Biomedical subjects
W B Gill
Publications and source records attributed to W B Gill.
DES effect on males.
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Pathological semen and anatomical abnormalities of the genital tract in human male subjects exposed to diethylstilbestrol in utero.
The in utero effects of diethylstilbestrol on the human male genital tract are reported in our followup study of male offspring of mothers treated with diethylstilbestrol. Anatomical and functional abnormalities were significantly greater in male patients exposed to diethylstilbestrol compared to male controls whose mothers were all participants in a prospective, randomized double-blind study on the effects of diethylstilbestrol on pregnancy at our hospital during the early 1950s. Epididymal cysts, hypotrophic testes and capsular induration of the testes were among the more common genital lesions found in more than 25 per cent of 159 male patients exposed to diethylstilbestrol compared to a 6.8 per cent incidence in 161 male controls. Spermatozoal analysis revealed severe pathological changes (Eliasson score more than 10) in 32 per cent of 31 patients exposed to diethylstilbestrol and 0 per cent of 20 male controls. Abnormal findings on physical examination combined with severe sperm abnormalities (Eliasson score more than 10) were found in 23 per cent of the male patients exposed to diethylstilbestrol versus none of the male controls. Cytologic examinations revealed no malignant cells from urine samples before and after prostatic massage or ejaculation, prostatic fluids and aspirates from epididymal cysts.
The influence of bladder fullness on upper urinary tract dimensions and renal excretory function.
Nearly full bladders (375 ml.) produced significantly greater dimensions of the renal calices, pelves and ureters on excretory urograms compared to nearly empty bladders. These dimensions were frequently to the point of being considered pathological dilatations. On planimetry the urographic areas of the pelviocaliceal systems decreased by 43 per cent on the right side and 38 per cent on the left side when the nearly full bladder was compared to the nearly empty bladder in 10 patients. Renal excretory function also was affected by nearly full bladders. Urea clearances after 1 hour were 24 per cent lower and creatinine clearances were 9 per cent lower when starting with a nearly full bladder as compared to starting with an empty bladder. The implications of these findings are of potential significance with respect to 1) interpretation of excretory urograms and 2) chronic urine holding in patients with recurrent urinary tract infections, impaired renal function and/or urolithiasis.
Follow-up study of male and female offspring of DES-exposed mothers.
This follow-up study presents the effects of DES on the genital tract of male and female offspring of mothers who were part of a double-blind, placebo-controlled investigation during 1951 and 1952 aimed at determining the effect of DES on pregnancy. Epididymal cysts, hypotrophic testes, and capsular induration were the more common genital lesions found in 25% of 163 DES-exposed males as compared to 6% in 168 control males. Semen analysis data on 39 subjects of the DES-exposed group and 25 subjects of the control group showed that 26% of the DES-exposed group produced an ejaculate volume under 1.5 ml; no such cases were observed in the control group. The average values for sperm density ant total motile spermatozoa per ejaculate, although in the normal range, were more than two times lower in the DES-exposed group as compared to the controls. A quality score of greater than 10 ("severely pathologic semen") was found in 28% of the DES-exposed group as compared to 0 in the control group. An association of pathologic semen quality with physical abnormalities was found only in the DES-exposed group. Two cases of azoospermia, one without genital abnormalities on physical examination and one with bilateral hypotrophic testes were observed so far in the DES-exposed group. Eighteen percent of 229 DES-exposed female patients had irregular menstrual cycles (oligomenorrhea) as compared to 10% of 136 controls. The history of pregnancy revealed a lower incidence of pregnancy in the DES-exposed group (18%) than in the control group (33%). Circumferential ridges of the vagina and cervix were seen in 40% of 229 DES-exposed females but in none of 136 controls. Colposcopic findings in the vagina revealed adenosis in 66.8% of the DES-exposed females and in 3.6% of the control group. Dysplastic lesions were more prevalent in the vagina and cervix of the DES-exposed subjects. No cases of cancer were observed in either the male or female offspring.
Inhibitory effects of urinary macromolecules on the crystallization of calcium oxalate.
Protective (inhibitory) effects of human urinary macromolecules on the crystallization of calcium oxalate were found when these urinary macromolecules were added to water or to salt solutions, which mimic human urine with respect to the concentrations of the most abundant small molecular weight species. The aspects of calcium oxalate crystallization affected by urinary macromolecules were: (i) an inhibition of nucleation (increased metastable limit), (ii) an inhibition of the crystallization rate, (iii) a decrease in the supersaturation level, and (iv) a decrease in adhesion of crystals to container surfaces.
Determinants of supersaturation levels and crystallization rates of calcium oxalate from urines of normal humans and stone formers: effects of nondialyzable materials.
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Evaluation of renal masses including retrograde renal brushing.
1. The evaluation of renal masses has become an increasingly important topic because of the increasing incidence of kidney cancer, the improved cure rate of renal carcinoma with the proper preoperative diagnosis, and the proliferation in renal mass diagnostic methodology. 2. A variety of benign entities can produce an abnormal renal mass with attendant difficulties in being distinguished from malignant neoplasms. Among these benign lesions are: simple renal cysts, polycystic kidneys, congenital variations in renal size and shape, segmental renal hypertrophy, renal infarcts, intrarenal hematomas, renal hamartomas, renal leiomyomas, renal adenomas, renal angiomas, renal fibrolipomatosis, hydronephrosis of a duplicated collecting system, renal abscesses, and xanthogranulomatous pyelonephritis. 3. Nephrotomography, nephrosonography (ultrasound), adrenalin renal arteriography, selective magnification renal arteriography, renal venography and cavography, lymphangiography, renal scintillation scanning, abnormal levels of enzymes in blood and urine, immunologic studies (circulating antibodies and tumor-associated antigens), percutaneous needle aspirations, and retrograde renal brushing have all increased the diagnostic accuracy of determining the etiology of renal masses. None of these diagnostic procedures is infallible. A judicious combination of procedures gives the most reliable diagnostic results. 4. A search continues for (a) chemical agent(s) or a chemical profile in the blood or urine which is (are) specific for renal carcinoma, but as yet this is an investigational area and not a practical clinical reality.
Structural and functional abnormalities in the sex organs of male offspring of mothers treated with diethylstilbestrol (DES).
The in utero effects of DES (Diethylstilbestrol) on the human male genital tract are reported in this follow-up study of male offspring of DES-treated mothers. Both anatomical and functional abnormalities were significantly greater in the DES-exposed males as compared to control males whose mothers were all participants in a prospective, randomized double blind study of the effects of DES on pregnancy at the Chicago Lying-in Hospital during the early 1950s. Epididymal cysts, hypotrophic testes and capsular induration of the testes were among the more common genital lesions found in 27% of 134 DES-exposed males as compared to a 7% incidence in 119 control males. Spermatozoa analyses revealed severely pathologic changes (Eliasson score greater than 10) in 29% of 28 DES-exposed males and 0% of 18 control males (with or without genital i.e., physical abnormalities). Abnormal findings on physical examination combined with sperm abnormalities (Eliasson score greater than or equal to 5) were found in 29% of DES-exposed males versus 0% of 18 control males. Cytologic examinations did not reveal malignant cells from the following materials: urines before and after prostatic massage or ejaculation, prostatic fluids and aspirates from epididymal cysts.
Further experience with circle tube nephroureterostomy urinary diversion.
Circle tube nephroureterostomy as an alternative method of urinary diversion has now been used in 80 patients, representing a wide variety of clinical problems. The technique offers several advantages over nephrostomy or intubated ureterostomy. Additional extensive experience with the procedure has substantiated the initially favorable impressions.
Radical retropubic prostatectomy and retroperitoneal lymphadenectomy following radiotherapy conversion of stage C to stage B carcinoma of the prostate.
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Supersaturation levels and crystallization rates of calcium oxalate from urines of normal humans and stone formers determined by a 14C-oxalate technique.
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Urinary diversion by circle tube: a valuable adjunct to the management of pelvic carcinoma.
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Dual renal cell carcinomas in a unilateral polycystic kidney.
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Cup-forceps cortical renal biopsy: an improved technique of open renal biopsy.
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Retrograde brushing: a new technique for obtaining histologic and cytologic material from ureteral, renal pelvic and renal caliceal lesions.
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The use of a hydrocortisone antibacterial urethral insert in the treatment of urethral strictures: a preliminary report.
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Renovascular hypertension developing as a complication of selective renal arteriography.
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