Intermittent hydronephrosis due to transitional cell carcinoma of the renal pelvis.
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Carcinoma, Transitional Cell↗
Biomedical subjects
G Williams
Publications and source records attributed to G Williams.
Studies on intracavernosal VIP levels during pharmacologically induced penile erections.
Intracavernosal and peripheral venous vasoactive intestinal polypeptide (VIP) levels were measured in men with predominantly organic or predominantly psychogenic impotence. The measurements were taken at intervals up to 30 min following intracavernosal injections of saline, papaverine hydrochloride and papaverine hydrochloride and phentolamine. Levels were also measured after tactile and visual sexual stimulation and following an intravenous injection of papaverine and phentolamine. A penile erection occurred in all men receiving intracavernosal vasoactive compounds. The mean VIP concentration did not alter significantly in either cavernosal or peripheral venous blood during the erection. Mean VIP concentrations were significantly greater in the neurogenic (all diabetic) group than in the other groups studied. Mean cavernosal and peripheral VIP concentrations did not alter following tactile or visual sexual stimulation and no significant alteration in mean peripheral venous VIP concentration occurred following injection of papaverine and phentolamine. The putative role of VIP in the induction of penile erection has not been elucidated in these studies.
Erectile Dysfunction↗
Prospective study of intravesical dimethyl sulphoxide in the treatment of chronic inflammatory bladder disease.
Thirty patients with biopsy-proven chronic inflammatory bladder disease were treated with intravesical dimethyl sulphoxide (DMSO). Satisfactory symptomatic relief was achieved in 80% of patients completing treatment and no significant side effects were encountered. Despite the improvement in symptoms there was no significant alteration in the endoscopic or morphological appearance of the bladder after treatment. Intravesical DMSO is safe and relatively easy to administer and seems to have a place in the management of patients with this difficult problem.
Administration, Intravesical↗
Assessment of the immediate and long-term effects of pharmacologically induced penile erections in the treatment of psychogenic and organic impotence.
Thirty-eight patients with predominantly organic and 29 with psychogenic impotence had intracavernosal injections of a combination of 30 mg papaverine and 1 mg phentolamine on at least one occasion. An immediate increase in length and penile rigidity resulted in all subjects. Eighteen of the organic patients subsequently developed spontaneous erections for periods ranging from 1 week to 1 month. Nineteen of the 24 patients in the psychogenic group had spontaneous erections, five for at least 4 months and 14 for 2 to 8 weeks. Increasing the dose was of benefit only to organic patients who initially had a poor response. Three of eight patients with a poor immediate response to pharmacologically induced penile erections (PIPE) were found to have venous incompetence. PIPE is therefore of value in the diagnosis and treatment of organic and psychogenic impotence.
Adult↗
Assessment of serum CA 19.9 as a tumour marker in patients with carcinoma of the bladder and prostate.
CA 19.9, a carbohydrate structure definable by a monoclonal antibody, is a useful tumour marker in the serum of patients with gastrointestinal malignancy. We report for the first time an assessment of its value in patients with cancer of the bladder and prostate. Elevated levels were found in six of 12 patients with invasive or metastatic bladder cancer but in only two of eight patients with superficial tumours. All patients with cancer of the prostate had levels within the normal range. A long-term study of its value in monitoring disease activity in patients with cancer of the bladder is warranted.
Antigens, Neoplasm↗
Detection of blood group antigens in frozen sections of prostatic epithelium.
The detection of blood group antigens (BGA) in non-malignant prostates by previous workers has been at best inconsistent. BGA have not before been detected in prostatic carcinomas. In this preliminary study, a variety of anti-BGA reagents, with known specificities that involve the carbohydrate backbone in addition to the BGA specific terminal monosaccharides, were used to study the expression of the A and H (O) BGA in cryostat sections of 16 patients with benign prostatic disease and nine with prostatic cancer. Positive staining, appropriate to the patients' blood group, was seen in all of the benign tissues when anti-BGA reagents that included specificity against type 2 backbone structures were used. Staining was absent, however, if the reagent had only type 1 specificity. The anti-A and anti-H (O) reagents which gave the best staining patterns in benign tissues were used in malignant tissues. No cancer was found to express A antigen but eight of the nine prostatic cancers were positive for the H (O) antigen irrespective of blood group. Using fresh frozen material and appropriate reagents, BGA may be reproducibly detected in the epithelium of all non-malignant prostates, suggesting that a significant component of BGA is probably lipid-based on type 2 carbohydrate backbone chains. Further studies of changes in BGA expression in prostatic cancer are warranted.
ABO Blood-Group System↗
Penile function following intracavernosal injection of vasoactive agents or saline.
Few studies on the pharmacological assessment or treatment of impotence have included controls. In a double-blind crossover study, 18 impotent men received either a 2 ml injection of a solution containing 30 mg papaverine and 1 mg phentolamine or a similar volume of normal saline into the corpus cavernosum. The immediate and delayed effects (4 weeks later) were assessed independently and the alternative injection then given. All injections with papaverine and phentolamine were followed by an immediate increase in penile length and rigidity, and 70% of these patients were able to have sexual intercourse for periods of 1 to 4 weeks. No change in penile length or rigidity occurred following the saline injection and only one patient showed some improvement in erection over the next 4 weeks. In the crossover study, no patient developed any increase in length or rigidity of the penis following injection of saline, and improvement in spontaneous erection occurred in only two cases. In contrast, all patients who received papaverine and phentolamine had an increase in penile length and rigidity, and 50% were able to have normal sexual intercourse over the next 4 weeks. This study confirms the value of a combination of vasoactive agents in the management of impotence, irrespective of its aetiology, and suggests that any placebo effect is minimal in this group of patients with considerable psychological overlay.
Adult↗
Intrascrotal adenomatoid tumours.
The adenomatoid tumour occurs in the genital tract of both sexes and is probably of mesothelial origin. We describe its occurrence in five men, two of whom had an intratesticular tumour, and discuss the clinical features of this lesion and the lessons to be learned regarding the management of testicular and paratesticular swellings.
Adenoma↗
Erectile dysfunction: diagnosis and treatment.
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Erectile Dysfunction↗
Measurement of bladder volume by real-time ultrasound.
The accuracy of a non-invasive method of measuring the volume of urine in the bladder using ultrasound was assessed 32 times in 18 patients with benign prostatic hypertrophy. A method originally used with B-mode scanners was applied to images obtained with a real-time scanner. Although the mean error of 8% of true volume (range -29% to +52%, standard deviation 23%) compared favourably with that of some series, the results were less accurate than those originally reported for this method using a B-mode scanner. Real-time ultrasound can provide an approximate measurement of bladder urine volume but is not sufficiently accurate in situations where more precise measurements of changes in residual urine are required.
Aged↗
Antecedents and outcome of very early neonatal seizures in infants born at or after term.
Recent experimentally derived evidence has confirmed earlier suggestions that seizures which occur within 48 h of birth in babies born at or later than 37 completed weeks gestation are particularly likely to reflect intrapartum asphyxia. We have compared 54 cases of such seizures with 41,090 controls in a geographically defined population. Nulliparity, hydramnios, post-term pregnancy, oxytocin augmentation of labour, abnormalities of fetal heart rate and/or meconium-stained amniotic fluid, prolonged second stage of labour, emergency caesarean section, assisted vaginal delivery, low Apgar score and resuscitation at delivery and subsequent ventilatory support were all statistically significantly more common among cases than among controls. Five of the 54 babies who developed seizures died within 28 days of birth and 11 of the 49 survivors had an impairment diagnosed by 3 years of age which was usually associated with some degree of cerebral palsy. Comparison of the frequency of antecedent perinatal risk factors in the seizure babies who died, those who survived with disabilities and normal survivors failed to reveal any clear pattern.
Cerebral Palsy↗
Microbiological diagnosis of suppurative keratitis in Bangladesh.
Experience in setting up an inexpensive microbiology laboratory in the Bangladesh National Society for the Blind Eye Hospital and Training Complex at Chittagong is presented, together with the results of a pilot study to identify organisms responsible in 33 consecutive cases of suppurative keratitis in the Chittagong area of Bangladesh. Of the 33 cases 21 were positively identified by means of Gram stain and/or culture. Two-thirds of the responsible organisms were bacteria, and one-third were fungi. The bacterial causes included Streptococcus pneumoniae and Pseudomonas aeruginosa. The fungi isolated were Aspergillus fumigatus, Aspergillus ochraceus, and Fusarium solani. Among the causes of failure to diagnose the organism was chronicity of infection and previous treatment. The value of the study in the planning of future treatment regimens, and the implications of setting up similar relatively cheap microbiology laboratory facilities in developing countries, are discussed.
Bacteria↗
Rapid method for stained renal biopsy specimens embedded in epoxy resin.
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Epoxy Resins↗
Metastatic teratoma from a regressed impalpable testicular primary.
A young man presented with a perineal tumour which despite intensive investigation, remained of unknown origin and required radical excision. It was subsequently shown to be a metastasis from a primary regressed testicular teratoma. It is important to exclude a testicular origin in these patients wherever possible because such tumours are often chemosensitive.
Adult↗
Recurrent ureteric obstruction in association with Henoch-Schönlein purpura.
The most common urological manifestation of Henoch-Schönlein purpura is focal proliferative glomerulonephritis. Ureteric obstruction as a consequence of the disease has been reported in children but is rare. We report an adult male patient with Henoch-Schönlein purpura causing unilateral, bi-focal, recurrent ureteric obstruction. We speculate that ureteric involvement in Henoch-Schönlein purpura may be more common than hitherto suspected and that even with a demonstrable obstructive episode, consideration must be given for an initial conservative approach.
Adult↗
Effect of a long-acting somatostatin analogue (SMS 201-995) on postprandial gastric emptying of 99mTc-tin colloid and mouth-to-caecum transit time in man.
The effect on gut motility of a single subcutaneous injection of 50 micrograms of the long-acting somatostatin analogue, SMS 201-995, was investigated in 8 normal volunteers who took a drink containing 99mTc and lactulose with a mixed meal. The rate of gastric emptying was assessed by disappearance of the isotope from the stomach area as measured by a gamma camera, and mouth-to-caecum transit time (MCTT) was measured by the appearance of hydrogen in the breath. Gastric emptying was accelerated, with a significant reduction of the time taken to 50% isotope disappearance (37.2 +/- 3.3 min during control study vs 23.3 +/- 3.4 min after SMS injection; p less than 0.01). In contrast, MCTT was prolonged from 57.3 +/- 9.4 min (control) to 203.6 +/- 14.7 min after SMS (p less than 0.001).
Adult↗
Staging of prostatic carcinoma with radionuclide bone scintigraphy and lymphography.
One hundred patients with histologically proven carcinoma of the prostate were examined by radionuclide bone scintigraphy and bipedal lymphography. In 27 cases the bone scintigram and lymphogram were positive, in 16 the bone scintigram only was positive and in 10 the lymphogram only was positive. Although radionuclide bone scintigraphy is the most useful single investigation for detecting metastatic spread from prostatic carcinoma, lymphography should be performed if the bone scintigram is negative, as it is likely to demonstrate nodal metastases in 18% of patients.
Bone Neoplasms↗
Real-time ultrasound measurement of bladder volume: a comparative study of three methods.
The accuracy of different ultrasound methods for determining the volume of urine in the bladder was compared using three methods in current use. Each method was applied to the same ultrasound images from 16 patients with prostatic hypertrophy. The calculated volumes were compared with the true volumes derived by measurement of voided and catheter-drained urine. All methods showed similar degrees of accuracy in quantifying bladder volumes. The range of errors of the best method tested was +/- 35% of true volume and this suggests that ultrasound measurement of bladder volume is not sufficiently accurate for many clinical and research applications.
Aged↗