Our aim was to describe a new surgical method for prophylaxis/cure of post obstetric fistula repair leakage based on restoring vaginal elasticity with Singapore skin flap. The rationale for this operation was based on the integral theory: scarring removes elasticity required for independent function of oppositely acting urethral closure forces so they become ‘tethered, forcibly opening the urethra when give the signal to close'. Skin graft restores elasticity and closure. Used prophylactically with Goh type 4 fistula (n = 45), 46% were dry against an expected 19%. In patients with successful fistula closure, still with severe leakage (n = 24), 71% were dry against an expected 26%.Tweetable abstractSingapore skin flap restores elasticity and prevents and treats incontinence in patients with successful obstetric fistula repair.

The distribution of neuropeptide Yin the ureter of the rat, rabbit, and man has beendetermined by radioimmunoassay and chromatographic analysis of the tissue extract. The localization of neuropeptide Y-immunoreactivity has been identified by immunocytochemistry. A regional distribution of neuropeptide Y was found; highest concentrations being present in the ureterovesical junction. Throughout the ureter, neuropeptide Y-immunoreactive nerve fibers were identified to surround the blood vessels and a few plexuses of neuropeptide Y-containing nerves were present within the muscle layers. Neuropeptide Y was not present within ganglion cells. Treatment of rats hydroxydopamine resulted in a significant reduction of neuropeptide Y concentrations in the middle, and lower thirds of the ureter. This depletion in extractable neuropeptide Y was ted with morphologic changes typical of axonal degeneration of the neuropeptide Y-containing nerve fibers.

Conference Abstract| January 01 1988 Human B-Calcitonin Gene-Related Peptide Human (B-CGRP) is a Potent Vasodilator in Man H M Cardoso; H M Cardoso 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar G Williams; G Williams 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar J A Ball; J A Ball 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar P K Mulderry; P K Mulderry 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar E Cooke; E Cooke *Thermography Department, St. Bartholomew' s Hospital, London EC1 Search for other works by this author on: This Site PubMed Google Scholar S R Bloom S R Bloom 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1988) 74 (s18): 43P. https://doi.org/10.1042/cs074043Pb Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Citation H M Cardoso, G Williams, J A Ball, P K Mulderry, E Cooke, S R Bloom; Human B-Calcitonin Gene-Related Peptide Human (B-CGRP) is a Potent Vasodilator in Man. Clin Sci (Lond) 1 January 1988; 74 (s18): 43P. doi: https://doi.org/10.1042/cs074043Pb Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1988 The Biochemical Society and the Medical Research Society1988 Article PDF first page preview Close Modal You do not currently have access to this content.

Conference Abstract| January 01 1988 Hypothalamic Regulatory Peptides in Obese Zucker Rats: Effects of Food Restriction G. Williams; G. Williams 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar Y. C. Lee; Y. C. Lee 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar J. A. Ball; J. A. Ball 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar H. M. Cardoso; H. M. Cardoso 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar M. A. Ghatei; M. A. Ghatei 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar M. J. Stock; M. J. Stock *Physiology Department, St. George's Hospital Medical School, London SW17 Search for other works by this author on: This Site PubMed Google Scholar S. R. Bloom S. R. Bloom 1Department of Medicine, RPMS, London W12 Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1988) 74 (s18): 43P. https://doi.org/10.1042/cs074043Pa Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation G. Williams, Y. C. Lee, J. A. Ball, H. M. Cardoso, M. A. Ghatei, M. J. Stock, S. R. Bloom; Hypothalamic Regulatory Peptides in Obese Zucker Rats: Effects of Food Restriction. Clin Sci (Lond) 1 January 1988; 74 (s18): 43P. doi: https://doi.org/10.1042/cs074043Pa Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1988 The Biochemical Society and the Medical Research Society1988 Article PDF first page preview Close Modal You do not currently have access to this content.

Long-acting somatostatin analogues such as SMS 201-995 (Sandoz) are being evaluated in a wide range of clinical indications, including gut neuroendocrine tumours and acrogemaly. Long-term continuous SMS 201-995 treatment has achieved useful symptomatic improvement in diarrhoea in 4 patients with metastatic VIPomas who had relapsed following previous treatment. Clinical improvement has outlasted suppression of VIP secretion (suggesting an additional direct antisecretory action of SMS 201-995) and has occurred despite expansion of hepatic metastases. In 6 patients with tumours secreting gastrin and/or glucagon, secretion of these peptides was acutely inhibited by SMS 201-995. However, endocrine and clinical responses to chronic treatment have been less consistent. SMS 201-995 is active orally at doses of 4-8 mg and when given thrice-daily to 6 patients with active acromegaly, suppressed mean 24-h growth hormone levels by 51-88%. Despite significantly reduced plasma insulin concentrations, glucose tolerance did not deteriorate. SMS 201-995 was also effective in suppressing thyroid-stimulating hormone (TSH) and thyroid hormone secretion in a patient with mild thyrotoxicosis due to non-tumoural inappropriate TSH hypersecretion. In all cases SMS 201-995 treatment has been well tolerated and has few side-effects.

The contribution of adrenal androgens to the maintenance and progression of so-called hormone-unresponsive prostatic carcinoma was studied in 20 patients with advanced relapsed disease. The role played by testicular androgens had been negated by prior orchiectomy or concurrent LHRH analogue therapy. Ketoconazole, an antifungal agent which inhibits adrenal and testicular androgenesis, administered in a dose of 400 mg 8-hourly, resulted in optimal suppression of adrenal androgens. The mean serum androstenedione concentration fell from 8.01 +/- 0.84 nMol/l to 1.55 +/- 0.25 nMol/l, P less than 0.001, and serum testosterone from 1.25 +/- 0.14 nMol/l to 0.36 +/- 0.06 nMol/l, P less than 0.01, after 6 months treatment. There was, however, no significant difference between patients receiving 400 and those receiving 200 mg. Androgen suppression resulted in six objective and ten subjective clinical responses. Ablation of both testicular and adrenal androgens can now be achieved using ketoconazole in combination with orchiectomy or LHRH analogues, but the high incidence of side effects may preclude its use in all patients with prostatic cancer. The results of this study support the concept of "total androgen ablation" as primary therapy in advanced prostatic cancer as a possible means of improving survival in this common malignancy.

It is worth noting that the duration of stay necessary after revision operations is consistently longer than that after a primary joint replacement (hips 28 v 20 days; knees 40-v 31 days).The cost of revision arthroplasty in-our study was also higher than that of the primary operation in terms of both materials and time consumed.

The association between treatment with danazol and hyperglucagonaemia was studied. Plasma glucagon concentrations were measured during an oral glucose tolerance test in seven women taking danazol and six healthy controls not taking danazol. Results showed that treatment with danazol is associated with severe hyperglucagonaemia, and in three patients glucagon concentrations reached the range suggestive of glucagonoma. It is important to recognise that this increasingly used drug may cause severe hyperglucagonaemia to prevent patients treated with danazol undergoing unnecessary investigations to localise glucagonoma.

both age and sex was significant (x2= 10 7, df= 1, p 0001).This excess in controls over diabetics of more than three to two was roughly constant at all ages and in both sexes.50 40 0 *r40 o 30U 0 20| Female controls o O 10 Female diabetics a E *\ 10 Male controls o 5 Male diabetics a 10-29 30-49 50-69 70-89 Age (years ) Prevalence of migraine in 500 diabetic patients (256 females) and 350 controls (178 females) by sex and age.

Seventeen patients with advanced progressive prostatic cancer who had relapsed or failed to respond to conventional endocrine therapy with oestrogens, orchiectomy or antiandrogens were treated with the LHRH analogue, ICI 118630. No significant objective tumour responses were seen, though 11 of 15 patients who presented with symptomatic metastatic bone pain had rapid short-term pain relief. The lack of objective clinical response seen in this study indicates no justification for the use of LHRH analogues in this group of patients. Though a significant subjective response was seen there was no added advantage over regular analgesics.

Tartrate labile acid phosphatase activity in two patients treated with ketoconazole after they had relapsed while taking an analogue of luteinising hormone releasing hormone. Hatched areas indicate treatment with the analogue; arrows show start of treatment with ketoconazole. The second patient had been treated for three months before October 1982, during which time tartrate labile acid phosphatase activity had remained below 10 IU/l.

Fifteen patients with advanced carcinoma of the prostate were treated with a luteinising hormone releasing hormone agonist ICI 118 630. Three of 5 patients who had failed conventional hormone therapy have had a marked alleviation of bone pain, though no objective evidence of disease regression. Nine of 10 patients previously untreated have shown objective evidence of disease response. This drug appears to have advantages over conventional hormone therapy.