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Biomedical subjects

H Ellis

Publications and source records attributed to H Ellis.

At least 109 records · Page 6Linked to original sources
PubMed1988

Acquired hernias of the diaphragm.

We present our experience over five and a half years of acquired hernias of the diaphragm. Each case represents a different presentation of this condition, which may follow blunt or penetrating trauma or iatrogenic injury. Diaphragmatic hernia may present in the acute phase after injury but late presentation may occur after many years, with chronic abdominal or respiratory symptoms, or with acute intestinal obstruction. The problems in diagnosis and management are discussed.

Adult↗
PubMed1988

Toxicity of bilirubin and bilirubin diglucuronide to rat tissue culture fibroblasts.

The effects of obstructive and non-obstructive jaundice on rat tissue culture fibroblasts have been compared. Tissue culture fibroblasts were grown in medium containing unconjugated bilirubin and medium containing conjugated bilirubin (bilirubin diglucuronide). The addition of bilirubin to the culture medium caused morphological changes in the fibroblasts and significantly decreased their rate of multiplication. The addition of bilirubin diglucuronide had no effect. As the fibroblast plays an important role in wound healing, patients with obstructive jaundice (where surgery is most frequently required) may be less likely to undergo wound failure than patients with non-obstructive jaundice.

Animals↗
PubMed1988

Pathological features of invasive breast cancer associated with a high risk of local recurrence after tumour excision and radical radiotherapy.

The histological slides of 273 breast cancer patients, treated by local excision and radiotherapy and followed up for 2-6 years, were reviewed in search of factors predictive of local recurrence. Local recurrence was found to be most closely related to the combination of a high proportion of intraduct carcinoma and extensive necrosis (comedocarcinoma). This latter group of 18 patients had a local recurrence rate of 50%. These patients are of particular interest since they form a small group with readily identifiable histological features.

Breast Diseases↗
PubMed1987

Peritoneal closure after lateral paramedian incision.

The lateral paramedian incision has been advocated as the strongest incision for abdominal surgery. We have evaluated this incision and tested the necessity for closing the deep peritoneal layer by a prospective randomized trial. All 206 patients undergoing laparotomy in the Surgical Unit in 1984, both elective and emergency cases, were included. In patients undergoing laparotomy through unscarred tissue, a lateral paramedian incision was performed and they were randomized to have either the peritoneum closed (n = 77) or left open (n = 75). Patients in whom the laparotomy was performed through a previous incision (n = 51) and those in whom the abdomen had to be opened urgently (n = 3) were excluded from the trial but studied separately (n = 54). The rectus sheath was closed with monofilament nylon in all cases. Patients were assessed for wound integrity during the immediate postoperative period and at 1, 3, 6 and 12 months after operation. So far the patients have been followed up for between 1 and 2 years and follow-up is continuing as in some cases incisional hernia may not be detected until several years after operation. There have been no cases of burst abdomen. No incisional hernias have developed in patients in whom a lateral paramedian incision was performed and the peritoneum was closed, and one incisional hernia has occurred in the patients in whom the peritoneum was left open. Seven incisional hernias have occurred in patients excluded from the trial of the lateral paramedian incision (13 per cent). We conclude that the lateral paramedian incision successfully abolishes the burst abdomen and that incisional hernia is rare. It is not necessary to close the peritoneum with this incision.

Clinical Trials as Topic↗
PubMed1987

Tumours of the small intestine.

Tumours of the small intestine are a relatively unusual group of benign and malignant tumours of both epithelial and supporting tissue origin. Their pathology, associated syndromes, clinical features, diagnosis, and management are discussed.

Adenocarcinoma↗
PubMed1987

Mass closure of abdominal wounds following major laparotomy in jaundiced patients.

Previous clinical studies have demonstrated an increased incidence of wound dehiscence and incisional hernia formation in jaundiced patients following major laparotomy. Nearly all of these patients had their wounds closed in layers. In order to determine the rate of wound failure in jaundiced patients when a mass closure technique is used, 343 non-jaundiced patients undergoing biliary surgery and 62 jaundiced patients undergoing surgery have been studied. All the wounds were closed using a mass closure technique and the patients were seen regularly as outpatients. There were no wound dehiscences in either group (incidence 0%). Twenty seven (7.9%) of the non-jaundiced patients and 4 (9.8%) of the surviving jaundiced patients developed incisional hernias within one year of operation. We conclude that the rate of wound dehiscence in jaundiced patients can be much reduced using the mass closure technique. The rate of incisional hernia formation in jaundiced patients following major laparotomy is similar to that found in non-jaundiced patients when this technique is used.

Abdomen↗
PubMed1987

Interim results of treatment of breast cancer with breast conservation for all patients.

Since April 1979, all female patients who have come to this unit with carcinoma of the breast have received primary treatment with breast conservation. Until December 1984, 288 patients underwent local excision of the tumor with radical radiotherapy. After 1 to 5 years, the overall and recurrence-free survival rates have been comparable with those expected after mastectomy. Local recurrence occurred in 7 of 76 (9%) patients who had stage I disease, and in 16 of 181 (9%) and 3 of 27 (11%) patients with stage II and stage III disease, respectively. Eleven patients required a mastectomy to control recurrence of the cancer, and of the 29 patients who died of breast cancer, only three had symptomatic local disease at the time of death.

Adult↗
PubMed1986

Randomized trial of oral adjuvant razoxane (ICRF 159) in resectable colorectal cancer: five-year follow-up.

Razoxane is one of the few agents which has shown activity in the treatment of advanced colorectal cancer. The drug has therefore been evaluated in a prospective randomized controlled trial as an adjuvant to surgery for resectable colorectal cancer. The results to median follow-up of 5 years are reported here. Accrual has ceased and a total of 272 patients entered the trial (133 control, 139 treatment). Treated patients received razoxane postoperatively on a continuous, long-term basis while control patients received identical clinical care but no adjuvant chemotherapy. Analysis of the results shows a significant prolongation of the time to recurrence for Dukes' C patients. All other groups including the overall analysis show no benefit although there is a consistent trend in favour of the treated patients except in Dukes' group 'D'. Razoxane is tolerated well by patients and causes minimal side-effects. However acute leukaemia occurred in three patients (2.45 per cent) after prolonged exposure to the drug and further evaluation should be in patients who are at high risk of developing recurrent cancer, in whom such a risk may be acceptable. It is concluded that razoxane is suitable for further evaluation in colorectal cancer and for incorporation into combination chemotherapy regimens.

Clinical Trials as Topic↗