Biomedical subjects
Publications and source records attributed to J A Thorpe.
Liposarcoma is one of the most common soft tissue sarcomas found in adults, yet it rarely develops in the alimentary tract. This report describes the pathological features and management of a liposarcoma of the esophagus.
A woman who had a large primary malignant melanoma of the oesophagus, with evidence of submucosal invasion and several local metastases, underwent resection two years after the onset of retrosternal pain and has survived for 12 years with no recurrence.
Whole megakaryocyte, megakaryocyte cytoplasmic and nuclear size were evaluated in human bone marrow obtained from posterior iliac crest and rib of subjects undergoing thoracotomy for repair of hiatal hernia. In addition the nuclear DNA content (ploidy) of the cells from each site was measured. Significantly larger mean megakaryocyte (P less than 0.002), and megakaryocyte cytoplasmic volumes (P less than 0.002), and different volume distributions were observed in costal marrow compared to the iliac crest. No change in mean nuclear volume was found. This was paralleled by no significant difference in mean ploidy. This suggests that the variation in megakaryocyte size with anatomical site is determined by the concomitant volume of cell cytoplasm, but not the nuclear volume.
The gastrointestinal tract is commonly involved in patients with lymphoma. Involvement of the oesophagus occurs in about 1% of patients. This case report describes a patient with oesophageal obstruction due to Hodgkin's disease of the oesophagus as the sole manifestation of a second relapse 10 years after initial diagnosis of the lymphoma.
Sixty patients undergoing coronary artery bypass surgery were studied prospectively in order to investigate the effect of a cardioselective beta-blocker on the incidence of postoperative supraventricular arrhythmias. Patients with good left ventricular function were randomly divided into two groups: 30 patients treated with atenolol and 30 patients acting as controls. Atrial fibrillation was seen in 11 patients and frequent premature atrial extrasystoles were noted in one. Eleven (37%) patients in the control group experienced arrhythmias whilst atenolol significantly reduced this incidence to 3% (one patient), P = 0.001. There was no significant relationship between the development of supraventricular arrhythmias and the following variables: age, sex, severity of preoperative symptoms, previous myocardial infarction, extent of coronary artery disease, technique of myocardial preservation used, ischaemic time, number and site of saphenous vein grafts, endarterectomies performed and perioperative serum potassium levels. It is concluded that the use of atenolol (started 72 h before operation) is effective in reducing the incidence of supraventricular arrhythmias following elective coronary artery bypass operations in patients with good left ventricular function.
Left ventricular aneurysm formation is a common complication of myocardial infarction. Depending on the definition used, the incidence in survivors of acute myocardial infarction is between 4% and 40%, with mural thrombi present in about half of all aneurysms. Infection of these thrombi at times of bacteraemia might be expected to occur quite commonly but has been described only occasionally. We present such a case and review previously reported cases.
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This case report describes the late development of an achalasia-like disturbance of oesophageal motility following irradiation to the neck for a pharyngeal lymphosarcoma. The radiological, manometric and endoscopic findings are recorded as well as laboratory investigations showing evidence of complete vagal denervation.
The value of a new system for the performance of oesophageal pressure and motility studies incorporating a hydraulic-capillary infusion pump has been assessed in 100 patients presenting to a regional cardiothoracic surgical unit with oesophageal dysfunction. This system has many advantages over conventional methods for the routine clinical assessment of oesophageal function.
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The effect of an intravenous dose (2 mg) of propranolol in the lower oesophageal sphincter was studied in 10 human volunteers. A hydraulic-capillary infusion manometric technique was used to measure the lower oesophageal sphincter pressure. A significant increase in sphincter pressure was recorded, together with increased amplitude and duration of oesophageal peristaltic activity. This study confirms the presence of specific beta-receptors in the lower oesophageal sphincter.
Although the radiological features of acute appendicitis have been well documented, the value of the plain abdominal radiograph has not been fully appreciated. This article summarises the role of radiology in acute appendicitis, especially in atypical cases and extremes of age, where there is often delay in diagnosis.
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