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Biomedical subjects

A L Watne

Publications and source records attributed to A L Watne.

At least 19 recordsLinked to original sources
PubMed1997

Colon polyps.

Colon polyps may be single or multiple, noninherited or inherited, histologically may vary from inflammatory, hamartomatous, neurogenic, or adenomatous, and may be benign or malignant. The various recognized syndromes are discussed including their clinical presentation, malignant potential, and associated tumors. Recognition of these clinical syndromes will allow the clinician to categorize the patient and the relative risk. The discussion goes into the genetic studies identifying the adenomatous polyposis coli gene on chromosome 5 q21 and the identification of mutations arising in the DNA repair genes (MSA2, MLH1, PMSI, and M52) in the HNPCC syndrome. This identified two divergent pathologies, both involving "multiple hits" with mucosal cells going from normal to adenoma-dysplasia-carcinoma. The understanding of the multiple hit concept with the adenoma-dysplasia-carcinoma progression will aid in the further understanding of the broad neoplastic process.

Adenoma↗
PubMed1997

Eosinophilic colitis presenting as a left-sided colocolonic intussusception with secondary large bowel obstruction: an uncommon entity with a rare presentation.

Eosinophilic gastroenteritis is a quite uncommon clinical entity usually involving the stomach or small bowel. Occasionally, the colon is involved. We have encountered a case of eosinophilic colitis leading to a left-sided colocolonic intussusception and subsequent large bowel obstruction. This is a unique presentation that, to our knowledge, has not been previously reported. We present our case in detail as well as a review of the literature to better understand this rare clinical entity.

Adult↗
PubMed1996

Small bowel carcinoid: review of a single institution experience and review of the literature.

We have undertaken a review of the small bowel carcinoids treated at Georgia Baptist Medical Center during the last 27 years in order to evaluate the clinical behavior, diagnostic approaches, treatment options, and prognosis of these neoplasms. A retrospective analysis of the tumor registry at Georgia Baptist Medical Center was undertaken. A total of 148 cases of carcinoid tumors were identified. Of these, 34 were located in the small bowel. Twenty-eight of these cases were diagnosed at our institution. The others were referred for oncology care. The patient records were reviewed for sex, race, age at presentation, location, 5-HIAA status, coexistent neoplasms, multifocality, size, metastatic status, clinical presentation, diagnostic intervention, extension, adjuvant therapy, treatment intervention, and survival. A review of the available literature was undertaken to analyze the historical results in the aforementioned categories. In retrospect, many of these tumors had been clinically active for some time. The authors outline a more aggressive workup in order to avoid acute, in extremis, and late stage presentation. We present an analysis of traditional views on survival and prognosis as related to the size and spread of small bowel carcinoid. We expect that this information will assist in the development of definitive treatment, effective adjuvant therapy, and symptomatic relief for this often frustrating neoplasm.

Adult↗
PubMed1991

Gynecological malignancies, brain tumors, and familial adenomatous polyposis.

The syndrome of familial adenomatous polyposis has a wide spectrum of clinical manifestations including adenomatous polyps of the colon and small bowel, adenocarcinoma of ampulla of Vater, tumors of the central nervous system, bone lesions, and various soft tissue tumors. The one common denominator is colonic polyposis. It is not known whether this phenotypic heterogeneity is due to various genotypes, or if the entire clinical spectrum is due to one genetic defect. We are reporting the association of gynecologic malignancies with familial adenomatous polyposis as an additional variant of this disease. This report is on two sisters from a family with familial polyposis coli who developed adenomatous polyposis of the colon, central nervous system tumors, and cancers of the ovary and uterus. The gynecological malignancies add another variant to this clinical syndrome.

Adenomatous Polyposis Coli↗
PubMed1991

Lymphoepithelioma-like carcinoma of the lung.

Historically lymphoepithelioma was a term used to describe an undifferentiated mucosal carcinoma with a lymphocytic component arising only from the nasopharynx, although recently, lymphoepithelioma-like carcinoma has been found to occur as a primary tumor of the lung. Thus far, five patients have been documented as having this rare anatomical presentation. The patient that is being presented is the latest case of lymphoepithelioma-like carcinoma of the lung and will be compared clinically and histologically with the other four cases. The case is presented in order to discuss optimal methods of diagnoses and treatment for this condition.

Aged↗
PubMed1990

Postoperative surveillance of patients with carcinoma of the colon and rectum.

The early detection and management of recurrence following curative resection for colorectal carcinoma can prolong survival. However, at the present time there is no consensus on the appropriate follow-up protocol for such patients. This investigation was undertaken to determine which tests and procedures are most useful in detecting recurrence and the frequency with which they should be employed. Another purpose of this study was to identify those patients at high risk for recurrence. Sixty-five patients who underwent curative resection of adenocarcinoma of the colon and rectum were followed for at least two years or until recurrence. Thirty were classified as Duke's A carcinoma of the colon, 18 were Duke's B, and 17 were Duke's C. Mean follow-up was 44.9 months. The follow-up regimen consisted of clinical exam, liver function tests, carcinoembryonic antigen (CEA) level, and chest x-ray every three months for the first two years postoperatively and every six months thereafter, and colonoscopy or barium enema and proctoscopy every six months for the first two years postoperatively and every year thereafter. Seventeen patients (26%) had a recurrence; 24% per cent of these developed within one year, 65 per cent developed within two years, 82 per cent developed within three years, and 94 per cent developed within four years of resection. Recurrence was detected by CEA in eight patients, chest x-ray in five, endoscopy in three, and laparotomy for small-bowel obstruction in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1987

Patterns of inheritance of colonic polyps.

While the inheritance pattern of familial polyposis coli is established as an autosomal dominant pattern, the expression of the various extracolonic manifestations associated with the neoplastic polyposis is less well understood. The discrete polyp cancer syndrome may not be recognized unless both polyps and colon cancer are considered in the inheritance pattern. The hamartomatous polyps follow a Mendelian-dominant inheritance pattern for the Peutz-Jeghers syndrome, while the inheritance pattern for the juvenile polyposis syndromes is less clear. Cowden's disease appears in a Mendelian dominant pattern, but the occurrence of colonic polyps is less well documented. The ganglioneuromas follow a mendelian dominant inheritance pattern, while the relationship and occurrence of colonic polyps in association with Torre's syndrome is uncertain. The Mendelian dominant inheritance pattern for the cancer family syndrome is documented; the role of colon polyps in this syndrome is less well understood. A further understanding of the inheritance patterns of these various colon polyps will lead to more understanding of the basic disease and help in prevention and early detection for treatment and cure.

Adenomatous Polyposis Coli↗
PubMed1987

Dynamics of glycoprotein metabolism in familial polyposis coli-derived colonic epithelial tissue.

Familial polyposis coli is a disease state that offers an opportunity to obtain colon tissue in a predictable manner in terms of identifying putative premalignant markers. Our results support the hypothesis that a sequential series of alterations occur in the dynamics of glycoprotein metabolism as normal colonic mucosa progresses to colon adenocarcinoma. Specifically, both nonmalignant polyps and colon adenocarcinoma tissue expressed diminished glycosylation of proteins, whereas an elevated level of activity for membrane-associated glycosyltransferases does not appear until colon cancer itself develops.

Adenocarcinoma↗
PubMed1986

Glycosyltransferase levels in familial polyposis coli.

Glycosyltransferase levels have been reported to be decreased in the tumor mucosa of adenocarcinoma of the colon. The purpose of this study was to determine if similar changes are present in the polyp mucosa of patients with Familial Polyposis Coli (FPC). The levels of eight glycosyltransferases were determined by measuring transfer of a radiolabeled sugar from a nucleotide sugar donor to a glycoprotein acceptor. The levels of four of the enzymes were significantly different in the mucosa of tumors and the polyp mucosa of patients with FPC as compared to the colonic mucosa of persons without known neoplastic disease. The changes were specific for these four enzymes and occurred to the same degree in tumor mucosa and the polyp mucosa. These changes in glycosyltransferase levels are a marker of the malignant transformation of the cell and since they occur in the histologically benign cells of FPC may serve as a key to understanding the neoplastic process.

Adenocarcinoma↗
PubMed1984

Treatment alternatives. Head and neck cancers.

No tumor system is more amenable to multidiscipline therapy than head and neck cancers. Diagnosis is enhanced by fine-needle cytology, computerized tomography (CT) scan, and tumor markers. Modified surgical techniques, CO2 laser, and immediate myocutaneous flap reconstruction have enhanced surgery. Endocurie therapy, radiosensitizers, and particle therapy supplementation have enhanced radiotherapy. Combination chemotherapy, immunotherapy, prostaglandin synthesis inhibitors, and retinoids have enhanced chemotherapy. Induction chemotherapy followed by surgery with or without postoperative radiotherapy is optimum multidisciplinary therapy. Reduction in exposure to tobacco, alcohol, sunlight, gamma irradiation, occupational toxins, and Epstein-Barr virus, and recognizing high-risk hereditary conditions, can help prevent these cancers.

Antineoplastic Agents↗
PubMed1984

Changing management in familial polyposis. Role of ileoanal endorectal pull-through.

Total colectomy with ileoproctostomy was performed in 32 members of a family spanning three generations and ranging in age from 10 to 54 years. In seven of these patients (22 percent) carcinoma developed in the retained rectum over a median follow-up period of 14 years. This high incidence of rectal carcinoma has demanded reevaluation of treatment recommendations in patients with polyposis coli. Ten patients aged 7 to 30 years have undergone total abdominal colectomy with ileoanal endorectal pull-through since 1980. All were one stage procedures without reservoir construction. Within 3 months the patients all had good control with 5 to 10 semiformed stools daily and had resumed normal activities. Follow-up date shows adequate dilatation of the distal ileum and no evidence of polyps. Total colectomy and ileoanal endorectal pull-through are effective treatment for familial polyposis in patients of all ages. It should be considered the primary procedure in new patients and an excellent method of converting those patients who have ileoproctostomy to a safer situation.

Adolescent↗
PubMed1984

The axillary mass in occult breast carcinoma. Case reports and overview.

The presentation of mammary carcinoma as an axillary mass is quite rare (0.5%). "Occult" breast cancer will be defined as nonpalpable breast carcinoma presenting as an axillary mass. This article presents two such patients and reviews the available literature. The patients are of similar age and have breast lesions at similar sites as "nonoccult" breast carcinoma. However, the prognosis is somewhat better than that of "nonoccult" breast cancer perhaps due to early histopathology and small primary size. This subject is reviewed in terms of case reports, clinical findings, radiographic findings, pathologic findings, management, treatment, prognosis, and a flowchart for surgical work-up.

Adenocarcinoma↗
PubMed1984

The elderly patient and colon surgery for cancer or diverticular disease.

The mortality and morbidity for 246 patients over the age of 50 who underwent colon resection for cancer or diverticular disease during a 5-year period were reviewed. The increased risk for patients over 70 years of age was based on the presence of two or more preoperative diseases, the occurrence of emergency surgery and the occurrence of postoperative complications, especially surgical infection.

Age Factors↗
PubMed1983

The occurrence of carcinoma of the rectum following ileoproctostomy for familial polyposis.

Ileoproctostomy was performed in 32 patients (13 Female and 19 male), with polyposis coli ranging in age from 10 to 54 years. Seven patients (22%) developed cancer of the retained rectum with a median follow-up of 14 years. Two (20%) of ten patients, followed for 10 to 15 years, and three (50%) of six patients, followed for 15 to 20 years, developed rectal cancer. Rectal cancer developed in two of 14 patients who had their ileoproctostomy at 14 cm and in five of 18 patients who had their ileoproctostomy at a higher level, with a median followup of 7 and 11 years, respectively. Rectal cancer developed in two of 15 teenage patients undergoing ileoproctostomy and in nine of 17 patients aged 20 to 54 years. The present average ages of the two groups were 25 and 41 years, and the average age at which rectal cancer appeared was 40 years. Three of the patients who developed rectal cancer had numerous polypectomies over the years, and there was a tendency to develop tubulovillous and villous adenomas with a variable degree of atypia leading to carcinoma. One patient also showed a return to high levels of coprostanol and secondary fecal bile acids. Proctocolectomy, if acceptable, may be the treatment of choice; ileoproctostomy may mean that the patient eventually will undergo a proctectomy. The ileoanal endorectal pull-through procedure has a great deal to offer to these patients, and further study is necessary to evaluate this procedure.

Adolescent↗