Search PubMed⌕ Search

Biomedical subjects

M C Bishop

Publications and source records attributed to M C Bishop.

At least 55 records · Page 3Linked to original sources
PubMed1994

Intravesical Evans bacille Calmette-Guérin for carcinoma in situ of the urinary bladder. Scottish Urological Oncology Group.

OBJECTIVE: To study the long-term results of a single 8 week course of intravesical Evans bacillus Calmette-Guérin (BCG) on carcinoma in situ (CIS) of the urinary bladder. PATIENTS AND METHODS: This study reports on 43 patients who each received a single 8 week course of intravesical BCG. RESULTS: In spite of the good initial complete response rate of 70%, the long-term follow-up was disappointing with half the patients either having recurrence or progression of their disease by 2 years. The patients had a close follow-up protocol with early radical treatment when disease progressed. The cause specific survival at 5 years was 70%. CONCLUSION: We feel that similar future treatment protocols without maintenance treatment are not justified.

Administration, Intravesical↗
PubMed1994

Ureteric stricture formation following ureteric instrumentation in patients with a nephrostomy drain in place.

OBJECTIVE: To determine what effect the presence of a nephrostomy, left on free drainage, might have on the rate of occurrence of ureteric strictures after ureteric instrumentation. PATIENTS AND METHODS: Eighteen patients were identified in this unit who had had ureteric instrumentation while a nephrostomy was in place. RESULTS: Eight of 11 patients in whom the nephrostomy was left open developed ureteric strictures. None of seven patients in whom the lumen was maintained by stenting and/or clamping of the nephrostomy developed strictures. The strictures needed dilatation and stenting in seven patients and the ureter had to be reimplanted in the other. CONCLUSION: In patients in whom a nephrostomy is in place, the opening should be occluded after ureteric instrumentation or a stent should be inserted if it is to be left on free drainage.

Adult↗
PubMed1993

Are backup arteriovenous fistulae necessary for patients on continuous ambulatory peritoneal dialysis?

The rationale for backup fistulae for patients on continuous ambulatory peritoneal dialysis (CAPD) is that many will require emergency haemodialysis and, subsequently, permanent haemodialysis. 42% of renal units in the UK have a policy of providing CAPD patients with backup arteriovenous fistulae. We have investigated whether this policy is justified. In our unit, of 176 patients who started CAPD between 1986 and 1989, most (73%) did not require haemodialysis over a median follow-up period of 4 years. Of the 153 backup fistulae created in 114 patients, only 10 were ever used for emergency haemodialysis. 23 other patients required emergency haemodialysis, but when required their fistulae were no longer functioning. The mean fistula patency times among patients in this study compared very favourably with those in other published work. This finding indicates that most fistulae are not available for emergency haemodialysis when required. 94% of fistulae were never used for haemodialysis. Hence it is no longer justifiable to create backup fistulae in CAPD patients.

Arteriovenous Shunt, Surgical↗
PubMed1991

Clam enterocystoplasty in general urological practice.

A series of 45 patients (31 female) underwent clam enterocystoplasty for urgency and incontinence. The majority had detrusor instability. Prolonged conservative treatment had failed in all cases. Improvement occurred in 71% and those younger than 30 years had better overall results; 29% remained incontinent, with 9% requiring a urinary diversion. Many patients did not achieve maximum benefit until 9 months post-operatively. Surgery had no statistically significant effect on any urodynamic parameter and post-operative complications were common. The operation was performed in either the coronal (19) or the sagittal plane (26); this did not influence results. In general, surgery was found to be technically simpler in the sagittal group and it is recommended that this becomes the standard procedure. We feel that this operation involves major surgery and should only be offered with reluctance.

Adult↗
PubMed1991

Effect of milk ingestion on pulmonary function in healthy and asthmatic subjects.

Since Maimonides, it has been common in folk medicine to proscribe milk for asthmatics because its putative stimulation of mucus production can exacerbate asthma symptoms. A literature review, however, failed to reveal any data supporting this notion. We, therefore, compared the effects of ingesting 16 oz. of whole milk (16 g lipid), skim milk (2 g lipid), and water (each on a separate day) on: (1) forced expiratory volume in 1 second (FEV1), (2) forced expiratory flow at 50% of vital capacity (V50), and (3) pulmonary diffusing capacity (DLCO) in 11 asthmatic and 10 nonasthmatic subjects. Measurements were taken at 30 minute intervals for 3 hours. The two milk types did not significantly change FEV1 or V50 in either group, indicating that the amount ingested did not change airway resistance sufficiently to alter airflow parameters. In the asthmatic group, however, DLCO decreased progressively over the 3 hours by 6.8 +/- 1.4% (mean +/- SE) per hour after whole milk (maximum reduction = 21 +/- 1.4%) but not after water or skim milk. In the nonasthmatic group, no significant effects were observed on DLCO after any of the liquids. These data suggest that milk lipids can disturb gas exchange in asthmatic patients.

Adult↗
PubMed1990

The dangers of a long urological waiting list.

Statistics on urological waiting lists suggest that there is considerable regional variation in delay before treatment. This clearly depends on many factors but is unlikely to indicate significant variation in morbidity either at presentation or during subsequent admission for surgery. Managers and politicians should be extremely wary if encouraged to base major changes in distribution of funding and equipment on a casual examination of waiting list figures. It is doubtful if delay in diagnosis or treatment seriously influences morbidity and mortality from urological illness.

Appointments and Schedules↗
PubMed1989

Oestrogen dosage in prostatic cancer: the threshold effect?

We present the results of a prospective randomised trial of Estradurin, a long-acting oestrogen preparation (polyoestradiol phosphate), 160 mg per month, compared with bilateral orchiectomy in patients with advanced prostatic carcinoma (T3M1; T4MO/M1). The dose was lower than that usually recommended to induce a consistent fall in serial plasma testosterone levels to within the castrate range. Most patients treated with oestrogen showed an initial clinical and biochemical response equal to that obtained for patients undergoing orchiectomy. The inevitable relapse in hormone sensitivity sometimes occurred very soon after the start of oestrogen treatment. Many patients had poorly suppressed plasma testosterone expressed as a mean of monthly serial measurements, but then responded to secondary orchiectomy. These data only suggest that, in the treatment of hormone-sensitive prostatic carcinoma, it may be necessary to reduce plasma testosterone to midway between castrate and normal ranges. The data support the theory that response to androgen withdrawal is qualitative rather than quantative. The effective dose of oestrogen may therefore be reduced and the risk of thrombo-embolic complications minimised.

Delayed-Action Preparations↗
PubMed1988

Use of older patients as cadaveric kidney donors.

We have no fixed upper age limit for cadaveric kidney donors and donors over the age of 50 provided kidneys for 22 per cent of our adult transplant recipients between 1983 and 1986. Immediate function following transplantation occurred in 17 per cent of these kidneys compared with 58 per cent for kidneys from donors under the age of 50. The 1-year actuarial graft survival rate for transplants from donors over 50 was 52 per cent, compared with 70 per cent for transplants from donors under 50 (P less than 0.05). Thus kidneys from older donors make an important contribution to the total pool of organs available for transplantation, but their use leads to inferior results in comparison with kidneys from younger donors.

Adolescent↗
PubMed1988

Haematuria in an adolescent due to bladder carcinoma.

A 14-year-old boy had a 6 month history of recurrent macroscopic haematuria. A papillary non-invasive transitional cell carcinoma of the bladder was found at cystoscopy and treated by transurethral resection. In comparison to adults, bladder carcinoma is a rare cause of haematuria in children who appear to have a favourable prognosis.

Adolescent↗
PubMed1987

Ureteric stone surgery in practice.

From 1983 to 1986 140 patients underwent surgery for ureteric calculus. In approximately 30% "blind" basket extraction was considered appropriate and continued to be effective. Increasing expertise with the rigid ureterorenoscope led to a considerable reduction in open ureterolithotomy (15% in 1985-86), the majority following failed ureteroscopic extraction. In the same year both "blind" basket extraction and ureteroscopy were successful in 82 and 86% of attempts respectively. Electrohydraulic and ultrasonic lithotripsy were used in 12 patients to reduce large impacted calculi. The commonest complication of ureteroscopic stone surgery was perforation; this occurred in 14% of cases, though it was usually trivial and near the vesicoureteric junction. Perforations higher in the ureter tended to follow endoscopic lithotripsy and were often associated with urinary extravasation. Extra-ureteric stone fragments were also occasionally observed in such cases. There were no serious sequelae, although the in-patient stay was prolonged beyond the 48 h customary for uncomplicated extraction. The results suggest that ureteroscopic stone extraction, which can be conveniently introduced into urological practice, should become a standard endoscopic procedure.

Endoscopy↗