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Biomedical subjects

E Hughes

Publications and source records attributed to E Hughes.

At least 109 records · Page 6Linked to original sources
PubMed1989

Reversal of hepatic encephalopathy and alteration in amino acid profiles after blocking a surgical splenorenal shunt by interventional radiological techniques.

Portal-systemic shunts are effective in preventing haemorrhage from varices in portal hypertension, but at the price of hepatic encephalopathy. We describe the blockage of a splenorenal shunt using interventional radiology, in a patient with incapacitating chronic encephalopathy. The procedure successfully reversed encephalopathy, without haemodynamic disturbances or haemorrhage from recurrent varices and was associated with a return of the plasma amino acid profile towards normal, with a reduction in aromatic amino acids and an increase in branch chain amino acids. This observation supports the hypothesis that changes in plasma amino acid profiles in patients with portal-systemic shunting are due to the diversion of portal blood rather than the underlying chronic liver disease.

Amino Acids↗
PubMed1988

Foreign view.

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Aged↗
PubMed1987

Immunoreactive trypsin in acute pancreatitis: elevated levels do not correlate with hyperamylasaemia.

Immunoreactive trypsin (IRT) was measured in the serum of patients presenting with acute pancreatitis (AP) and compared to serum amylase levels. Both were elevated beyond the normal range at presentation (mean IRT 557 +/- 252 micrograms/l, range 181-1000 micrograms/l, mean control IRT 42 +/- 14 micrograms/l, range 15-82 micrograms/l; mean amylase 4500 +/- 3200 IU/l, range 600-10,500 IU/l, control amylase mean 175 +/- 43 IU/l, range 48-320 IU/l). There was minimal correlation between IRT and amylase elevation but both returned to normal at the same rate in patients who recovered. In 2 patients with persistently elevated IRT levels, one was found to have a pancreatic pseudocyst and the other subsequently died from alcoholic haemorrhagic pancreatitis. IRT is no better than amylase as a single diagnostic assay in AP but may be greatly elevated when amylase elevation is minimal. The combination of the two may improve diagnostic accuracy and persistent elevation of IRT may be of prognostic importance.

Acute Disease↗
PubMed1987

Pulmonary lymphangiomyomatosis complicating pregnancy. A case report.

A 32-year-old primigravida presented with cough and dyspnea at 16 weeks' gestation. Chest roentgenogram revealed a large pleural effusion and diffuse interstitial infiltrates. Moderate arterial hypoxemia and a significant reduction in vital capacity were present. Thoracentesis revealed sterile chyle with no evidence of malignancy. Spontaneous delivery of a healthy infant occurred at 38 weeks, but no change was seen in either the pulmonary infiltrates or chylothorax. Open lung biopsy confirmed the clinical impression of pulmonary lymphangiomyomatosis, and a pleurodesis was performed. Progesterone and estrogen receptor assays on the lung biopsy material revealed only minimal binding. Following two years of therapy with tamoxifen citrate and megestrol acetate, the chylothorax has not recurred, and there has been no other appreciable change in pulmonary function.

Adult↗
PubMed1986

Screening for intrauterine growth retardation using ratio of mid-arm circumference to occipitofrontal circumference.

Uncritical application of standard weight percentile charts, derived from white infants, to infants from different ethnic groups may result in an overestimate of the incidence of intrauterine growth retardation in those groups. The ratio of mid-arm circumference to occipitofrontal circumference was studied in 194 babies (49 Asian, 58 black, and 87 white). In contrast with birth weight the ratio did not vary among the ethnic groups; it was also independent of sex. In a prospective study of 64 neonates whose weight was below the 10th percentile on standard charts the ratio of mid-arm circumference to occipitofrontal circumference was a more accurate predictor than weight of those infants who would develop symptoms associated with intrauterine growth retardation. The ratio of mid-arm circumference to occipitofrontal circumference therefore provides a simple, accurate, and cheap way of assessing intrauterine growth retardation in areas with a large multiethnic population, where birth weight varies greatly.

Anthropometry↗
PubMed1986

A balanced de novo X/autosome translocation in a girl with manifestations of Lowe syndrome.

The Oculo-cerebro-renal syndrome of Lowe is an X-linked recessive disorder characterised by mental and growth retardation, renal rickets with renal tubular acidosis, generalised aminoaciduria, hypotonia, cataracts, glaucoma and frontal bossing. Manifestations of this syndrome were seen in a girl with no family history of the disorder, but who was found to have a de novo balanced X/3 translocation, with a breakpoint at Xq25. She had also inherited a balanced 14/17 translocation from her father. It is postulated that the clinical picture may be the result of disruption of the X chromosome within the gene at the locus for Lowe syndrome, with non-random inactivation of the normal X, which may permit the expression of this X-linked recessive disorder in a girl.

Child↗
PubMed1984

A prospective study of intrapulmonary fat accumulation in the newborn lung following intralipid infusion.

In order to assess the safety and stability of a parenteral fat emulsion (Intralipid) in total parenteral nutrition (TPN), 29 infants were infused Vamin glucose and Dextrose electrolyte solution as well as one of two isocaloric regimens; either 25% Dextrose (Group I) or 10% Intralipid (Group II). Regular biochemical monitoring was performed in all cases and no infants became lipaemic nor developed abnormally high levels of total free fatty acid. Eight infants died and only those who had received fat emulsion had lipid staining material distending the pulmonary vessels. One infant having low infusion rates of Intralipid had massive fat accumulation in the lungs, but biochemistry during life had been normal. We speculate that in ill infants the emulsion becomes less stable and agglomeration of fat particles occurs which are then fully filtered out by the lungs before metabolism of the exogenous fat can occur.

Clinical Trials as Topic↗
PubMed1984

The cost of like surgical cases.

A system of costing services provided to patients undergoing surgical procedures was instigated in a private and a public Victorian hospital. The cost of managing the care of patients undergoing like surgical procedures was developed and compared. It is suggested that such a system of cost allocation would enable members of the medical profession to be more cost conscious.

Australia↗
PubMed1983

Human warts permanently removed by static electricity.

The CED was found to be a highly effective, safe, inexpensive, and simple device to use for complete wart removal with no regrowth or scarring. The warts are shed in the same manner as the surface epithelium exfoliates or sloughs off. Plantar warts cause a great deal of pain in walking and surgical procedures are warranted in some cases. Since these warts tend to become very large and to extend deeply into the dermis, when they are removed surgically the patient is incapacitated for a period of time. Opening the area to bacteria may cause additional infection, and the surgery may result in tender scar formation. According to our study group, the CED offers an effective alternate means of therapy for removing warts and alleviating the pain associated with them.

Electric Stimulation Therapy↗
PubMed1982

Preserving the ascending colon as an alternative surgical option in ulcerative colitis.

Six patients with ulcerative colitis were studied to assess the histologic appearance of the ascending colon which was preserved at the initial operation performed more than ten years previous. Inflammatory cells were increased in all patients, but ulceration was not present microscopically. Most patients had less than five bowel movements a day. Because of good long term survival of the mucosa, wider use of a surgical approach is proposed, based upon excising the colonic mucosa most prone to ulceration and metabolic derangement. The procedure entails subtotal colectomy, mucosectomy of the rectal mucosa and preservation of the ascending colon as a neorectum. Prime advantages are the lack of a stoma and fewer bowel movements than result from other operations.

Adult↗
PubMed1982

Long term results of restorative resection and total excision for carcinoma of the middle third of the rectum.

Restorative resection for carcinoma of the middle third of the rectum has been facilitated by the recent introduction of the staplers. Before restorative resection with end-to-end anastomosis can become the treatment of choice, it must be proved that survival prospects after restorative resection are similar to those obtained after total abdominoperineal excision. The results of curative restorative resection and total excision in 417 patients with a single carcinoma of the middle third of the rectum managed by one of us are examined. Between 1950 and 1980, the proportion of patients treated by restorative resection for carcinoma of the middle third of the rectum increased from 26 to 93 per cent. Distribution by sex, age, tumor stage and tumor differentiation did not differ significantly between the two groups of patients operated upon. Cancer specific survival did not differ significantly between patients treated by restorative resection or total excision. Ten year survival rates were 60 and 59 per cent, respectively. Survival related to tumor stage and differentiation was not influenced by the type of operation. Tumor size, greater--p less than 0.04--in patients managed by total excision, had no significant influence on survival prospects. The results justify sphincter preservation and suggest that increased usage of restorative resection by stapling technique is not likely to lessen survival prospects in patients with carcinoma of the middle third of the rectum.

Adenocarcinoma↗
PubMed1981

Ovarian involvement in adenocarcinoma of the colon and rectum.

Thirty-six of 998 female patients with carcinoma of the colon and rectum had ovarian involvement at the time of the initial operation. Resection of tumor of the colon and rectum was performed upon 882 patients. The ovarian tumors were removed in 30 of the 36 patients with ovarian involvement. Ovarian involvement was associated with a significantly worsened, p = 0.009, cancer specific five year survival rate; five year survival prospects for patients with, and without, ovarian involvement were 38 and 60 per cent, respectively. Ovarian involvement also significantly, p = 0.014, worsened the survival rate of the 25 patients treated by curative resection of the tumor of the colon and rectum and associated ovarian spread. The five year cancer specific survival rate for female patients without ovarian involvement was 72 per cent, whereas ovarian involvement reduced the survival rate to 50 per cent.

Adenocarcinoma↗
PubMed1981

Symptom duration and survival prospects in carcinoma of the rectum.

Between 1950 and 1978, 1,228 patients were operated upon by one of us for carcinoma of the rectum. Symptom duration data were available for 1,081 patients. Forty-five per cent of the patients had symptoms preoperatively for less than three months, 22 per cent for three to six months, 15 per cent for six to 12 months and 18 per cent for 12 months or longer. The frequency of major symptoms did not differ significantly with increasing symptom duration. Symptom duration was not related to sex, age, tumor site within the rectum or tumor stage distribution. The proportion of curative to palliative operative procedures performed was unrelated to the duration of symptoms. The cancer specific survival rate was better for the total patient series and for those treated by curative resection if symptoms had been present for 12 months or longer compared with those of less than three months' duration, p = 0.001 and p = 0.01, respectively. Survival prospects were also better for patients with symptoms of less than six months' duration compared with those of six months or longer, p = 0.01 and p = 0.04, respectively. These results indicate that earlier diagnosis during the symptomatic period of carcinoma of the rectum cannot be expected to improve cancer specific survival rates. They direct attention to the importance of preclinical diagnosis.

Adult↗