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Biomedical subjects

D F Badenoch

Publications and source records attributed to D F Badenoch.

At least 37 records · Page 2Linked to original sources
PubMed1990

Microbiological study of bladder tumors, their histology and infective complications.

The microbiology of bladder tumors and the infective complications of transurethral resection (TURBT) were studied prospectively in 51 patients. Patients taking antimicrobials were excluded. Those with significant preoperative bacteriuria were included in the study when results of the preoperative urine specimen were unavailable at the time of operation. Infected tumors were found in 18 percent of males and 75 percent of females. A wide range of bacteria, including anaerobes, was isolated; when streptococci or coliforms were cultured from the tumor, they were always found in significant numbers in the preoperative urine specimen. Perioperative bacteremia and postoperative complications requiring parenteral antibiotics were more common in females and in patients with significant preoperative bacteriuria. No correlation was found between tumor infection and histologic grade or stage of tumor. Patients with sterile preoperative urine and positive bacterial cultures from tumors were no more likely to have postoperative urinary tract infections than those with negative tumor cultures.

Aged↗
PubMed1990

Sperm motility, velocity and migration.

Four different methods for evaluating sperm motility were analysed for experimental error: subjective assessment of a wet film preparation, sperm velocity measured by time-lapse photography, sperm velocity measured by computer analysis and sperm migration across a nucleopore membrane. Subjective assessment of motility was found to be inaccurate, within single observer and between 2 observers. Both methods of measuring mean sperm velocity were accurate, particularly that using the computer analysis system; a high technical failure rate was found using time-lapse photography. Sperm migration across a nucleopore membrane was found to be highly inaccurate. Two groups were then analysed for the predictive value of these tests (excluding sperm migration): 104 proven fertile men and 53 infertile men. Although subjective motility was able to predict from which group the sample came at optimum cut-off with 78% accuracy, computer analysed sperm velocity could predict with overall 91% accuracy at optimum cut-off. Computer analysis of sperm velocity offers a rapid, objective and predictive assessment of sperm function.

Humans↗
PubMed1990

Sperm morphological analysis: comparison of two methods in human semen.

Sperm morphological analysis was performed by 2 methods: light microscopy on Papanicolaou stained material and scanning electron microscopy. Both methods were found to have acceptably low levels of observer error and a positive correlation existed between them. Sperm morphology was analysed by both methods in 2 groups: (1) 104 proven "fertile" men, husbands of women who had just given birth and whose paternity had been proven by HLA studies with greater than 95.5% certainty; (2) 53 infertile men from primary infertile marriages in whom no female cause could be found and excluding those with azoospermia. There was no statistically significant difference in medians between the 2 groups when sperm morphology was analysed by light microscopy, but analysis by scanning electron microscopy did show a significant difference.

Humans↗
PubMed1989

Transitional cell carcinoma of the renal pelvis and ureter.

In a retrospective study of 185 patients with transitional cell carcinoma of the renal pelvis and ureter, of whom 127 were treated by total nephroureterectomy and 58 by conservative resection, the survival of those with superficial well differentiated tumours was greater than 90% in each group. When urothelium was left behind after conservative resection, there was a 22% rate of recurrence on the same side but this almost only occurred when the original tumour had been multifocal. Post-operative radiotherapy did not improve survival.

Adult↗
PubMed1989

Sperm density measurement: should this be abandoned?

Sperm density measurement by means of the Makler chamber was performed on a single semen specimen from 2 groups: 104 proven fertile men and 53 infertile men; 11.5% of the fertile population had a sperm density less than 20 million/ml (median 84, mean 91.3, SD 60.5) and 33% of the infertile population had a sperm density greater than 20 million/ml (median 10, mean 26.9, SD 34.8). There was a statistically significant difference in median between the 2 groups, but when a discriminant analysis was applied, sperm density could predict fertile status with only 68% accuracy at optimum cut-off. Sperm density is valueless in distinguishing fertile from infertile men and is neither useful in diagnosis nor in monitoring the progress of treatment for male infertility. It should be abandoned as a quotable measurement of male fertility.

Adult↗
PubMed1988

Reappraisal of the role of radical radiotherapy and salvage cystectomy in the treatment of invasive (T2/T3) bladder cancer.

One hundred and eighty-two patients with invasive (T2/T3) bladder cancer were treated by radical radiotherapy at the London Hospital between 1974 and December 1985. Cystectomy was reserved for patients whose tumours either did not respond completely to radiation or recurred later, provided they were fit for surgery and had not developed distant metastases. The overall corrected 5-year survival rate was 40%; 75 patients responded to radiation and did not relapse during the period of follow-up; 20 patients had an initial response to radiation but subsequently relapsed, with a 5-year survival rate following relapse of 20%. Of these, 11 patients had a cystectomy with a 5-year survival following relapse of 36%, whereas all 9 patients who did not have a cystectomy died within 3 years; 87 patients who did not respond to radiation had a 5-year survival rate of 18%. Of these, 22 patients underwent salvage cystectomy with a 5-year survival of 47%, whereas the 65 patients who did not have a cystectomy had a 5-year survival of 3%. These results justify a policy of radical radiotherapy and salvage cystectomy rather than elective cystectomy in the treatment of invasive bladder cancer.

Adult↗
PubMed1988

Chemotherapy for carcinoma in situ of the bladder.

In an 8-year period, 71 patients were diagnosed as having carcinoma in situ of the bladder. Twenty patients with primary carcinoma in situ were treated with systemic cyclophosphamide or intravesical mitomycin C and 19 of them survived 3 years. Three patients required cystectomy: 1 for invasive cancer and 2 for intractable symptoms in the absence of tumour. Fifty-one patients had either secondary or concomitant carcinoma in situ. Systemic or intravesical chemotherapy was given to 28 patients in whom carcinoma in situ was associated with G1 or G2 exophytic superficial tumour: there was only one cancer death in 3 years. Fifteen patients with G3 carcinoma in situ associated with a G3 or invasive exophytic tumour were treated with radiotherapy: 9 responded but 4 of the 6 with radio-insensitive tumours died of cancer within 3 years. Eight patients with secondary carcinoma in situ were managed by transurethral resection alone: in 6 there was spontaneous regression and 2 developed muscle invasion within 1 year. These results compare well with those of immunotherapy or early radical surgery and suggest that chemotherapy should be given a trial in patients with carcinoma in situ.

Administration, Intravesical↗
PubMed1988

Administration of a gonadotropin releasing hormone analogue in oligozoospermic infertile males.

This study investigated the stimulatory potential of a superactive gonadotropin releasing hormone analogue in idiopathic oligozoospermia. In a double-blind trial, 19 men were randomized to receive buserelin (D-Ser(TBU)6-GnRH ethylamide) in one of two dosages or saline, twice weekly, for twelve weeks. Treatment did not lead to a significant increase in serum concentrations of the pituitary gonadotropins or in sperm concentrations. However, in the dosages and schedules investigated, there was no inhibitory effect of the analogue. Further assessment of this approach is suggested.

Buserelin↗
PubMed1987

Early repair of accidental injury to the ureter or bladder following gynaecological surgery.

Operative injury to the ureter or bladder in 59 women who had received no previous pelvic radiotherapy was repaired as soon as possible after referral. In 32, this was less than 6 weeks from the injury, while in 27 patients the delay in referral was greater than 6 weeks. Ureteric injuries in 40 patients (43 ureters) were repaired by the Boari-Ockerblad technique. Post-operative vesicovaginal fistulae in 19 women were repaired transvesically with an omental patch. Primary healing was obtained in all cases whether early or late. These results support our recommendation for early intervention in these injuries.

Female↗
PubMed1987

Oral ciprofloxacin as prophylaxis in transurethral resection of the prostate.

A new quinolone antibacterial, ciprofloxacin, was evaluated as oral prophylaxis for transurethral resection of the prostate in a randomised controlled trial. A 3-day course of perioperative ciprofloxacin 250 mg twice daily reduced the post-operative infection rate, the post-operative hospital stay and the frequency of infective complications. Ciprofloxacin was well tolerated and no significant haematological or biochemical side effects were detected.

Bacteriuria↗
PubMed1987

Oral ciprofloxacin as prophylaxis for optical urethrotomy.

It is known that urethral strictures predispose to bacteriuria. We studied a series of patients undergoing optical urethrotomy to see if antibiotic prophylaxis was justified. Twenty-three patients were randomised to receive either no prophylaxis or a short peri-operative course of oral ciprofloxacin. Two patients with sterile pre-operative urine and two patients with pre-operative bacteriuria given no prophylaxis had post-operative bacteriuria, whereas all patients given ciprofloxacin had sterile urine after operation. Antibiotic prophylaxis may be indicated in patients undergoing optical urethrotomy.

Adult↗
PubMed1985

Perineal nerve damage in genuine stress urinary incontinence. An electrophysiological study.

Twelve patients with genuine stress incontinence of urine were investigated using manometric and electrophysiological techniques. All were shown to have slowed conduction in the perineal branch of the pudendal nerve which innervates the periurethral striated sphincter muscle. The mean perineal nerve terminal motor latency in these patients was 3.9 +/- 0.8 (ms) and in 20 age and parity matched control subjects was 2.0 +/- 0.2 (ms) (P less than 0.001). These results are consistent with a neurogenic factor in patients with genuine stress incontinence of urine which may have implications regarding selection of patients for surgery to restore urethral competence.

Adult↗
PubMed1985

DNA content of human semen--an objective measurement of sperm density.

In this study we have adapted a well tried and sensitive fluorometric assay for DNA that uses m-diamino benzoic acid (DABA) for its reaction with deoxyribose which is cleaved by perchloric acid from DNA. We have confirmed that this is easily measured in human semen. The method has been used on 200 samples of semen from patients attending the Infertility Clinic and men attending before and after vasectomy to give a wide range of sperm density. The objective DNA estimation has been compared with sperm density measurement made by an experienced laboratory observer using the Makler chamber and making his observations in ignorance of the DNA estimations. There was good correlation between DNA concentration and sperm density. The experimental accuracy of the two methods was found to be comparable. The advantage of the method is its objectivity. However, its disadvantages are its cost in terms of time and material and it cannot be used to confirm post-vasectomy azoospermia because the method also measures DNA in leucocytes.

DNA↗