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Biomedical subjects

S N Lloyd

Publications and source records attributed to S N Lloyd.

30 records · Page 2Linked to original sources

Terazosin in the treatment of benign prostatic hyperplasia: a multicentre, placebo-controlled trial.

The dynamic component of bladder outflow obstruction due to benign prostatic hyperplasia (BPH) has been shown to be modified by alpha 1 adrenergic receptors. Terazosin is an alpha 1 receptor-blocking agent with a long half-life permitting once-daily dosing. This drug was administered in a multicentre, randomised, placebo-controlled trial involving patients with symptomatic bladder outflow obstruction. Of 132 patients recruited for the study, 86 were randomised to receive placebo or terazosin, 81 completed the study, and 80 were considered eligible for efficacy analysis. All terazosin treatment groups showed dramatic improvement in obstructive symptoms when compared with the placebo group, but these differences were not statistically significant because of the small numbers of patients in each group. There were improvements in peak urinary flow rates, mean urinary flow rates, and residual urine volumes for the placebo and terazosin groups, but there were no statistically significant differences in the changes between the groups. Terazosin was well tolerated by patients in this study and may provide symptomatic relief in patients with BPH.

Adrenergic alpha-Antagonists↗

Local hyperthermia for prostatic disease: in vitro studies on human prostatic cancer cell lines.

Local hyperthermia for benign and malignant prostatic disease remains largely empirical. In an attempt to understand the biological action of hyperthermia, and its potentiation by antiandrogen seen in clinical practice, the interaction of the two has been studied in prostatic cancer cell lines. Human prostatic cancer cell lines LNCaP and DU 145 were studied to examine the effects of heat shock treatment (HST), androgen (5 alpha-dihydrotestosterone: 5 alpha DHT) and antiandrogen (hydroxyflutamide: OH-Flut) on cell growth and survival. Response (measured as increased DNA content) to 5 alpha DHT demonstrated that LNCaP was androgen sensitive, whereas DU 145 was androgen insensitive; OH-Flut stimulated LNCaP growth but had no effect on DU 145 growth. Thermotolerance was exhibited by DU 145 cells but not by LNCaP cells. The combination of HST followed by OH-Flut markedly reduced survival of LNCaP cells compared with HST alone. This effect was not observed in DU 145 cells. The enhanced cytotoxic effect of antiandrogen and hyperthermia could minimise the effect of thermotolerance in malignant cells surviving initial hyperthermia treatment and might suggest real clinical value for the combination or sequence.

Cell Division↗

Nucleolar organizer regions in benign and malignant prostatic disease.

A modified silver stain technique for visualizing nucleolar organizer regions (AgNOR counting) was applied to 24 benign and 23 malignant prostatic biopsies. Marked inter-observer variation was found, particularly in sections with high AgNOR counts. After averaging the AgNOR counts of both observers, there was no significant difference in counts between the benign and the malignant biopsies. The AgNOR count appeared to be increased in tumours up to Gleason histological grade 6, but not in tumours of Gleason histological grade 7 or more.

Humans↗

Who should have a prostatectomy? A survey of the management of patients presenting with bladder outflow obstruction.

A postal questionnaire was sent to 33 urologists and to 15 general surgeons who perform prostatic surgery in Scotland. Forty-six out of 48 surgeons replied. The waiting time for outpatient consultations and waiting list statistics of the respondents were compared. Differences in access to and use of imaging, laboratory and urodynamic facilities are reported. Waiting times were affected by the individual surgeon's policy. In busy units, the desire to achieve acceptable waiting times may lead to rationing of treatment to only the most severe cases. Better provision and use of modern investigational facilities might better select those patients who will benefit most from surgical management, leading to more effective use of resources. Medical audit of surgical patients must start from the time of their referral and not confine itself to patients undergoing treatment.

Attitude of Health Personnel↗

Endoscopic transvesical extramural ureterolithotomy.

The technique of endoscopic transvesical extramural ureterolithotomy for calculi impacted in the lower ureter is described. Ten patients are presented in whom calculi could not be extracted using conventional methods; 9 of the 10 calculi were successfully removed using this approach with no long-term complications.

Adult↗

Epidermal growth factor receptor, nuclear proliferation antigen and interleukin-2 receptor expression in prostatic cancer.

Immunohistochemical methods have been used to study the relationship between epidermal growth factor receptor (EGF-R), T-lymphocyte infiltrate, interleukin-2 receptor (IL-2R) expression and the degree of cellular proliferation using the monoclonal antibody Ki-67. EGF-R was detected in only 2 out of the 19 malignant biopsies, but was present in the benign elements of all twelve of the heterogeneous biopsies examined. The level of immune response, as indicated by the percentage of T cells expressing the IL-2R, did not correlate with the expression of the nuclear proliferation antigen determined by Ki-67 monoclonal antibody staining intensity. This study fails to show a statistically significant correlation between the expression of EGF-R or nuclear proliferation antigen and the degree of the cell mediated immune response to the tumour.

Adenocarcinoma↗

The non-deflating Foley catheter.

Fourteen cases of retained intravesical Foley balloon catheters occurred in the West Suffolk Hospital between 1988 and 1989. In all cases this was due to failure of the balloon to deflate. All cases were successfully managed with radiological techniques. The alternative methods described for retrieval of retained balloon catheters are reviewed, and two recommended methods are described in detail.

Catheters, Indwelling↗

Ki-67 antibody immunostaining in benign and malignant human prostatic disease.

Indices of mitotic potential may improve prognostic discrimination in patients with malignant disease. Ki-67 is a monoclonal antibody directed against an unknown proliferation antigen which has been shown to be a measure of mitotic potential. Sixty-four benign and eighty malignant prostatic biopsies were stained with the Ki-67 antibody. Nuclear and cytoplasmic staining was identified in benign and malignant biopsies using immunoalkaline phosphatase and immunoperoxidase staining reactions. Nuclear staining was identified in 14 benign and 44 malignant biopsies. Nuclear staining for Ki-67 was seen in 36% of biopsies with Gleason histological score (GHS) 2-4, 71% with GHS 5-7 and 62% with GHS 8-10. Nuclear staining was associated with advanced local disease stage, but not with metastatic disease stage. Clinical follow-up is required to establish the value of Ki-67 immunostaining as a prognostic determinant in prostatic cancer.

Antibodies, Monoclonal↗

Transforming growth factor-alpha expression in benign and malignant human prostatic disease.

Investigation of biological variables in prostatic disease may not only prevent patients with a good prognosis being overtreated, but allow better selection of appropriate therapy, and may identify potential targets for novel therapies. This study investigates the growth factor transforming growth factor-alpha (TGF alpha) expression in benign and malignant prostatic biopsies using both radioimmunoassay and immunohistochemistry, considering its role in malignant epithelial transformation and as a prognostic indicator. Biochemical methods were less satisfactory than the more selective immunohistochemical methods, due to the heterogeneity of prostatic tissue. Seventy-one percent of benign biopsies (range 0-18.62ng/mg DNA) and 69% of malignant biopsies (range 0-11.1ng/mg DNA) had detectable levels of TGF alpha using radioimmunoassay. Immunohistochemical staining for TGF alpha identified expression in 15% of benign (4 out of 27) and 53% malignant biopsies (18 out of 34). Positive staining was also identified in premalignant lesions and within stromal elements, thus implying the factor's role in autocrine/paracrine growth and/or malignant transformation. Immunostaining for TGF alpha may enhance detection of premalignant lesions and small foci of malignant glands which are otherwise difficult to identify using standard histopathological techniques.

Biomarkers, Tumor↗