, despite the advantages of immunologic methods, we cannot recommend the application of the radioimmunoassay for prostatic acid phosphatase for screening of males for adenocarcinoma of the prostate. At present, no clear explanation can be offered for the elevation of serum prostatic acid phosphatase in patients with apparently localized adenocarcinoma, but it may be of prognostic significance. We have found marked variability in the production of prostatic acid phosphatase by neoplastic acini, and normal levels of prostatic acid phosphatase in patients with metastatic carcinoma may be associated with tumors of limited secretory capacity. Clearly, both the physiologic and methodologic limitations of current radioimmunoassays should be recognized.

Acid Phosphatase↗
PubMed1979

Prostatic acid phosphatase by radioimmunoassay tumor marker in bone marrow.

Bone marrow acid phosphatase was determined by radioimmunoassay and enzymatic analysis in 95 patients with benign prostatic hypertrophy, 50 patients with disseminated prostatic carcinoma and 36 patients with non-prostatic malignancy. The results indicate superior specificity of the radioimmunoassay. A brief review of the topic and the clinical implications are discussed.

Acid Phosphatase↗
PubMed1979

An objective look at acid phosphatase determinations: a comparison of biochemical and immunological methods.

Measurements of serum and bone marrow acid phosphatase were made by 3 enzymatic methods, alpha-naphthyl phosphate, beta-glycerol phosphate, and thymolphthalein monophosphate, and ocmpared to a double antibody radioimmunoassay. Serum and bone marrow acid phosphatase levels were studied in 46 controls with histologically proven benign prostatic hyperplasia and in 135 patients with various stages of prostatic carcinoma. In the control group the upper limit for bone marrow acid phosphatase was found to be significantly higher than the corresponding serum limit with respect to the enzymatic assays studied. The radioimmunoassay was the only method suitable for the analysis of the prostatic acid phosphatase content of bone marrow. A larger number of elevations were noted in patients with extracapsular and metastatic disease when prostatic acid phosphatase measurement was carried out by radioimmunoassay as compared to enzymatic methods. However, only 8% of the patients with intracapsular disease had elevations of prostatic acid phosphatase as measured by radioimmunoassay. Additional standardisation of immunological methods and clinical trials is required before comparison can be made of results from various centres using immunological methods for the measurement of prostatic acid phosphatase and a true assessment made of the usefulness of this procedure.

Acid Phosphatase↗
PubMed1979

Radiation therapy for adenocarcinoma of the prostate.

Forty-eight patients with different stages of adenocarcinoma of the prostate were treated by external beam therapy. Biopsy results are correlated with stage of disease, original grade of tumour and with the findings on examination. The authors discuss the significance of histologic progression of the disease particularly in relation to prognosis. They review the place of staging lymphadenectomy before radiotherapy and the overall morbidity associated with treatment.

Adenocarcinoma↗
PubMed1978

Therapeutic experience with netilmicin.

Netilmicin, a new aminoglycoside antibiotic, was used to treat 19 patients with urinary tract infection and 5 with systemic infection. The causal organisms were Escherichia coli (in 2), Klebsiella pneumoniae (in 4), Serratia marcescens (in 12) and Pseudomonas aeruginosa (in 7); 1 patient was infected with two of these organisms. All the isolates of causal organisms except one of Serratia were initially sensitive to netilmicin but many were resistant to other aminoglycosides. Sixteen of the urinary tract infections responded to netilmicin therapy, although relapse occurred in three patients. Two of the three patients with musculoskeletal infection responded to combined therapy with surgery and netilmicin; the other patient responded to the same regimen but with carbenicillin added. Netilmicin cured pneumonia in one patient but failed in the other patient with pneumonia, who had leukemia. Superinfection occurred in five patients with urinary tract infection. Adverse reactions to netilmicin were minor. Netilmicin may prove to be a useful agent, particularly for infections due to multiresistant Klebsiella or Serratia, or when prolonged aminoglycoside therapy is required.

Adolescent↗
PubMed1978

Adenocarcinoma of the prostate in perspective.

Adenocarcinoma of the prostate is responsible for one of every nine deaths from cancer in Canada. In this review epidemiologic factors are considered and current staging systems are outlined. The American Urological System is recommended for staging because of its ability to reflect changes in the understanding of the biologic behaviour of this neoplasm. The adoption of a quantitative grading scheme is suggested to complement the information obtained from the staging assessment. The routes of spread of this disease, along with the procedures used to assess metastatic involvement, are described. Immunologic methods for the analysis of prostatic acid phosphatase have been shown to be superior to the enzymatic methods previously used, and the role of the new techniques is discussed. Emphasis is placed on radiotherapy and endocrine therapy for the treatment of this neoplasm, and the concept of withholding endocrine therapy until symptoms appear is discussed. Potential future developments in this field are considered.

Acid Phosphatase↗
PubMed1978

Bone marrow acid phosphatase by radioimmunoassay.

A double-antibody radioimmunoassay was developed and utilized to measure prostatic acid phosphatase in bone marrow aspirates. One hundred-eighteen patients with carcinoma of the prostate in various clinical stages, and fifty with benign prostatic hyperplasia were studied. In patients with carcinoma, levels of prostatic acid phosphatase in bone marrow aspirates were found to correlate well with increasing clinical stage of the disease. Determination of bone marrow prostatic acid phosphatase by radioimmunoassay may be a valuable adjunct to clinicopathologic staging of prostatic carcinoma.

Acid Phosphatase↗
PubMed1978

Cystourethritis.

We believe this review lists the major factors and mechanisms considered responsible for producing cystourethritis. Knowledge of these factors and mechanisms is essential before effective investigation of this disease can be undertaken. We suggest a rational scheme for investigation of these patients. We believe successful treatment depends on establishing the probable cause in each individual patient. In view of the multifactorial etiology of the disease, attempts to find a single effective medical or surgical therapy will be doomed to failure.

Bacteriuria↗
PubMed1978

Urethral pressure profile in female stress incontinence.

The accuracy of the urethral pressure profile as a measure of sphincteric competence was examined in female subjects. Most profile measurements selected proved to be significantly different in patients with stress incontinence from those in controls. However, the measurement that seemed to have the highest potential for diagnostic accuracy was the maximum closure pressure in the continence zone, recorded with the bladder full and the patient standing. The concept of the continence zone and incorporating the effect of standing were believed to be the main reasons for this high accuracy. The second best measurement was the maximum closure pressure with the bladder full and the patient surpine. To lessen the chances of a diagnostic error it was recommended that both of these measurements should be obtained. The physiological implications of these findings and the clinical role of the urethral pressure profile examination in the assessment of female patients with urinary incontinence are discussed.

Adult↗
PubMed1978

Two-point determination of plasma ammonia with the centrifugal analyzer.

A simple, convenient, and rapid method for determining ammonia in plasma by the glutamate dehydrogenase reaction is described for the centrifugal analyzer. The measuring principle is fixed-time, with NADH as the coenzyme. ADP is added to stabilize glutamate dehydrogenase and prevent interference from endogenous plasma ADP. The reaction is linear to 400 mumol of ammonia per liter. The plasma sample volume is 100 microliter and the whole procedure takes only 25 min, including the 15-min preincubation. The normal range for venous plasma was 44 +/- 13.5 (SD) mumol of ammonia per liter.

Ammonia↗
PubMed1977

Intestinocystoplasty in treatment of interstitial cystitis.

Nine cases of interstitial cystitis treated by intestinocystoplasty are reviewed. The longest follow-up is seventy-eight months. Two patients have since died of unrelated causes. The results reveal seven symptomatic cures and two failures. Long-term renal and vesical function have been well maintained.

Adult↗
PubMed1977

The treatment of the uninhibited bladder with dicyclomine.

Symptomatic treatment of the uninhibited bladder has presented a challenge because of the lack of an effective, well tolerated smooth muscle relaxant for the bladder that can be used during an extended interval. In a preliminary study oral dicyclomine produced resolution or significant improvement of symptoms in 24 of 27 patients and an increase in bladder capacity by an average of 137 plus or minus 26 ml. (91 plus or minus 22 per cent) after 8 weeks of therapy. Additional controlled trials definitely are warranted.

Administration, Oral↗
PubMed1977

Carcinoma of the prostate: a critical look at staging.

To stage accurately the extent of the disease comprehensive investigations were done on 75 patients with histologically documented carcinoma of the prostate. Estimation of bone marrow acid phosphatase appears to be the most sensitive test to detect blood-borne metastases. Serum acid phosphatase appears to be of little value in the detection of early blood spread and may have a role only in monitoring the effect of treatment on advanced disease. Bone scanning with technetium compounds has the disadvantage of non-specificity but has far greater sensitivity than a skeletal survey. Bone marrow cytology was not rewarding in the detection of early metastatic disease. Pedal lymphangiography is a highly inaccurate method to detect lymphatic spread of carcinoma of the prostate and pelvic lymphadenectomy, when indicated, remains the only truly adequate method to assess lymph node involvement. There was a 37 per cent incidence of metastatic lymph node pathology in 30 patients undergoing this procedure before either radical prostatectomy or deep x-ray therapy. A close correlation was found between stage and grade of disease and incidence of nodal pathology. There was some correlation between degree of nodal involvement and evidence of blood spread as detected by elevated bone marrow acid phosphatase levels. The significance of this finding remains unclear.

Acid Phosphatase↗
PubMed1976

Urethral response to latex and Silastic catheters.

The reaction of the urethral mucosa to latex and Silastic catheters was compared in two groups of patients undergoing prostatectomy. The bacteriologic response in the two groups differed little; however, Silastic catheters produced less cellular reaction than latex catheters.

Catheters, Indwelling↗