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Biomedical subjects

H M Gilmour

Publications and source records attributed to H M Gilmour.

30 records · Page 2Linked to original sources

Histology of rectal gonorrhoea in men, with a note on anorectal infection with Neisseria meningitidis.

The histology of the rectal mucosa in 57 men with culturally-proven rectal gonorrhoea is described and the results compared with the findings in biopsies from 57 non-infected men. An acute inflammatory cell infiltration of the rectal mucosa was found in three (5.3%) and two (3.5%) infected and non-infected men respectively. Twenty-one (36.8%) men with rectal gonorrhoea and nine (15.8%) non-infected men had an increased number of chronic inflammatory cells in the lamina propria.

Acute Disease↗

Proctitis in homosexual men. A diagnostic problem.

One hundred and seventy six men with histories of anal intercourse were studied to determine if there was a correlation between the clinical features, cytological findings in the mucosal secretions, and the histological appearance of the rectal mucosa. The presence or absence of gastrointestinal symptoms did not differentiate between patients with and without proctitis. Sigmoidoscopy was normal in each of the 117 men with normal rectal histology. Macroscopic abnormalities were evident in the mucosa of nine of 11 men with infective proctitis, and sigmoidoscopy was normal in 40 of the 48 men with chronic proctitis. Cytological examination was often useful in detecting infective proctitis but not chronic proctitis.

Adolescent↗

Clinical spectrum of "solitary ulcer" of the rectum.

A review of 40 patients with "solitary ulcer" of the rectum confirmed by rectal biopsy has provided information about the natural history of this unusual condition. At presentation, symptoms usually were the passage of blood and mucus per rectum, alteration in bowel habits, and anorectal pain. Solitary or multiple ulcers were found within 13 cm of the anal margin in 27 patients and were usually sited anteriorly; in 13 patients macroscopic ulceration was absent, though the histopathology of the rectal biopsy specimens was otherwise similar. Rectal mucosal prolapse was found in 25 of 29 patients examined specifically for this. Thirty-one patients were followed-up for a mean period of 4.8 yr (range 1-15 yr). In 22 patients, rectal ulceration was observed at presentation. In 14 of these patients, ulceration persisted despite treatment. In 9 patients presenting without macroscopic ulceration, rectal ulcers were not observed during follow-up; thus two patient groups were apparent. Neither medical nor local surgical treatment consistently achieved relief of symptoms or healing of the lesion.

Adolescent↗

Experimental acute pancreatitis in the rat--a new model.

A new experimental model of acute pancreatitis in the rat has been devised. It consists of a closed duodenal loop into which infected bile is injected under pressure; intestinal continuity is maintained by a plastic tube passed through the loop. Histological and biochemical evidence of acute pancreatitis in the rat model is presented. The model has been compared with that of Nevalainen and with control groups of rats undergoing bile duct ligation and sham operation. The model produces a consistently fatal acute pancreatitis, more severe than that produced by Nevalainen's model, with a survival time fo 28+/-12.8 (SD) hours. A combination of the reflux of infected bile under increased pressure into the pancreatic duct, at a known time, produces a model which may be suitable for the investigation of therapeutic agents.

Acute Disease↗

Vulval tuberculosis.

A patient with chronic tuberculous ulceration of the vulva is reported. Tuberculosis of the external genitalia is unusual and primary infections are rare. Venereal transmission of the infection could not be proven in this patient, but appears the most likely origin of the disease. Complete healing of the vulval ulcer, with rapid relief of symptoms, followed antituberculosis chemotherapy. The importance of biopsy in the diagnosis of chronic genital ulcers is emphasised.

Adult↗

Rectal biopsy in patients presenting to an infectious disease unit with diarrhoeal disease.

The role of sigmoidoscopy and rectal biopsy was investigated in patients referred to an infectious diseases unit with diarrhoea. Seventy-four patients were studied. Nine patients (12%) had inflammatory bowel disease, either ulcerative colitis or Crohn's disease. Thirty-six patients (48%) had infective diarrhoea. A wide variety of conditions accounted for the diarrhoea in the remaining patients. Sigmoidoscopy was abnormal in 25 patients and rectal biopsy in 56. The abnormalities in rectal mucosal histology were classified into six grades. Some patients with infective diarrhoea showed rather characteristic histological changes which may be of diagnostic value. Eight showed features which suggested a diagnosis of inflammatory bowel disease. However, repeat rectal biopsy in the convalescent period showed a striking improvement in the patients with infective diarrhoea. In contrast, the histological changes persisted in the patients with inflammatory bowel disease. Repeat rectal biopsy may be essential before making a firm diagnosis of inflammatory bowel disease in some patients who present with diarrhoea and apparently typical histological changes.

Adult↗

High flow oxygen therapy for pneumatosis coli.

Symptomatic and radiological resolution of pneumatosis coli was achieved by intermittent high flow oxygen therapy in five patients. In each case the extent of the disease was defined by colonoscopy and contrast radiography before treatment. Despite the confirmation of pneumocyst resolution, recurrence of colonic gas cysts was noted in two patients at six months and one year after treatment. Bacteriological studies indicated that resolution of the disease, induced by oxygen therapy, was not associated with eradication of anerobic bacteria from stool and colonic mucosa. The clinical features and response to treatment of this group of patients are discussed, with particular reference to previously reported methods of oxygen administration.

Aged↗

Arteriovenous malformations of the intestine.

Arteriovenous malforamtions of the intestine are recognized as an uncommon cause of chronic gastrointestinal bleeding. In previous reports, the role of selective mesenteric angiography in the localization of the lesion has been emphasized; with confirmation by in vitro injection of radioopaque dye into the resected specimen. The histologic appearances of arteriovenous malformations are well recognized, although terminology is still confused. In this report, two distinct entities of small vessel malformation are described and the terms submucosal endothelial angiodysplasia and submucosal fibromuscular angiodysplasia are offered.

Aged↗