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Biomedical subjects

H Ellis

Publications and source records attributed to H Ellis.

At least 163 records · Page 9Linked to original sources
PubMed1982

Effects of fecal stream on experimental colorectal carcinogenesis. Morphologic and histochemical changes.

The effect of alteration of fecal stream in the presence of the carcinogen 1.2 Dimethylhydrazine, 2 HCl (DMH) has been studied in rats who have undergone surgical division of the colon to produce emptying and filling loops with areas of both decreased and increased fecal exposure. The progressive development of lesions with increasing severity related to prolonged exposure to carcinogen is demonstrated. These changes are preceded and accompanied by alteration of glycoprotein secretion. In the operated rats (1) neoplastic growth appears enhanced and it arises sooner and more proximally than in nonoperated animals; (2) the lesions show tendency to occur at the site of the anastomosis with relative sparing of the distal colon; and (3) tumors are more numerous in areas with increased fecal concentration (filling and small emptying loops), in contrast with their absence in the distal segment of the long emptying loops. Two possible explanations for this preferential distribution are suggested. First, the increased susceptibility to the carcinogen in a previously traumatized area (anastomotic site). Second, the changes in the carcinogenic effect and bile acid concentration as a result of fecal stasis produced by interference with the normal peristalsis of the bowel due to surgical division. The importance of these observations in planning surgery to the colon is considered.

1,2-Dimethylhydrazine↗
PubMed1982

Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies.

Burst abdomen and incisional herniation are continuing problems for the general surgeon. A prospective study was carried out to define the extent of the problem. Over five years from 1975 to 1980 a total of 1129 major laparotomy wounds in adults were assessed at regular intervals for 12 months after operation. There were 19 burst abdomens (1.7%) and 84 incisional hernias (7.4%). The introduction of the mass-closure technique reduced the incidence of burst abdomen from over 3% in 1975 to 0.95% in 1979. It did not, however, improve the rate for incisional hernias, which was 7.6% in 1979. Many factors are associated with incisional herniation: old age, male sex, obesity, bowel surgery, type of suture, chest infection, abdominal distension, and, most important, wound infection. More work is needed to find the ideal method of wound closure, and efforts should be made to eliminate wound infection.

Female↗
PubMed1982

The causes and prevention of intestinal adhesions.

Although intestinal obstruction from intra-abdominal adhesions is a relatively common surgical emergency, the vast majority of adhesions are harmless and may be protective or even life-saving. The causes of intestinal adhesions are presented, and various methods advocated to prevent adhesions are discussed. The surgeon is advised to reduce unnecessary adhesion formation by meticulous surgical technique, control those adhesions which inevitably form to obtain their beneficial effects, and to avoid the risk of subsequent obstruction.

Abdomen↗
PubMed1982

Adjuvant oral razoxane (ICRF-159) in resectable colorectal cancer.

One hundred and seventy six patients (81 controls, 95 receiving treatment) have entered a prospective randomized trial of long-term oral adjuvant razoxane (ICRF-159) following removal of a colorectal cancer. The median follow-up is 34 months. The treated patients in Dukes' groups B and C have a significantly longer disease-free interval than the control patients (P = 0.01 'as randomized' and P = 0.004 'as treated'). The differences in survival for Dukes' groups B and C are not significant, although follow-up is short. In Dukes' groups B and C, however, 24 of 56 of the patients in the control group have died (43%), as against only 17 of 64 in the treatment group (27%). The treatment produces very few side-effects, is well tolerated by patients, and is taken orally.

Administration, Oral↗
PubMed1982

Spectrum of breast disease in outpatient surgical practice.

Seven hundred and fifty-three new referrals with problems relating to the breast were seen as outpatients in a general surgical clinic during 1980 and 1981. The age distribution and final diagnoses are reported with a breakdown into the varying pathological groups. The relationship of diagnosis to previous benign breast disease, parity and breastfeeding is discussed.

Adolescent↗
PubMed1981

A controlled prospective trial of adjuvant razoxane in resectable colorectal cancer.

Following resection of their tumour, 162 patients with colorectal cancer entered a prospective randomized controlled clinical trial of adjuvant oral razoxane. Thirty-one patients were Duke's group A; 49 group B; 61 group C; and 17 group D; an additional four patients were randomized in error. The adjuvant group received the usual clinical care and 125 mg razoxane twice daily for 5 consecutive days (monday-friday) every week indefinitely. Control patients received the same clinical care as the adjuvant group, but no razoxane. At 3 years, 134 patients (84%) are evaluable. The recurrence rate in the first 6 months was 20% and 28% respectively in the Duke's B and C controls compared with 4% and 9% in the corresponding razoxane treated patients. Most recurrences occurred within the first 6 months from randomization. When all patients as randomized are included in the analysis of survival, irrespective of whether they were cured by surgery (Duke's A), had advanced cancer (Duke's D), or took no razoxane when randomized to take it, then as might be expected any differences there may be between the razoxane-treated and control patients with minimal residual disease (Duke's B and C) are so distorted that the p value of the difference in survival was 0.93. If however only patients with Duke's group B or C are taken (49 controls and 47 treated), log-rank analysis reveals a difference in the cancer mortality curves (p = 0.07). If patients who had been randomized to take razoxane, but who had not taken it at any time (and therefore received the same treatment as controls) are analysed with the controls, the difference between the two groups increases further, with p less than 0.05. The razoxane-treated patients experienced no significant toxicity apart from a readily reversible mild leukopenia in 52% while gastrointestinal symptoms necessitated stopping the drug in only four patients. These four all took the drug for less than 4 weeks. Because there was no toxicity to subtract from any benefit razoxane adjuvant treatment produced and the quality of life was not impaired, the therapeutic benefit of surgery wsa increased to the extent that razoxane increased survival of patients with Duke's B and C tumours.

Clinical Trials as Topic↗
PubMed1981

Simple mechanical method for decreasing the incidence of thromboembolism.

Increasing awareness of the dangers of low dose heparin therapy has stimulated interest in mechanical methods for decreasing the incidence of thromboembolism. Plantar flexion and dorsiflexion of the feet while the patient is on the operating table by the use of a mechanical device (the Pedi-Pulsor) significantly decreases the incidence of deep vein thrombosis (45 percent in control patients versus 18 percent with the Pedi-Pulsor [p - 0.05]). In addition, use of this machine during the postoperative period should further aid in decreasing the incidence of thromboembolism.

Adult↗