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Biomedical subjects

R R Hall

Publications and source records attributed to R R Hall.

At least 73 records · Page 4Linked to original sources
PubMed1986

Immunological and colorimetric determination of prostatic acid phosphatase--technical and clinical reappraisal in symptomatic patients.

We compared a selection of quantitative immunological methods for prostatic acid phosphatase (PAP) with routine colorimetric assays for total and tartrate-labile acid phosphatase and evaluated their relative clinical merits in the differential diagnosis of prostatic carcinoma. We also assessed a wide range of commercial control materials for suitability of use with these methods. Patients studied included 111 cases of prostatic carcinoma, 42 cases of benign prostatic hyperplasia, and 33 controls. The principles of the methods used included determination of enzymatic activity using p-nitrophenyl phosphate, RIA, immunoradiometric, and enzymoimmunometric assays. Performance characteristics for the immunological methods were inferior to manufacturers' precision and specificity claims. We identified control materials that were unsuitable for routine use. Poor discrimination between clinical groups was observed for all methods. Analysis by use of a receiver operator characteristic plot failed to improve this. We conclude that the immunological methods we studied offer no advantages over colorimetric methods in the differential diagnosis of prostatic cancer in symptomatic patients.

Acid Phosphatase↗
PubMed1985

Epidermal-growth-factor receptors in human bladder cancer: comparison of invasive and superficial tumours.

The presence of epidermal-growth-factor (EGF) receptors in normal and neoplastic human urothelium was studied in 12 control patients and in 48 patients with transitional cell carcinoma of the bladder, 24 with invasive (pT3) and 24 with superficial tumours (9 pT1, 15 pTa). EGF receptors were identified on frozen sections by means of an indirect immunoperoxidase technique with a monoclonal antibody against the EGF receptor. Significantly more invasive tumours (21 of 24) than superficial (7 of 24) were stained positively for the EGF receptor (X2 = 14.49; p less than 0.001). Significantly more poorly differentiated tumours (18 of 21) than moderately differentiated tumours (10 of 27) were EGF-receptor positive (X2 = 9.6; p less than 0.01). No control sample stained positively for the EGF receptor. These findings suggest that the presence of a high intensity of staining for the EGF receptor in human bladder tumours is associated with poor differentiation and with invasion.

Adult↗
PubMed1985

Rapid ward assessment of renal function by reflectance photometric determination of plasma creatinine.

The Ames Seralyzer reflectance photometer and disposable reagent strips for the determination of plasma creatinine were evaluated in the laboratory and on a urology ward over a 3-month period. Principles of the instrument used are described, as are details of the evaluation procedures. Reproducibility of results under optimum conditions gave coefficients of variation less than 7%. Under routine conditions of use, medical staff and laboratory analysts achieved high correlation with the routine laboratory method of analysis (r = 0.986, N = 108: r = 0.996, N = 102 respectively). Potential sources of inaccuracy were identified. Seralyzer determination of plasma creatinine can be rapidly, simply and reliably performed by medical staff on a urology ward, thereby facilitating assessment of renal function governed by clinical requirement rather than by laboratory convenience.

Creatinine↗
PubMed1985

The role of the ileal conduit in the development of upper tract dilatation.

The purpose of this study was to clarify the role of the conduit in the development of upper tract dilatation after ileal conduit urinary diversion. Twenty-seven patients with a normal upper tract were compared with 17 who had developed upper tract dilatation. Patients were studied by means of a technique to measure pressure and flow under "steady-state" conditions. Pressure activity was classified into two types. Type I pressure activity (frequency 6.2 +/- 3/min; amplitude 4.7 +/- 3 cm H2O) resulted in to-and-fro movement of contrast and the escape into the appliance of small volumes of contrast. In controls, most of the output from the conduit occurred during type I activity (73 +/- 14%). Type III/IV pressure activity resulted in vigorous aboral peristalsis and occurred infrequently in controls (frequency 5 +/- 4/h). In patients with upper tract dilatation, in contrast, type III/IV peristaltic activity occurred frequently (frequency 37 +/- 30/h; P less than 0.001: amplitude 72 +/- 34 cm H2O) and was responsible for most of the output (70 +/- 17%; P less than 0.001). The findings support the hypothesis that high pressure activity in the conduit is an important factor in the aetiology of upper tract dilatation, and they are compatible with the presence in such patients of functionally important obstructions of the distal conduit.

Dilatation, Pathologic↗
PubMed1985

Pretreatment of cytokinetics in acute myelogenous leukemia. Age-related prognostic implications.

To determine the clinical and biologic relevance of cellular kinetics in leukemia, DNA flow cytometric analysis was performed on bone marrow biopsy specimens from 148 previously untreated adult patients with acute myelogenous leukemia. The proportion of cells in synthesis, second growth, and mitosis (S + G2M) ranged from 4% to 33% with a median of 14%. The overall incidence of complete remission was not affected by the pretreatment cell cycle distribution. As in earlier studies, there was a marked decline in remission rate with advancing age from 73% for patients age less than or equal to 50 yr to 50% for those greater than 50 (P less than 0.01). Although not affecting remission induction overall, an increasing proportion of cells in S + G2M phase was favorable in patients under the age of 50 yr, but was associated with a progressive decline in remission rate in older patients (P = 0.01). This age-related divergent effect of cell cycle kinetics on initial response to therapy was confined to the less favorable subgroup of patients with karyotypic abnormalities, whereas patients with normal diploid cytogenetics had a consistently higher response rate regardless of proliferative activity. A positive correlation was also observed between percent of S + G2M cells and the proportion of diploid metaphases in young patients, contrasting with a negative correlation in the older age group. Our observations strongly suggest that the well-recognized prognostic effect of age on remission induction is not entirely host-mediated, but is at least partly an expression of disease-intrinsic differences between young and older patients.

Adult↗
PubMed1984

A flexible cystoscope.

An assessment of the prototype Olympus Flexible Cystoscope in routine urological practice is presented. The results show that the instrument compares favourably in all respects with standard rigid equipment and has the advantage that cystoscopy can be performed supine and under local anaesthesia with ease. Biopsies may be taken; small lesions fulgurised and ureteric catheterisation can be performed without general anaesthesia.

Anesthesia, Local↗
PubMed1984

Treatment of invasive bladder cancer by local resection and high dose methotrexate.

Fifty-seven patients with transitional cell carcinoma of the bladder, categories pT2, pT3a and pT3b, were treated by transurethral resection of the tumour mass (54 cases) or partial cystectomy (3 cases) followed by 8 doses of methotrexate 2 g i.v. every 3 weeks with appropriate Leucovorin rescue. At completion of chemotherapy 6 months after TUR 33/57 patients were tumour-free; 5/57 had new superficial tumours; 13/57 had persistent tumour invading muscle, 3 showed tumour progression and 3 had died from treatment complications. One-year survival was 45/57 (82%); 2-year survival was 23/39. Although some patients developed metastases and others have grown new superficial tumours, of those surviving, the bladder was free of the original invasive tumour in 38/45 (84%) at 1 year and in 19/24 (79%) at 2 years. It is concluded that transurethral resection plus high dose methotrexate may offer an effective alternative to radiotherapy or cystectomy for a significant proportion of patients with invasive bladder cancer.

Adult↗
PubMed1984

Depression of glucuronyltransferase activity by glucocorticoids in adult female mice.

Three experiments were conducted to examine the effect of glucocorticoids on glucuronidation in the adult female mouse. In the first experiment, four mice served as controls, while four other mice were each given 80 micrograms triamcinolone acetonide (TA) at 39, 25, 15 and 1 h before they were killed. Liver homogenates from all animals were assayed for activity of uridine diphospho-glucuronyltransferase (UDP-GT). The mean enzymatic activity was 115 and 58 nmol of rho-nitrophenol conjugated to glucuronic acid X h-1 X mg of hepatic protein-1 for control and TA-treated mice, respectively (P less than .01). In Exp. 2, 48 mice were divided randomly into 12 groups, with four groups of controls, and four each treated with either 100 micrograms TA or 100 micrograms dexamethasone (DEX) at -4 and 0 h. All of the mice were given 2.5 mmol phenolphthalein (P) at 0 h. The excretion of free P was similar for all groups: however, mice treated with TA or DEX excreted significantly less P-glucuronide and mice treated with TA excreted significantly less P-sulfate than did the controls. In the third experiment, 30 mice each served as controls or were treated with 80 micrograms TA or 500 micrograms metyrapone (M) at -4 and 0 h. Also at 0 h, animals were given .12, .15, .19, .24 or .29 mg rho-cresol/g of body weight. The LD50 of rho-cresol for the control, TA- and M-treated groups were .19, .15 and .24 mg of rho-cresol/g of body weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1982

Combination chemotherapy for advanced bladder cancer.

Adriamycin, bleomycin, 5-fluorouracil and methotrexate have been used in combination in a Phase II study and as adjuvant chemotherapy for patients with locally advanced bladder cancer. Although early results with metastatic disease showed considerable antitumour activity, longer follow-up has shown this drug combination to be ineffective.

Bleomycin↗
PubMed1981

Prophylactic oral methotrexate therapy for multiple superficial bladder carcinoma.

Sixteen patients with multiple, frequently recurring Ta/T1 transitional cell carcinoma of the bladder were treated with methotrexate syrup 50 mg orally every week, for 18 months. In 11 patients the frequency, number and size of tumour recurrences decreased markedly. In 3 patients the incidence of tumour recurrence appeared unchanged and in 2 patients the disease progressed and required cystectomy. Overall, the average number of tumours recurring per patient month at risk fell significantly from 2.6 to 1.2 while taking methotrexate. It is suggested that oral methotrexate may provide an effective alternative to intravesical chemotherapy for the prevention of recurrent superficial bladder carcinoma.

Administration, Oral↗