Biomedical subjects
Publications and source records attributed to N Saunders.
The recognition and treatment of premalignant lesions affecting the uterine cervix will in most instances prevent the subsequent development of invasive cervical cancer. The various therapeutic options available to the clinician for the eradication of cervical premalignant disease are discussed.
262 doctors in research oriented posts completed a questionnaire on their career and influences upon it. 14% did not regard themselves as committed to a career in research. Of those who did, less than one-third made their choice by graduation; almost half did so 3 or more years after qualification. For 41%, research was a planned career; 39% developed their interest within a job that was not necessarily research oriented; and 20% entered research fortuitously. 29% of the sample had undertaken intercalated degrees. 50% had a higher medical degree, 14% had a non-medical research degree, and a further 11% had both; 25% possessed neither. The most frequently reported positive influence on the decision to follow a research career was intrinsic motivation (eg, interest in a particular subject), though a teacher or mentor had a considerable influence on the decision of 59% of respondents. Only 40% of respondents did some research at medical school; of these, 43% thought that it had positively affected them considerably, and only 16% that it had not done so at all.
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In 14 anesthetized mongrel dogs, we studied the factors that influenced aortic systolic pressure (PaO) and peak aortic systolic flow (Qao) during positive-pressure inflations at three respiratory rates: 8, 14, and 24 breaths/min. At all three respiratory rates, pulmonary arterial flow fell by 15% of the preinspiratory value by end inhalation. Qao also fell at all three respiratory rates, reaching a nadir close to end exhalation (EE). Qao fell less (7% of the base line) at the fast respiratory rate than at the medium and slow respiratory rates (15% of the base line). Pao rose more during the early part of inflation at the medium and fast rates (5 +/- 0.9 Torr) than at the slow rate (3 +/- 0.7 Torr); then Pao fell to a nadir near EE at the slow (-5.6 +/- 1.6 Torr) and at the medium (-2.3 +/- 1 Torr) respiratory rates. At the fast rate it fell to a value not different from control (0.1 +/- 0.5 Torr). The ratio of peak arterial pressure to peak arterial flow increased throughout inflation reaching a peak at EE. A model was developed that predicted the major qualitative features of the changes in Qao seen in these studies. Changes in Pao resulted from the interaction between decreases in Qao and transmitted increases in pleural pressure, and are modified by changes in systemic impedance.
To assess the hemodynamic effects of spontaneous inspiration, we studied 12 anesthetized mongrel dogs during normal and loaded inspiration, before and after bilateral cervical vagotomy. Peak aortic flow fell (15--20%) whereas peak pulmonary artery flow rose (15--20%) under all conditions. When aortic flow fell, left ventricular diastolic size decreased whereas aortic and left atrial transmural pressures increased slightly. Right ventricular diastolic size and right atrial transmural pressure increased. During inspiratory loading transmural pressures rose more, but the fall in aortic flow remained the same. After vagotomy, inspiration was prolonged, allowing aortic flow to return to preinspiratory levels. At this time left ventricular diastolic size was increased compared to preinspiratory levels and there were further increases in left atrial and aortic transmural pressures. We have concluded that at least two factors affect aortic flow during inspiration: 1) a decrease in left ventricular preload that is associated with decreased left ventricular compliance, and 2) increased impedance to left ventricular emptying as reflected by the increase in aortic transmural pressure. This may play a greater role during inspiratory loading and when inspiration is prolonged.
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167 patients with T1 bladder transitional cell tumours treated by transurethral resection or cystodiathermy are reviewed. The overall crude survival was 83.2% in 3 years and 71.8% in 5 years. 7.8% of the patients developed an invasive tumour and these patients had an unfavourable initial tumour with moderate or poor differentiation and high or moderate mitotic rate. High or moderate pleomorphism was particularly unfavourable. Multiple tumours did as well as single ones but more of them had invasion of the lamina propria and a larger number were treated by either radiotherapy or cystectomy.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.