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Biomedical subjects

A E Kark

Publications and source records attributed to A E Kark.

At least 55 records · Page 3Linked to original sources
PubMed1984

Voice changes after thyroidectomy: role of the external laryngeal nerve.

Hitherto voice changes have been regarded as an infrequent complication of thyroidectomy and damage to the recurrent laryngeal nerve has been given as their major cause. Voice function was assessed in 325 patients after thyroidectomy. Permanent changes occurred in 35 (25%) after subtotal thyroidectomy and in 19 (11%) after lobectomy. The commonest cause of voice change appeared to be injury to the external laryngeal nerves on one or both sides. Damage to the recurrent laryngeal nerve, which was routinely identified and protected, was rarely a cause. When the external laryngeal nerves were identified and preserved, permanent voice changes occurred in only 5% of cases; this was similar to the incidence of 3% in controls after endotracheal intubation alone. The course of the external laryngeal nerve is variable, and consequently mass ligation of the vessels at the top of the upper pole will damage it in a high proportion of cases. To minimise this serious complication these nerves should be identified and protected as well as the recurrent nerves and voice function should be assessed early in the postoperative period by laryngoscopy and by a speech therapist.

Adolescent↗
PubMed1984

Sites of recurrent tumour after 'curative' colorectal surgery: implications for adjuvant therapy.

The pattern of recurrent tumour following 'curative' colorectal surgery was examined in a necropsy series and a prospective clinical series. In the necropsy series the commonest pattern of recurrence was disseminated disease (73 per cent) and recurrence in a single site was much less common (27 per cent). In the clinical series recurrence in a single site was commoner (55 per cent). The difference between the two series is statistically significant (P = 0.02, chi 2), and is probably due to under-diagnosis of disseminated recurrence in the clinical series. In both series local recurrence and hepatic metastases occurred almost equally but usually as part of disseminated disease. We conclude that after 'curative' surgery for colorectal cancer, recurrence is usually disseminated (73 per cent) and therefore therapy adjuvant to surgery should be active systemically. Adjuvant therapy directed at a single site (e.g. radiotherapy or intrahepatic chemotherapy) should be combined with a systemic therapy.

Adult↗
PubMed1984

Inhibition of experimental colorectal cancer by razoxane (ICRF-159).

Large bowel cancer induced in rats by dimethylhydrazine (DMH) closely resembles human disease both histologically and clinically. In this study it has been used to assess the antimitotic drug razoxane (ICRF-159). Dimethylhydrazine induced benign colorectal tumours after 20 weeks and adenocarcinomas from 30 weeks. Razoxane was given from week 25 until the end of experiment (week 35) to see if this drug could inhibit the development of tumours. Animals were randomly allocated to four groups: DMH + razoxane (26), DMH + control (26), control + razoxane (25), control + control (25). There were fewer malignant colorectal tumours in rats receiving razoxane than in the controls (10 vs. 24; P = 0.04). Some animals developed malignant tumours of the small intestine as well as the large bowel and the number of malignant tumours for the whole intestinal tract was also reduced in animals receiving razoxane (15 vs. 32; P = 0.025). This study demonstrates inhibition of the development of malignant tumours in rats by razoxane. This finding may have relevance to colorectal cancer in man where razoxane has been used in disseminated disease and as an adjuvant to surgery.

1,2-Dimethylhydrazine↗
PubMed1984

Postmastectomy breast reconstruction with an inflatable prosthesis.

Breast reconstruction was carried out in 38 patients after modified radical mastectomy, using a saline-filled inflatable prosthesis placed in a submuscular pocket. In 79 per cent the reconstructed breast had normal texture without complications. One patient was dissatisfied with the cosmetic result. Marked capsular contraction occurred in two cases (6 per cent) and late deflation in five (14 per cent).

Adult↗
PubMed1983

Late leakage of saline-filled breast prosthesis.

Twenty-four women with breast cancer have had postmastectomy submuscular reconstruction with a valved inflatable prosthetic mammary implant. In four cases (16.6%) spontaneous deflation occurred between seven and 12 months after reconstruction.

Adult↗
PubMed1983

The effect of undernutrition and disease site and stage on cell-mediated immunity in gastrointestinal cancer.

In order to assess whether impairment of cell-mediated immunity in cancer was due to the presence, site and stage of malignant disease or to associated undernourishment, 48 patients with gastrointestinal cancer were compared to 27 patients with benign gastrointestinal disease. Cell-mediated immunity (CMI) was assessed by delayed hypersensitivity (DHS) skin test response to recall antigens and lymphocyte mitogenic response to phytohaemagglutinin (PHA). Patients were grouped according to nutritional status assessed from a history of weight loss and changes in the ratio of total body potassium (TBK mmol) to total body water (TBW kg). The results showed that, whilst cancer patients as a whole had significantly worse DHS response, there were no significant differences between benign and malignant groups of equivalent nutritional status and in both types of disease response decreased significantly with worsening nutritional status (chi 2(2) = 6.83 cancer, 6.11 benign, p less than 0.05). PHA response was significantly worse in the worst nourished cancer patients than in those with normal nutritional status (p less than 0.05, Wilcoxon). Disease site and stage had no significant effect on either test. The results suggest that depression of CMI response in gastrointestinal cancer is due to undernutrition and is not a cancer specific effect.

Adult↗
PubMed1983

Chemotherapy of chemically-induced colorectal tumours.

Benign and malignant tumours were induced in the large bowel of rats by the carcinogen 1,2-dimethylhydrazine (DMH). Benign tumours appeared from week 20 onwards and malignant tumours from week 30. 5-Fluorouracil was administered intraperitoneally in maximally tolerated doses from week 26 onwards and failed to influence significantly the development of either benign or malignant tumours. Tumours induced by DMH are a close model of human colorectal cancer and suitable for testing anticancer drugs. Agents with greater activity against colorectal cancer are required.

Animals↗
PubMed1980

Dietary intakes, resting metabolic rates, and body composition in benign and malignant gastrointestinal disease.

Dietary protein and energy intakes were assessed in 42 patients with cancer and 24 with benign conditions of the gastrointestinal tract. The relations of dietary intake to body composition was examined. Resulting metabolic rate was measured in 51 patients. No significant differences in dietary intake or metabolic rate were found between patients with cancer and those with benign disease. There were significant positive correlations between protein and energy intakes and the ratio of total body potassium to total body water in patients with benign disease but not in those with cancer. Weight loss was probably due to inadequate food intake, the main defect being energy deficiency, since protein intake was usually well maintained. Supplementing with energy the voluntary ingested diet of patients with cancer would probably prevent weight loss in most cases.

Adult↗
PubMed1980

Jaw wiring.

Explore the source record for details and available documents.

Adult↗
PubMed1979

Infusion cholecystography in the diagnosis of acute cholecystitis.

The use of infusion cholecystography as an aid in the diagnosis of acute cholecystitis was investigated in 21 patients. Seventeen of 18 patients (94 per cent) with positive cholecyst-tomograms who underwent laparotomy had confirmation of acutely inflamed gallbladders both macroscopically and histologically. These findings suggest that infusion cholecystography can make a significant contribution in reducing the incidence of misdiagnosis in acute cholecystitis, and that the investigation should be part of the management of patients in whom early surgery is planned.

Acute Disease↗
PubMed1979

Gastric reduction for morbid obesity: technique and indications.

The results of gastric reduction for obesity in 12 patients are described. Emphasis is laid on preoperative weight loss, using jaw wiring in 9 patients. The successful outcome of the operation was found to depend on the formation of a small gastric pouch and a narrow gastro-jejunal anastomosis. A constant-sized pouch was achieved by forming the pouch around a 100-ml silicone balloon devised for the purpose. Postoperative results were good in 7 patients, partial success was achieved in 3 patients and there were 2 failures. It is concluded that the procedure will produce successful results provided that a small proximal pouch with a narrow outlet is fashioned in motivated and psychologically well-balanced patients.

Adult↗