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Biomedical subjects

I Eardley

Publications and source records attributed to I Eardley.

68 records · Page 4Linked to original sources
PubMed1992

Rectal obstruction secondary to carcinoma of the prostate treated by transanal resection of the prostate.

Rectal obstruction caused by carcinoma of the prostate is uncommon. If the disease does not respond to either hormonal treatment or radiotherapy, the only surgical means of relieving the obstruction has been the formation of a colostomy. We present an alternative treatment, since many of these patients are elderly with a short life expectancy and they may have difficulty coping with a stoma. Seven transanal endoscopic resections of the prostate (TARP) have been performed on 5 patients. The procedure is not without complications, but it does offer simple surgical palliation of the rectal obstruction and obviates the need for a colostomy.

Aged↗
PubMed1991

Neurophysiology of the striated urethral sphincter in multiple sclerosis.

Urethrovesical dysfunction is common in patients with multiple sclerosis. We present the results of urodynamic and neurophysiological studies in a series of 24 patients with multiple sclerosis associated with urinary symptoms. Urethral sphincter electromyography showed only minor abnormalities but studies of central conduction demonstrated abnormal sensory conduction in 88% and abnormal motor conduction in 80% of the patients studied. These abnormalities of central conduction correlated well with the urodynamic findings.

Adult↗
PubMed1991

The neurourology of tropical spastic paraparesis.

We report the clinical features, urodynamic results and neurophysiological findings in 6 patients with urinary symptoms related to tropical spastic paraplegia. The widespread nature of the pathological changes within the nervous system result in a complex variety of urodynamic and neurophysiological features.

Aged↗
PubMed1990

A new technique for assessing the efferent innervation of the human striated urethral sphincter.

A technique is described for recording the electromyographic response of the striated urethral sphincter to transcutaneous magnetic stimulation of the brain and spinal cord. A series of 11 control patients have been studied and 3 examples of patients with neurological disease also are reported. The most reliable response was recorded after facilitated transcranial stimulation of the cerebral cortex, with the mean latency of the electromyographic response in the striated sphincter being 26.4 msec. (standard deviation 2.21). It is concluded that assessment of the latency of the striated urethral sphincter electromyographic response to transcranial magnetic stimulation may be a useful technique in the investigation of patients with disorders of micturition.

Aged↗
PubMed1990

Pharmacocavernometry in the assessment of erectile impotence.

Thirty-three impotent men underwent pharmacocavernometry and cavernography. Ten patients had a good clinical response to 60 mg papaverine, nine had a moderate clinical response and in 14, the response was judged to be a poor one. Twelve patients had evidence of abnormal venous leakage from the corpora. Subsequent investigation with isotope phallography showed six patients to have arterial insufficiency and in three of these patients this was amenable to reconstructive vascular surgery. We conclude that pharmacocavernometry provides a useful, cheap and reliable method for the investigation of impotent men which may be performed on an outpatient basis.

Adult↗
PubMed1989

The value of urethral sphincter electromyography in the differential diagnosis of parkinsonism.

A series of 54 patients presenting with parkinsonism underwent clinical assessment and urethral sphincter electromyography (EMG). After clinical assessment, 26 were thought to be suffering from probable multiple system atrophy (MSA), 15 were thought to have possible MSA and 13 were diagnosed as having probable idiopathic Parkinson's disease (IPD). Of those with probable MSA, 16 were found to have an abnormal urethral sphincter EMG. In the group with possible MSA, only 5 patients had an abnormal EMG while in the group with probable IPD, only 1 patient had an abnormal EMG. It was concluded that urethral sphincter electromyography provides a useful method of distinguishing between idiopathic Parkinson's disease and multiple system atrophy. It also provides a means of identifying those patients with parkinsonism whose incontinence may well be worsened, or in whom incontinence may develop following lower urinary tract surgery.

Aged↗
PubMed1989

Biofilms, bacteria and bladder catheters. A clinical study.

Biofilms were present on 16 of 33 urethral catheters examined. In 11 cases the catheter carried a different microbial flora from that of the bladder urine. The length of time the catheter was in situ did not influence biofilm formation, and all types of materials tested supported biofilm growth. Biofilms were seen on 2 of the 7 catheters where prophylactic antibiotics had been used.

Bacteria↗
PubMed1989

Tendinitis--a common complication after renal transplantation.

A group of 170 patients having functional renal allografts were evaluated at least six months after renal transplantation. They were assessed for symptoms and signs of tendinitis in the Achilles and Supraspinatus tendons. Of the 170 patients, 34 had tendinitis. Four patients (11.8%) had spontaneous rupture of the Achilles tendon one week to 72 months after transplantation. All of the symptomatic patients had received steroids, and 81% of these had been treated with methylprednisolone. Of the asymptomatic patients 89% received steroid and 69% received methylprednisolone. There was a significant correlation between symptoms of tendinitis and the cumulative steroid dose. The number of matching HLA loci of the donor kidney and the length of time on dialysis were also related to the incidence of tendinitis. Unlike a previous study (1) we could not find significant differences between the 34 patients with tendinitis and controls with reference to the levels of serum phosphate, alkaline phosphatase, albumin adjusted calcium, or cholecalciferol therapy prior to transplantation. Our data confirm that tendinitis is surprisingly common in patients after renal transplantation (20.0%).

Achilles Tendon↗
PubMed1989

Plasma lignocaine levels during transurethral prostatectomy.

It has been reported that transurethral absorption of lignocaine may cause systemic toxicity when associated with mucosal damage within the urethra. We measured the serum levels of lignocaine in 30 patients after the transurethral administration of 400 mg lignocaine gel just before transurethral prostatectomy. In 11 patients additional lignocaine was given as part of the anaesthetic induction (Group A). In 19 patients no additional lignocaine was given (Group B). Two patients in Group A and three patients in Group B also underwent Otis urethrotomy. The mean peak plasma lignocaine concentration as measured by sequential venous samples was 1424 ng/ml in Group A and 72 ng/ml in Group B. We conclude that 400 mg lignocaine gel applied endourethrally before transurethral resection of the prostate results in plasma concentrations well below the toxic levels.

Aged↗
PubMed1988

Modified nephro-ureterectomy. Long-term follow-up with particular reference to subsequent bladder tumours.

Nephro-ureterectomy is the standard treatment for transitional carcinoma of the renal pelvis and caliceal system. In recent years a modification of the conventional two-incision technique has been described in which the intramural ureter is resected endoscopically and the remaining ureter is removed in continuity with the kidney through a single loin incision. Twenty-one patients had their renal pelvic tumours treated by this modified technique between 1970 and 1983. Of 16 patients available for analysis, 37.5% subsequently developed bladder tumours. It was concluded that this modified technique has no greater incidence of subsequent bladder tumour development than the conventional technique of nephro-ureterectomy, whilst giving considerable benefit to the patient.

Adult↗
PubMed1986

Imipenem pharmacokinetics in elective colorectal surgery.

A study of the pharmacokinetics of imipenem in 22 patients undergoing elective colorectal surgery was performed. Samples of plasma, fat, muscle and viscera were assayed at various intervals following intravenous injection of 1 g imipenem and 1 g cilastatin. The concentration of imipenem in plasma was approximately ten times that found in the tissues. The half-life was similar in plasma, muscle and fat (approximately 1 h). Visceral levels showed a slower fall (T 1/2 83 min). Plasma and tissue levels exceeded the MIC90 for all common pathogens for at least the first two hours of surgery. We conclude that imipenem is a suitable agent for antibiotic prophylaxis in colorectal surgery.

Colon↗
PubMed1986

Ureterorenal endoscopy: which instrument, what cost?

This report describes the design, availability, repair facilities and costs of rigid ureteroscopes. Clinical factors affecting design are detailed. A classification is given. A new test of flow dynamics is described. Short operating ureteroscopes with a stable or integral telescope system appear to be superior to other types, especially as they may be used for antegrade ureteroscopy.

Endoscopes↗