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Biomedical subjects

A Allan

Publications and source records attributed to A Allan.

At least 73 records · Page 4Linked to original sources
PubMed1985

Crypt cell production rate in ulcerative proctocolitis: differential increments in remission and relapse.

Crypt cell production rate (CCPR) has been measured by a stathmokinetic technique in the relapse and remission phases of ulcerative proctocolitis. Rectal biopsies were obtained from eight patients with colitis in relapse, 14 patients with colitis in remission, and 14 patients with histologically normal mucosa. Biopsies were maintained in organ culture for 16 hours and were then exposed to vincristine for one to three hours. Crypt cell production rate was determined from the rate of accumulation of arrested metaphases. Mean CCPR in the relapse group (14.2 cells/crypt/hour) was 45% faster than in the remission group (9.8 cells/crypt/hour; p less than 0.001), which was in turn 14% faster than in normal mucosa (8.6 cells/crypt/hour; p less than 0.04). More rapid turnover of the rectal epithelium in quiescent as well as active colitis may help to explain the enhanced risk of carcinogenesis in this disease.

Adolescent↗
PubMed1985

Effect of filtrate containing Clostridium difficile toxin on rectal mucosa maintained in organ culture.

Rectal biopsies were maintained in organ culture over a 24-hour culture period, with good preservation of histological architecture. A filtrate containing Clostridium difficile toxin significantly inhibited the rise in epithelial alkaline phosphatase activity normally seen during culture. This effect was abolished by pre-incubation of the filtrate with Clostridium sordellii antitoxin, or heat inactivation. This effect is most probably due to a toxin of C. difficile. The method provides a new quantitative approach to the study of luminal toxins as possible pathogenic agents in idiopathic inflammatory diseases of the colon.

Alkaline Phosphatase↗
PubMed1985

Abdominal wound closure: a controlled trial of polyamide (nylon) and polydioxanone suture (PDS).

Two hundred and thirty three patients with major laparotomy wounds, either midline or transverse, were randomly allocated to mass closure using No 1 (BPC) polyamide (Nylon) or polydioxanone suture (PDS). Wounds were assessed during the hospital stay and postoperatively in outpatients, at six weeks and six months, for evidence of wound failure or wound infection. Two wound failures occurred in the PDS group (one burst abdomen and one incisional hernia) although neither was directly attributable to suture failure. The overall wound infection rate was 13.3%; 2.9% being major infections and the majority (two thirds) occurring in the PDS group. There were no reported wound sinuses or wound pain in either group at six months. Polydioxanone suture may be an alternative to polyamide for laparotomy closure but is associated with a higher, though not statistically significant, incidence of wound failure and infection.

Adult↗
PubMed1985

Anal fissure.

Anal fissures are both common and disabling. Patients can be in pain for weeks before receiving effective treatment, and unnecessary discomfort may be prevented by timely operation. Existing forms of treatment are reviewed with particular reference to lateral subcutaneous sphincterotomy.

Acute Disease↗
PubMed1984

Transient hypercalciuria after commencing total intravenous nutrition.

A study of 28 patients receiving a standard regimen of total intravenous nutrition (I.V.N.) for periods of > 14 days has shown the transient development of hypercalciuria in 14 patients (50%). The peak incidence of hypercalciuria occurred in 11 patients (39%) after 1 week of I.V.N. and hypercalciuria persisted for 1-4 weeks. In only one patient was hypercalciuria present at the end of the treatment period. Urine calcium (Ca) and nitrogen (N) excretion rates correlated significantly (r = 0.48 p < 0.001) and urine N excretion varied from week to week in parallel with urine Ca excretion in the hypercalciuric group of patients. There was no significant difference in urine Ca excretion between 12 patients who received 3.75 mmol Ca/day and 16 patients who received 8.75 mmol Ca/day. It is concluded that transient hypercalciuria may be related to increased protein catabolism and N excretion and that it probably does not indicate a major problem in mineral metabolism.

Journal Article↗
PubMed1983

The use of graduated compression stockings in the prevention of postoperative deep vein thrombosis.

The efficacy of graduated compression stockings in the prevention of postoperative deep vein thrombosis was studied in a randomized, prospective, controlled trial of 200 patients, aged 40 years and over, undergoing abdominal surgery (100 for benign disease, 100 for malignant conditions). Deep vein thrombosis was diagnosed by the 125I-fibrinogen test. The incidence of deep vein thrombosis was 35.9 per cent in the control group (103 patients) and 15.5 per cent in the stockinged group (97 patients) (P less than 0.025). In the patients with benign disease, deep vein thrombosis developed in 24.5 per cent of the control limbs and 6.1 per cent of stockinged limbs (P less than 0.005); in patients with malignant disease the similar figures were 27.9 and 11.5 per cent (P less than 0.05). Increasing age did not alter the efficacy of the stockings. It is concluded that graduated compression stockings provide a safe and effective method of prophylaxis against deep vein thrombosis.

Abdomen↗
PubMed1983

In vitro model for the assessment of luminal factors on rectal mucosa.

An organ culture method for the maintenance of rectal biopsies over a period of 24 hours is described. Good preservation of histological architecture and continued crypt cell proliferation were shown over the culture period. The colonic enzyme alkaline phosphatase was found to rise over the period of culture. This rise was dependent upon continued protein synthesis by the cell. Changes in alkaline phosphatase activity during culture in biopsies from patients with ulcerative colitis and Crohn's disease are reported. This organ culture system and the measurement of alkaline phosphatase activity during culture provides a new approach to the assessment of luminal antigens as possible effectors of colonic epithelial cell damage.

Alkaline Phosphatase↗
PubMed1982

Early discharge following hernia repair in unselected patients.

The feasibility and safety of early discharge from hospital following inguinal hernia repair in selected patients is well established. The following is an account of 104 unselected patients who presented consecutively to an Inner London hospital with inguinal hernias. The intention was to discharge all patients 48 h after operation, but for a variety of reasons a later discharge day was planned preoperatively in 50. Of the 104 patients, 62 (60 per cent) were discharged on the planned day, but only 23 per cent left hospital 48 h after operation. The factors which accounted for this are discussed. It was possible, however, to discharge over 85 per cent within 5 days of operation.

Adult↗
PubMed1982

Biliary-type pain as a manifestation of genital tract infection: the Curtis-Fitz-Hugh syndrome.

Ten patients with biliary-type pain, in whom investigations of the biliary tract were negative, are reported. All the patients were sexually active premenopausal women and all had evidence of infection with chlamydia trachomatis. Five patients submitted to laparoscopy had fibrinous adhesions between the anterior surface of the liver and the parietal peritoneum (perihepatitis). All 10 patients were diagnosed as suffering from the Curtis-Fitz-Hugh syndrome caused by Chlamydia trachomatis. The clinical similarities between the Curtis-Fitz-Hugh syndrome (right upper quadrant abdominal pain, perihepatitis and genital tract infection) and acute biliary disease are emphasized and the diagnostic implications discussed.

Adolescent↗
PubMed1981

Chlamydia and the Curtis-Fitz-Hugh syndrome.

Ten women with acute right upper-quadrant abdominal pain but negative results for biliary investigations had a current or past history of pelvic inflammatory disease. A diagnosis of the Curtis-Fitz-Hugh syndrome was made and was confirmed in five patients by laparoscopy. Neisseria gonorrhoeae was not isolated from the cervical and urethral swabbings of seven patients tested. Chlamydia trachomatis was isolated from the endocervical canal in one of six patients examined. Of sera from nine patients tested by a micro-immunofluorescence test, nine and six samples respectively showed type-specific IgG and IgM antibodies against C trachomatis serotypes D-K. Type-specific IgG and IgA antibodies were also detected in the cervical and urethral discharge of two out of five patients and in the peritoneal aspirate of two. The presence of high titres of IgG or IgM in sera and IgG or IgA in the local discharges of our patients suggests that C trachomatis was probably the cause of the CFH syndrome.

Adolescent↗
PubMedDate not supplied

Segmental colonic resection is an appropriate operation for short skip lesions due to Crohn's disease in the colon.

Thirty-six patients have had a segmental colonic resection for Crohn's colitis between 1948 and 1984. There were 2 deaths caused by intraabdominal abscesses present before operation. There were no cases of anastomotic dehiscence in the 29 patients having segmental resection and immediate anastomosis. The reoperation rate at 10 years was 66% (95% confidence interval, 48-84%), the majority of reresections being for recurrent large bowel Crohn's disease. The 10-year reoperation rates were higher than after subtotal colectomy and ileorectal anastomosis (53%; 95% confidence interval, 37-69%) performed in a comparable group of patients with colonic Crohn's disease. The difference did not achieve statistical significance. These findings suggest that when a patient with Crohn's disease has a short segment of diseased large bowel, a segmental resection is feasible and safe.

Adolescent↗