Biomedical subjects
G D Chisholm
Publications and source records attributed to G D Chisholm.
The use of 123I labelled oestradiol in detecting the human prostate using a gamma camera.
123I labelled oestradiol was administered into patients with either benign hypertrophy or malignancy of the prostate, in order to detect the prostate. Using a gamma camera the results showed considerable radioactivity in the bladder-prostate region. The exact anatomical position of the prostate was determined by emptying the bladder and introducing 123I labelled sodium iodide into the balloon of the catheter already inserted in the bladder. The results demonstrated that the detected radioactivity in this region was in the bladder rather than the prostate. This conclusion was later confirmed by the presence of high level of the radioactivity in the urine and the extremely low concentration of the radioactivity in the prostate after the removal of the gland.
Uptake and distribution of 3H testosterone in tissues of male Praomys (Mastomys) Natalensis: an in vivo and in vitro study on the prostate.
Following the administration of labelled testosterone into 4-6 month old intact, or 24 h orchiectomized Praomys (Mastomys) Natalensis, the uptake of radioactivity by the prostate and other tissues was measured at different intervals. Two hours after the injection of the hormone, the concentration of radioactivity in the prostate was significantly higher than in most of the other organs, but less than that of the liver and kidney. Most of the radioactivity taken up by the liver and kidney disappeared 8-16 h after the administration of the hormone. Orchiectomy enhanced the uptake of the radioactivity by the prostate. Administration of unlabelled testosterone prior to the injection of labelled hormone or the addition of unlabelled testosterone in the incubation media significantly reduced the uptake of radioactivity by the prostate. These changes did not occur in the non target tissues. In an in vitro system prostatic tissue took up significantly more radioactivity than the diaphragm. These findings have been compared with the results of the similar experiments reported on the prostate of the male rat and the female Mastomys.
Bladder dysfunction and neuropathy in diabetes.
Established urodynamic and electrophysiological techniques have been applied to assess the frequency and extent of autonomic and peripheral neuropathy in 60 subjects with diabetes mellitus; 38 were diabetics with suggestive symptoms and the others were representative newly diagnosed (11) or treated (11) diabetics. Objective evidence neuropathic bladder dysfunction was detected in 43 of them (71.7%). The commonest abnormality was a hypotonic, insensitive large capacity bladder, which condition was usually asymptomatic. Less freuqently (15%) was this complicated by bladder decompensation and sphincter involvement, resulting in excessive residual urine and infection; some of these had bladder paralysis with chronic painless retention of urine (7%). Electrophysiological studies found a sensory defect in the lower limbs in all tested patients (100%), and in 41 patients (69%) as associated motor conduction abnormality, which was more frequent and marked in the lower than the upper limb. These functional abnormalities appeared to be related to the severity of diabetes, but less to its duration. Indeed of 11 newly diagnosed diabetics tested 7 had a peripheral neuropathy and 4 urodynamic abnormalities. The high incidence of bladder dysfunction and peripheral neuropathy in this series indicates the frequency of subclinical diabetic neuropathy and a factor needing more emphasis in diabetic uropathy.
Intracellular localisation of 5alpha-dihydrotestosterone in human benign prostatic hypertrophy.
When slices of benign hypertrophied human prostate and abdominal muscle were incubated with either [3H]testosterone or 5alpha-dihydro[3H]testosterone, the uptake of radioactivity by prostatic tissue was significantly higher than that of the muscle (P less than 0.01). The uptake of labelled androgen by prostatic tissue could be significantly reduced by adding the unlabelled steroid to the incubation medium. After the incubation of prostatic tissue with 5alpha-dihydro[3H]testosterone, the amount of the radioactivity taken up by the whole homogenate and the nuclear preparation of the prostatic tissue were measured. DNA content of the nuclei and the whole homogenate was also estimated. The mean+/-S.E.M. of 5alpha-dihydrotestosterone associated with the nuclei was 65+/-4.4%, ranging from (52.2-79.8%). The activity of acid phosphatase was measured in 30 samples of prostatic tissue. The mean +/- S.E.M. was 20.7+/-1.5 U/g tissue (9.8+/-0.9 U/mg DNA). The correlation between the activity of this enzyme and the uptake of androgen by prostatic tissue is evaluated.
Preventing casualty wound infection.
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Lymphography and pelvic lymphadenectomy in carcinoma of the prostate.
20 of 45 new patients with prostatic carcinoma have undergone lymphography and lymphadenectomy to determine the N-category. The overall accuracy of lymphography was 75%. Lymphadenectomy was a safe procedure with minimal morbidity. Although it would be premature to recommend its universal adoption in the management of this disease, its further application and study seems desirable. Full TNM classification has proved to be of considerable value in the management of these patients. This study confirms that 50% of T3 MO tumours are free of lymph node metastases.
Serum 5alpha-dihydrotestosterone and testosterone changes with age in man.
Serum 5alpha-dihydrotestosterone (DHT) and testosterone (T) were measured in 98 normal adult men aged between 20-80 years, separating T and DHT by thin layer chromatography and using a sensitive and reliable radio-immunoassay. In three age groups between 20-40, 40-60 and 60-80, the means +/- SEM for serum DHT were 84 +/- 4, 79 +/- 3 and 67 +/- 3 (ng/100 ml) respectively. The corresponding values for testosterone were 559 +/- 25, 491 +/- 25 and 475 +/- 28 (ng/100 ml). A significant decrease was observed in the DHT level of the 60-80 years age group compared to either the 20-40 (P less than 0.01) or the 40-60 (P less than 0.02) age groups. There was a moderate decline in the testosterone level of the 60-80 years age group compared to 20-40 years (P less than 0.05) but there were no significant changes in the testosterone levels between other groups.
Proceedings: Serum androgens in male and female Praomys (Mastomys) natelensis.
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Serum testosterone and dihydrotestosterone changes with age in rat.
Serum testosterone (T) and 5alpha-dihydrotestosterone (DHT) were measured in young, adult and old Albino Wistar male rats using a sensitive and reliable radioimmunoassay, after separating T from DHT by thin layer chromatography. The mean plus or minus S.E.M. for T in young, adult and old rats were 62 plus or minus 11, 250 plus or minus 27 and 125 plus or minus 25 (ng/100 ml) respectively. Serum T was increased in adults (P less than 0.001) and decreased in old rats (P less than 0.01). The mean plus or minus S.E.M. for serum DHT was 8 plus or minus 2, 19 plus or minus 2 and 17 plus or minus 1 (ng/100 ml) for young, adult and old rats respectively. DHT was increased in adults (P less than 0.001), but did not change in old rats.
The nonsurgical treatment of prostatic carcinoma.
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T.N.M. classification for urological tumours (U.I.C.C.) - 1974.
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Identification of a prostate in female praomys (Mastomys) natalensis using 3-H steroids.
The female of the species Praomys (Mastomys) Natalensis has a ventral prostate similar both in position and in histological appearance to the ventral lobe of the male prostate. The hormonal uptake of this female prostate has been investigated using (3-H) testosterone and (3-H) oestradiol. The results showed that the uptake of these steroid hormones by the prostate was identically to our findings in the male prostate. The potential value of a female prostate in prostatic research is discussed.
Serial Fluorine-18 bone scans in the follow-up of carcinoma of the prostate.
74 patients with prostatic cancer were studied annually by combined radiological and fluorine-18 scan survey over a 5-year period. The results of the long term follow-up of bone cans is reported. At the time of the initial diagnosis 71-5% of the patients had advanced disease and 56% had radiological or scan evidence of metastases. A critical evaluation of the scans resulted in the detection of early bone lesions in 25% of patients with no radiological evidence of metastases. Follow-up of these patients has shown that scan abnormalities preceded radiological changes from between 1 to 4 years and there was good correlation proven histologically by bone biopsy or autopsy in more than half of the patients. In patients with a positive bone scan and positive X-rays the scan abnormalities were more extensive than the corresponding X-ray lesions. When bone healing occurred with endocrine treatment this was more readily apparent on the X-rays. False negative scans were not seen with fluorine-18 which allows for greater accuracy in the detection of skeletal metastases. Bone scanning has enabled correct staging to be carried out. This study confirms the high incidence of cardiac and vascular complications in patients treated with oestrogens.
Stone screening and follow-up are necessary?
In a series of 120 patients with renal stones 60% were found to have a treatable metabolic abnormality. Idiopathic hypercalciuria and the incomplete form of renal tubular acidosis were the two most common abnormalities. Both conditions in the untreated form were associated with an unacceptably high stone recurrence rate and incidence of change. In view of this, follow-up is considered essential and if medical treatment is to be offered this should be in the form of a controlled clinical trial.
Flat carcinoma in Situ of bladder.
36 patients with flat carcinoma in situ of the bladder have been reviewed. Those with widespread disease usually presented with dysuria or obstructive outflow tract symptoms and radical surgery appeared to give better results than radiotherapy. However, when the lesion was confined to small areas of the bladder mucosa, haematuria or pain were the main presenting symptoms and a conservative approach seemed justified. It is suggested that the term flat carcinoma in situ be used for this lesion whose behavior differs significantly from that of the commoner papillary or invasive tumours. The pathological appearances are to be reported elsewhere in full.
Urinary infection and prostatectomy.
The incidence of urinary infection before and after operation for benign prostatic hypertrophy has been reviewed in 140 patients. Repeated screening for bacteriuria was used throughout the hospital admission. Infection was present in 24% before operation and there was a significant correlation between the incidence of infection and the duration of preoperative catheterisation. Postoperative infection developed in 31% and there was no relation between this incidence and the type of prostatectomy; specific antibacterial therapy was significantly more effective in eradicating urinary infection acquired after operation than before. At the time of discharge from the ward, 10% had infected urine, but only 3% of patients had persistent infection at follow-up 6 weeks after operation.
5alpha-dihydrotestosterone stimulation of human prostate in organ culture.
Explants of human benign hypertrophied prostate were cultured for 8 days. The effect of 5alpha-dihydrotestosterone on the morphology, DNA and glucose utilization of 14 cases was investigated. In four cases proliferation was clearly more extensive in the dihydrotestosterone-treated explants than in the controls. In six explants, there were no morphological differences between those cultured with or without dihydrotestosterone and in half of these, proliferation was present. Four explants were either necrotic or did not contain epithelial cells. The mean DNA content of the treated explants was higher than that of the controls (P smaller than 0.01). There was no significant difference in the rate of glucose utilization by the explants treated with dihydrotestosterone, and by the controls.