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Biomedical subjects

G Sutton

Publications and source records attributed to G Sutton.

At least 73 records · Page 4Linked to original sources
PubMed1989

Surgical staging of carcinoma of the ovaries.

One hundred and eighty-seven patients with stages I, II and III optimal (metastatic lesions of less than 3 centimeters) epithelial carcinoma of the ovaries were evaluated preoperatively and had standardized exploration and biopsy. The protocol called for examination and biopsy of the peritoneum, diaphragm, omentum, pelvic and para-aortic lymph nodes and aspiration of ascites or peritoneal washings for cytologic examination. Of those patients with metastases to the omentum, the clinical impression did not correlate with pathologic findings in 45 per cent. The findings were similar for diaphragmatic lymph nodes (50 per cent), pelvic lymph nodes (71 per cent) and para-aortic lymph nodes (96 per cent). Nine of 97 patients clinically thought to have stage I disease had the stage elevated to II and III based on pathologic findings. Similarly, 15 patients thought to have stage II were found to have stage III based on histopathologic findings. There were 74 complications in 54 patients, with 29 having at least one complication. Surgical exploration for early stage carcinoma of the ovary should include biopsy of the retroperitoneal pelvic and para-aortic lymph nodes, excision of the infracolic omentum, biopsies of pelvic and abdominal peritoneum, including the right diaphragm, and peritoneal cytologic studies.

Adenocarcinoma↗
PubMed1987

Ovarian carcinoma with extracellular mucin production: reassessment of "pseudomyxoma ovarii et peritonei".

Peritoneal implants of mucin and columnar epithelium with variable amounts of free peritoneal mucin complicated 11 mucinous ovarian neoplasms. Slides of the primary ovarian tumors were reviewed in eight cases. Although all contained areas of mucinous cystadenomatous tumor of low malignant potential, the neoplasms displayed additional features not well recognized as manifestations of invasive disease in the ovary. Irregular pools of mucin were present in the ovarian stroma and contained at least rare fragments of columnar epithelium in most cases. The epithelium was often more plentiful in the peritoneal mucin. Cytologic atypia was minimal in all except one case. Goblet cells were present in both the ovarian tumor epithelium and the peritoneal implants in most cases and may have a role in dissemination of the tumor. We propose the term "ovarian carcinoma with extracellular mucin production" for this form of mucinous carcinoma; this term is both descriptive of its histologic appearance and indicative of its malignant behavior. Eight of the 11 patients died of their disease from 8 months to 13.5 years after diagnosis. One additional patient died of chemotherapy-related leukemia. The mean survival was 4.2 years. The short-term prognosis is better than that for mucinous carcinoma in general, but most patients eventually die of their disease.

Adenocarcinoma, Mucinous↗
PubMed1987

Untreated heart failure: clinical and neuroendocrine effects of introducing diuretics.

The clinical and neuroendocrine response to diuretic treatment was assessed at rest and on exercise in 12 patients with heart failure. Before treatment all patients were limited by breathlessness on exercise; one was oedematous. Plasma renin activity and aldosterone were normal but plasma noradrenaline was raised both at rest and on exercise. After one month's treatment with frusemide (40 mg) and amiloride (5 mg) weight was significantly reduced by a mean of 3.5 kg and exercise capacity had doubled. Plasma noradrenaline fell to normal at rest but remained abnormally raised on exercise. Plasma renin activity and aldosterone increased significantly both at rest and on exercise. Diuretics bring about a considerable clinical improvement in patients with chronic heart failure but they stimulate the renin-angiotensin system. Activation of the renin-angiotensin system in moderate heart failure occurs as a response to diuretic treatment rather than as a result of the disease process itself.

Adult↗
PubMed1986

Does non-clinical decompression stress lead to brain damage in abalone divers?

Abalone divers are subject to considerable decompression stresses and could be at risk of progressive cognitive impairment. A sample of abalone divers was compared with a sample of fishermen, by means of a battery of neuropsychological tests. No evidence of cognitive impairment was found in the divers, in spite of evidence of their exposure to decompression stress. The implications for other professional divers and for recreational underwater divers who follow standard decompression protocols are reassuring.

Adult↗
PubMed1986

The renal response to neuroendocrine inhibition in chronic heart failure: double-blind comparison of captopril and prazosin.

Activation of the renin-angiotensin and sympathetic systems in chronic heart failure causes important renal vasoconstriction. In a double-blind cross-over study, treatment with captopril for one month reduced systemic and renal vascular resistance by 14% and 25%, increased renal blood flow by 12%, and increased the percentage of the cardiac output perfusion to the kidney by 13%. Treatment with prazosin for one month also reduced systemic vascular resistance by 8%, renal vascular resistance increased by 20%, and renal blood flow and the percentage of the cardiac output going to the kidney fell by 14% and 26%. During captopril treatment, plasma aldosterone concentration was reduced to normal, but during prazosin treatment there was an initial increase in aldosterone of 45%, and a sustained increase in plasma noradrenaline concentration of 26%. Body weight decreased by 1.7 kg on captopril, but increased by 3.0 kg on prazosin, correlating inversely with the changes in renal blood flow. Sympathetic inhibition with prazosin causes systemic vasodilatation which diverts blood from the kidney and may result in fluid retention. Inhibition of the renin system with captopril causes preferential renal vasodilatation and can improve renal perfusion in chronic heart failure.

Aged↗
PubMed1986

Adriamycin chemotherapy for malignant mixed mesodermal tumor of the ovary. A Gynecologic Oncology Group Study.

Malignant mixed mesodermal tumor (MMMT) of the ovary is a rare, but usually fatal, cancer for which there exists no proven postsurgical therapy. The Gynecologic Oncology Group has evaluated adriamycin in this disease at a dose of 75/m2. Among 10 evaluable cases with measurable disease there was one partial response and no complete responses. Of 21 cases with nonmeasurable tumor four remain clinically free of cancer from 2 to 45 months. There were two treatment-related deaths. We conclude that adriamycin alone as first-line chemotherapy in patients with MMMT of the ovary is not sufficiently active to be clinically useful.

Doxorubicin↗
PubMed1986

Vasodilatation with captopril and prazosin in chronic heart failure: double blind study at rest and on exercise.

A double blind cross over study was performed to compare the long term hormonal, haemodynamic, and clinical responses to specific inhibition of the renin-angiotensin-aldosterone system (captopril) and of the alpha 1 adrenoceptors of the sympathetic system (prazosin) both at rest and during upright exercise in patients with chronic heart failure. Sixteen patients completed one month's treatment with each drug. During conventional diuretic treatment (control) plasma renin activity, aldosterone, and noradrenaline were increased at rest and on exercise. Control left ventricular filling pressures were raised, and correlated significantly with plasma renin activity both at rest and on exercise. Systemic vascular resistance was increased at rest, and its reduction during exercise correlated inversely with the increase in plasma renin activity and plasma noradrenaline. After one month's treatment with captopril there were reductions in plasma aldosterone, weight, left ventricular filling pressure, and systemic vascular resistance at rest and on exercise. Dyspnoea was relieved and exercise capacity increased. The greater fall in systemic vascular resistance on exercise no longer correlated with the increase in plasma renin activity. During treatment with prazosin there were increases in plasma noradrenaline and, transiently, in plasma aldosterone. Fluid retention occurred, and left ventricular filling pressure was unchanged. Compared with control values systemic vascular resistance was reduced at rest but not on exercise. Dyspnoea and exercise capacity did not improve. In chronic heart failure, vasodilatation by inhibition of the alpha adrenergic system with prazosin causes compensatory stimulation of the renin-angiotensin-aldosterone system and does not result in clinical benefit. Inhibition of the renin-angiotensin-aldosterone system with captopril causes secondary vasodilatation at rest and on exercise and results in improvement in symptoms and exercise capacity.

Aged↗
PubMed1986

Villous adenoma of the uterine cervix associated with invasive adenocarcinoma: a histologic, ultrastructural, and immunohistochemical study.

An unusual neoplasm of the uterine cervix had the features of a villous adenoma with an adjacent adenocarcinoma. Histologic and electron microscopic features of the lesion are described, as well as immunohistochemical staining of the lesion for carcinoembryonic antigen. Electron microscopic evidence of intestinal differentiation in the villous adenoma suggests a rarely recognized potential for intestinal metaplasia in the uterine cervix. The association of villous adenoma with cervical adenocarcinoma underscores the malignant potential and the need for complete excision of this rare cervical lesion.

Adenocarcinoma↗
PubMed1985

Clinical importance of the renin-angiotensin system in chronic heart failure: double blind comparison of captopril and prazosin.

Nineteen patients with chronic heart failure participated in a double blind crossover trial of captopril and prazosin--two drugs with differing neuroendocrine effects--to determine whether neuroendocrine changes could explain clinical and haemodynamic responses to treatment. Patients were assessed before and after acute and long term (four weeks') treatment with each drug given in random order. Sixteen patients completed the study. During captopril haemodynamic improvement was maintained by inhibition of the renin-angiotensin system. Breathlessness was relieved in 15 patients and exercise capacity increased. During prazosin a reduction in systemic vascular resistance was maintained, but plasma renin activity and aldosterone and noradrenaline concentrations increased, fluid retention developed, and clinical benefit did not occur. These results suggest that clinical and haemodynamic responses to long term vasodilator treatment for chronic heart failure are related to neuroendocrine changes. In patients with chronic heart failure inhibition of the renin-angiotensin system results in clinical benefit, whereas inhibition of the alpha adrenergic system does not.

Aged↗
PubMed1985

Radiography of the small bowel in patients with gynecologic malignancies.

The records and radiographs of 284 patients with gynecologic malignancy were reviewed to determine the incidence and nature of small-bowel abnormalities. Seventeen percent of the patients had small-bowel studies. Twenty-four percent of patients with ovarian cancer had radiologic examination of the small bowel, and in almost all cases the abnormalities were due to metastatic disease. In patients with cervical cancer, small-bowel radiography was performed in 14% of patients, and in most cases the abnormalities were due to radiation damage. Small-bowel obstruction was found in 20 patients. In the ovarian-cancer group, all obstructions were due to metastatic disease, whereas in the cervical cancer group, obstruction was due to metastases, radiation, or adhesions. The site of obstruction was a useful differential point, since all obstructions due to radiation were in the ileum, whereas 58% of obstructions due to metastases were in the duodenum or jejunum. The radiologic studies interpreted in light of the clinical circumstances were highly accurate in determining the location and nature of small-bowel complications in these patients.

Barium Sulfate↗
PubMed1984

Para-aortic nodal metastases in early cervical carcinoma: long-term survival following extended-field radiotherapy.

From 1960 to 1979 there were a total of 14 patients followed at the University of Pennsylvania with early cervical carcinoma who had histologically documented metastases to the para-aortic nodes and who were treated with extended-field radiotherapy. Thirteen of these patients were stage IB and one was stage IIA. All patients underwent exploratory laparotomy and lymph node dissection, followed by extended-field radiotherapy. Six patients are alive with NED for greater than 5 years; one patient is alive with NED at 3 years. An additional patient is now alive and well almost 3 years from a biopsy documented recurrence treated with chemotherapy, and 6 years from initial diagnosis. Thus 8 of 14 patients have enjoyed a long-term survival. Five patients experienced severe treatment-related morbidity. Two had long-term survival, two died of disease, and one died of radiation complications with NED on autopsy. Each of the six patients that died of disease had recurrences at distant sites. One also had a pelvic recurrence. These patients appear to have a prognosis quite different from that of patients with locally advanced cervical cancer metastatic to the para-aortic nodes and deserve aggressive treatment. The need for adjuvant systemic therapy is stressed.

Aorta↗
PubMed1983

Anorexia nervosa in treated gonadal dysgenesis: case report and review.

The 12th reported case of anorexia nervosa in association with the 45,XO genotype and Turner's phenotype is presented. This patient received hormonal treatment but had a poor psychological outcome. Reasons for a possible increased coincidence of the two disorders, and the relationships among hormonal treatment, onset of puberty, and development of anorexia nervosa, are discussed in light of this and previous cases.

Adolescent↗