Search PubMed⌕ Search

Biomedical subjects

M R Butler

Publications and source records attributed to M R Butler.

At least 37 records · Page 2Linked to original sources
PubMed1989

Extracorporeal shockwave lithotripsy using ultrasonic imaging: urologists' experience.

The EDAP LT.01 is a second generation shockwave lithotripter which employs ultrasound imaging and piezoelectric shockwave generation. We describe the first 12 months of its use in the treatment of urinary calculi by urologists with no previous practical experience of ultrasonography. A total of 406 calculi (359 renal and 47 ureteric) in 317 patients were treated. Analgesia or sedation was not routinely used and 59% of all treatments were performed as outpatient procedures. The clearance rate of renal calculi smaller than 1 cm was 81%, while that of calculi larger than 3 cm was 80% (mean clearance 77.5%). Lithotripsy of ureteric calculi following retrograde manipulation to a renal site resulted in 94.4% clearance compared with 39% for those treated at a ureteric site; 93% of 684 lithotripsy treatments were either painless or caused only mild pain. Our experience with imaging and treating urinary calculi with the EDAP LT.01 lithotripter has been excellent. Patients are treated effectively and inexpensively as out-patients without analgesia or sedation.

Adolescent↗
PubMed1989

Study of appropriate antibiotic therapy in transurethral prostatectomy.

Septicaemia is the commonest cause of morbidity and mortality following transurethral prostatectomy. Routine blind antibiotic prophylaxis is not always effective and there is a tendency to over-use potent new and expensive antimicrobials. Attempts to "sterilise" the urine preoperatively are also expensive and disruptive. However, appropriate treatment/prophylaxis can be administered economically using rapidly obtained laboratory results. We describe here a technique of routine direct antibiotic sensitivity testing (DST) of the patient's urine pre-operatively and before catheter removal. Such testing can be performed by junior medical staff in a ward side-room. An appropriate antibiotic may then be administered parenterally 1 h before surgery or catheter removal. A total of 102 consecutive patients underwent TURP and only 1 of those with infected urine became septicaemic. In this instance, an appropriate antibiotic had been incorrectly given orally before removal of the catheter. If the antibiotic sensitivities of a patient's urine are known, and an appropriate antibiotic is given parenterally 1 h pre-operatively or before catheter removal, the incidence of septicaemia following transurethral surgery may be significantly reduced.

Anti-Bacterial Agents↗
PubMed1988

Transcriptional activation of the glutathione S-transferase pi gene in human ureteric and bladder carcinomas.

Using a cDNA clone derived from the rat Glutathione S-Transferase P (GST-P) gene, we have investigated homologous transcripts in a range of normal and malignant human tissues. A major transcript, of 0.75 Kb, representing human GST-pi mRNA, was present in total RNA purified from peripheral white blood cells, bladder, ureteric and prostate tissues. In total RNA derived from histopathologically benign/normal tissues, peripheral leucocytes and from hyperplastic and malignant prostates, levels of the mature transcript varied by less than 1.5-fold (n = 70). In contrast, levels of transcript were significantly elevated (up to 16-fold) in total RNA derived from bladder and ureteric carcinomas, with the highest levels of elevation approaching those previously found only for the GST-P gene in experimentally induced rodent hepatocellular carcinomas. A wide range of stage and grade of tumour has been investigated (pT1 to pT4; G1 to G3, respectively), suggesting that the transcriptional activation of the GST-pi gene is a characteristic common to many bladder/ureteric carcinomas in man.

Carcinoma↗
PubMed1988

Bilateral ureteric carcinoma.

We report two rare cases of bilateral simultaneous ureteric carcinoma. The radiological features and problems of management are discussed.

Carcinoma, Transitional Cell↗
PubMed1986

Superficial bladder tumors (stage pTa, grades 1 and 2): the importance of recurrence pattern following initial resection.

We treated 414 new patients with stage pTa, grades 1 and 2 bladder tumors by transurethral resection between 1970 and 1982. All of the patients with grade 3 or previous upper tract tumors, or who had been treated at some stage with intravesical chemotherapy were excluded. Followup for 5 or more years was available in 188 of the patients. There was a low increase in T stage (6 per cent). Of the patients followed for 5 or more years 46 per cent remained free of tumor. Only 16 per cent of the patients had multiple tumors at presentation and 20 per cent had tumors of 10 gm. or more. These factors were associated with a worse prognosis. Patients free of tumor at 3 months had an 80 per cent chance of having no further recurrences and this rate remained the same up to 2 years from the start of the disease. Patients with a recurrence at 3 months were much less likely to remain free of tumor, and had a higher chance of recurrence at every future visit.

Follow-Up Studies↗
PubMed1985

Preperitoneal ectopic testis: a case report.

We report a 5 1/2-year-old boy with preperitoneal ectopic testes. This condition has been reported only once before. Both testes were attached to the umbilicus and at operation were successfully placed in the scrotum.

Child, Preschool↗
PubMed1985

Testicular tumors in subfertile men: report of 4 cases with implications for management of patients presenting with infertility.

We report on 4 men attending our infertility clinic in whom seminomas developed. A review of testicular biopsies performed for investigation of subfertility in 2 patients revealed in situ and early invasive carcinoma. Infertile men have a prevalence of carcinoma in situ in the range of 1 per 100 to 200, with a high risk of progression to invasive germ cell tumor (50 per cent within 5 years of diagnosis). Biopsy is the only method of detection of the in situ lesion and, therefore, is recommended in the investigation of oligospermic and azoospermic male subjects. The surgical approach to and diagnostic sensitivity of testicular biopsy are reviewed, and the management of carcinoma in situ is discussed.

Adult↗
PubMed1985

Bladder neck contracture following prostatectomy.

In an 11-year period, 49 patients developed bladder neck contracture after prostatectomy--an incidence of 0.86%. This complication was found to be more common after resection of small fibrous hyperplastic prostates. The best results for treatment of the contracture were obtained after bladder neck incision, which gave a 9% incidence of recurrence; after transurethral resection of the bladder neck contracture the recurrence rate was 46%, and after bladder neck dilatation it rose to 100%.

Aged↗
PubMed1984

Flexible cystourethroscopy: advantages and limitations.

Much interest has been expressed in flexible cystourethroscopy, which has obvious potential advantages. In this study it was compared to rigid endoscopy in 25 patients. It was found to be a painless procedure, but not as accurate in diagnosing vesical lesions as the rigid endoscope.

Cystoscopes↗