Search PubMed⌕ Search

Biomedical subjects

I Eardley

Publications and source records attributed to I Eardley.

At least 55 records · Page 3Linked to original sources
PubMed1998

A novel in vitro bladder pelvic nerve afferent model in the rat.

OBJECTIVE: To develop an in vitro model to allow electrophysiological recordings from pelvic nerve afferents of the urinary bladder in the rat and to ascertain the stability and reproducibility of the model with time. MATERIALS AND METHODS: Six male Wistar rats (body weight approximately 100 g) were used in the study. The bladder (complete with accessory organs of prostate and seminal vesicles), urethra and penis, together with the attached pelvic nerve and L6/S1 nerve trunk, were removed intact and placed in a specially designed recording chamber containing oxygenated Krebs solution maintained at 30 degrees C. The bladder was catheterized urethrally and attached to a continuous-infusion pump and a pressure transducer. The L6/S1 nerve trunk was placed across a silicone-gel wall into a separate chamber containing liquid paraffin, in which multiunit recordings from pelvic nerve afferents originating from the bladder were made. The afferent nerve activities in response to repeated bladder distension with saline, at 0.04 mL/min for 8 min over 3 h, were compared using the paired t-test to assess the reproducibility of the model. Conduction velocity studies were also carried out to ascertain the proportion of C- and A delta-fibres in the multiunit recordings. RESULTS: Repeated bladder distension with saline over 3 h produced consistent and reproducible afferent nerve responses, signifying that the afferent nerves recorded in this study neither sensitize nor desensitize over time. This is an essential prerequisite when using this model to study the effects of pharmacological manipulation of the bladder on its afferent nerve response. Conduction velocity studies showed that approximately 30% of the afferent fibres recorded from were C-fibres with the remaining being A delta-fibres. CONCLUSIONS: An in vitro bladder pelvic nerve afferent model for the rat was developed successfully; it is stable and produces reproducible results with repeated bladder distension over at least 3 h.

Afferent Pathways↗
PubMed1998

The evaluation of sexual function in men presenting with symptomatic benign prostatic hyperplasia.

OBJECTIVE: To evaluate quantitatively and qualitatively the degree of sexual dysfunction in an unselected population of men attending a prostate-assessment clinic using a sexual-function inventory, and to ascertain the degree of correlation between sexual dysfunction, urinary symptoms and age. PATIENTS AND METHODS: In all, 168 men with symptomatic BPH attending a prostate assessment clinic were investigated prospectively using the International Prostate Symptom Score (IPSS), BPH Impact Index (BPHII), a measurement of urinary flow rate and residual urine volume, and a sexual function questionnaire. The results were assessed using Spearman's rank order correlation to discern any correlations between the measured variables. RESULTS: The data from 140 patients were available for analysis; of these, low scores were obtained in 59% for sexual drive, in 56% for erections (with 46% of men satisfying the National Institute of Health criterion for impotence) and in 38% for ejaculation. There was a statistically significant rank order correlation between age and the sexual symptom scores for each of the three categories (sexual drive, erection and ejaculation), but no correlation between age and the problem assessment scores for these domains, suggesting that the older patients are just as bothered by their sexual dysfunction as the younger men. Furthermore, the BPHII scores correlated weakly but significantly with all aspects of sexual function, including overall sexual satisfaction, in contrast to the poor correlation seen with the total IPSS and sexual function scores. CONCLUSION: There is a significant number of patients with symptomatic BPH who have sexual dysfunction, with the proportion increasing with advancing age and with the older men still showing a high degree of bother from their symptoms. Sexual function scores were better correlated with BPHII scores than with the total IPSS, although some of the individual IPSS questions correlated well.

Adult↗
PubMed1997

Transurethral needle ablation of the prostate for the treatment of benign prostatic hyperplasia: a collaborative multicentre study.

OBJECTIVE: To assess the efficacy and safety of transurethral needle ablation of the prostate (TUNA) for patients with symptomatic benign prostatic hyperplasia (BPH) in a multicentre trial. PATIENTS AND METHODS: Seventy-six patients were recruited from five centres; all were treated with the TUNA system consisting of a powered radiofrequency generator and a TUNA catheter. The patients were evaluated prospectively using the international prostate symptom score (IPSS), uroflowmetry, quality-of-life score, and other variables, and followed for a mean of 12 months after treatment. RESULTS: Sixty-eight patients were available for follow-up: TUNA produced significant improvements in the IPSS (median 22 before, to 7.5 after treatment). urinary flow rate (mean 8.7 before, to 11.6 mL/s after treatment) and quality-of-life score (median 5 before, to 2 after treatment) at 12 months. CONCLUSIONS: If these early promising results are maintained. In the medium to long term, TUNA therapy will be a useful low-morbidity alternative for patients with symptomatic BPH.

Aged↗
PubMed1997

The role of phosphodiesterase inhibitors in impotence.

Penile erection is mediated by nitric oxide (NO) and its second messenger cyclic guanosine monophosphate (cGMP). The activity of cGMP is modulated by the enzyme phosphodiesterase (PDE). The most important physiological isoform of the enzyme in the penis is PDE5. Sildenafil is a specific inhibitor of this enzyme which potentiates nitrergic cavernosal relaxation in vitro and in animals. Clinical studies suggest that it is effective in the treatment of male erectile dysfunction (MED), which would make it the first orally active therapy for this condition.

Journal Article↗
PubMed1996

Cytokeratin 20 as an objective marker of urothelial dysplasia.

OBJECTIVE: To investigate the dysregulation of cytokeratin 20 (CK20) expression in urothelial dysplasia and its potential as a diagnostic aid. PATIENTS AND METHODS: Twenty-two patients were selected on the basis that they had undergone one or more biopsies showing dysplasia before the development of a transitional cell carcinoma (TCC): 15 of these patients also had a prior history of TCC. The dysplasia was classified as mild in 12, moderate in 14 or severe dysplasia/carcinoma in situ in 10 patients, ensuring that a spectrum of morphological appearances was represented. Control biopsies were obtained from seven children undergoing bladder reconstructions and 23 patients with recurrent urinary tract infections, haematuria or functional bladder symptoms, but no history of TCC. RESULTS: The expression of CK20 was restricted to superficial 'umbrella' cells and occasional intermediate cells in the control biopsies, even in the presence of severe inflammation. In 31 of the 36 cases of dysplasia complete loss of restriction was seen at least focally with positive expression in all layers of the urothelium. CONCLUSION: The abnormal expression of CK20 is a reliable, positive marker of urothelial dysplasia in the urinary bladder. Immunostaining for CK20 is therefore a useful adjunct to morphology in the diagnosis of dysplasia, of particular value in the distinction from reactive states where diagnostic difficulties are greatest.

Aged↗
PubMed1994

Surgical outcome of orchidopexy. II. Trapped and ascending testes.

OBJECTIVE: To review the outcome of orchidopexy in boys with testicular ascent. PATIENTS AND METHODS: The case notes of all the boys who underwent orchidopexy over an 18-year period, under the care of a single consultant, were collected. The reports of patients who at the initial assessment had normally descended testes and subsequently developed maldescent, were reviewed. RESULTS: At the time of the initial assessment, 69 boys (77 testes) had normally descended testes but subsequently developed maldescent. In the intervening period, 37 of these patients (38 testes) had undergone inguinal surgery for a hernia or a hydrocele (trapped testes). The remaining 34 patients had not undergone surgery and were designated as having an 'ascending testis'. The results of surgery were excellent in all but six cases. Of these, five testes failed to reach the bottom of the scrotum and one was excised. A hernial sac was found in 16 of 28 boys with a trapped testis in whom the data was recorded. CONCLUSION: Testicular ascent is uncommon and can occur spontaneously or following ipsilateral groin surgery where scarring is a likely aetiological factor. The results of surgery are usually excellent.

Child↗
PubMed1993

Data collection and complication rates in clinical audit.

Audit data were collected continuously between February 1988 and July 1991. For the initial period (February 1988-June 1990) data were collected by monitoring of ward admission and discharge records and by collecting data from operating theatre records whilst complications were noted in a 'complications book' which was kept on the notes trolley. In July 1991, when a computerized system for storing and processing audit data was introduced into the department, the methods of data collection changed. For each patient a proforma was attached to the clinical notes which was filled in at each stage of the hospital stay. On this proforma was a list of possible complications which were ticked, as appropriate, at the time of discharge from hospital. We have reviewed the results of clinical audit during these two periods. The number of operations performed per month fell slightly in the latter period (p = 0.005). However, there was a significant increase in both the number of complications (p < 0.0001) and in the complication rate (p < 0.0001). Further analysis showed that there was a similar increase in the number of recorded major and minor complications, and that this increase was also seen even when changes in medical personnel were accounted for. We suggest that the increased complication rate recorded in the latter period reflects the change in the method of data collection. This has important implications when comparing outcome measures for clinical departments.

Consultants↗
PubMed1992

Use of the ASI titanium stent in the management of bladder outflow obstruction due to benign prostatic hyperplasia.

An expandable titanium intraprostatic stent was inserted into 30 patients with infravesical obstruction due to benign prostatic hyperplasia (BPH). All of the men were considered unsuitable for transurethral resection of the prostate as a result of comorbid conditions. In 25 patients effective micturition was reestablished with this technique. In 21 of these men, who have been followed for longer than 1 year, the mean maximum flow rate at 1 year was 10.8 ml. per second and the mean residual urine was 56 ml. Although urinary tract infections occurred subsequent to stent insertion in 10 individuals, these resolved after appropriate antibiotic treatment and no stents have had to be removed for this reason. Followup cystoscopy or examination by electron microscopy of those stents that have been removed has shown partial epithelialization of the stent surface in a proportion of patients, and a minor degree of incrustation occurred in 1 case. We conclude that an expandable intraprostatic titanium stent is an acceptable alternative to transurethral resection of the prostate or long-term catheterization in this particular group of high risk patients.

Aged↗
PubMed1992

Surgery for hypospadias fistula.

The results of 12 years' experience in the surgical treatment of hypospadias fistula are presented. Overall, there was a success rate of approximately 50% for each attempt at surgical closure of a fistula. The chances of success were not significantly influenced by the number of previous surgical procedures. The best results were obtained with fistulae on the shaft of the penis which were closed with mucosal inversion and advancement of a skin flap over the fistula.

Child↗
PubMed1992

Finasteride in the treatment of benign prostatic hyperplasia. A urodynamic evaluation.

A group of 69 men with bladder outflow obstruction due to benign prostatic hyperplasia (BPH) were treated in a double-blind, placebo-controlled study with finasteride (Proscar, MK-906), a 5-alpha reductase inhibitor, 5 mg or 10 mg/day or placebo for 3 months; subsequently, 20 patients received finasteride 5 mg/day for a further 9 months in an open extension study. In treated patients dihydrotestosterone declined by over 60%, remaining unchanged with placebo. Symptom scores fell significantly in all 3 groups. Mean maximum flow rates fell slightly in placebo-treated patients but improved by 1.5 ml/s in the 10 mg group and by 3.3 ml/s in the 5 mg group. After 1 year's treatment, the reduction in symptom score and increase in flow rate were well maintained; the mean prostate volume was reduced by 14% and prostatic specific antigen declined by 28%. It was concluded that finasteride shows some efficacy in the treatment of BPH, with minimal toxicity, but 12 months of therapy or longer may be necessary to achieve maximal effect.

Aged↗
PubMed1992

Surgical outcome of orchiopexy. I. Previously unoperated testes.

A total of 1209 undescended testes in 961 boys who had no previous surgery for this problem have been reviewed with particular regard to the outcome of surgery in relation to the pre-operative and intra-operative assessment of the position of the testis. A third of impalpable testes were found at operation in the abdomen, a third in the inguinal canal and a quarter in the superficial inguinal pouch; 1% of all testes and 7% of impalpable testes were absent; 96% of all testes reached the scrotum at operation and this figure included 69% of abdominal and 94% of canalicular testes. In all 24 testes were excised--7 of which were abdominal, 8 canalicular and 9 were in the superficial inguinal pouch. The generalisation that the higher the undescended testis before operation the poorer the result, does not always hold true.

Adolescent↗
PubMed1992

Prostate specific antigen and bone scan correlation in the staging and monitoring of patients with prostatic cancer.

The ability of serum prostate specific antigen (PSA) to predict bone metastases at initial presentation was determined in 146 patients, and in 66 patients during a 3-year period; 14.7% of patients with bone metastases at presentation had a PSA value less than 20 ng/ml. All patients who subsequently developed bone metastases had a PSA greater than 20 ng/ml and the rise in PSA often antedated the detection of bone metastases. Bone scans are still necessary in the initial staging but following diagnosis and treatment can be replaced by serum PSA measurement in monitoring patients with prostatic cancer.

Biomarkers, Tumor↗