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Biomedical subjects

J W Fielding

Publications and source records attributed to J W Fielding.

143 records · Page 8Linked to original sources
PubMedDate not supplied

Prognostic factors for gastric cancer influencing clinical practice.

Despite a slow decline in the incidence of gastric cancer over the last 90 years, we can still expect to see over 100,000 patients die of this disease each decade in England and Wales. The 5-year survival rate has not improved during this century, which is largely due to the stage at diagnosis being unchanged. There are a number of prognostic determinants in gastric cancer which have clinical relevance. Age is an important determinant; patients under 40 years commonly have more advanced diffuse lesions than older patients so that a higher index of suspicion needs to be maintained in younger patients with persistent symptoms. Conflicting reports make it unclear whether the duration of symptoms bears any relationship to tumor stage, but there is some evidence that actively shortening the symptom duration by early investigation can have a beneficial effect in the proportion of patients diagnosed with early cancers. The site of the tumor is important; unfortunately, the proportion of patients with cardia lesions is increasing and this has had the effect of reducing the overall survival. Tumor size should not play a part in the decision to resect a lesion as most studies show no clear relationship between tumor size and stage. Tumor stage is the most important prognostic determinant and efforts to increase the proportion of stage I cancers presenting for surgery can be shown to alter the natural history of the disease, by diagnosing it when it is still surgically curable.

ABO Blood-Group System↗
PubMedDate not supplied

Pathologic prognostic factors for gastrointestinal cancer.

Numerous clinicopathologic factors have been reported to have prognostic significance for gastrointestinal cancer. Many problems, however, confront the surgeon assessing the extent of disease and the clinical and molecular pathologist distinguishing differences in tumor differentiation, behavior, and defining important prognostic markers of cancer. This review assesses current pathologic prognostic variables of gastric and colorectal cancer that have been reported to influence survival.

Biomarkers, Tumor↗
PubMedDate not supplied

Pugh nail fixation of displaced femoral neck fractures. A long term follow-up.

Of 695 intracapsular hip fractures with known end results, 80 per cent occurred in women whose average age was 71 years; of 101 consecutive undisplaced intracapsular fractures reported up to 1959, 81 were treated by internal fixation and 20 nonoperatively and all united but 11 per cent developed necrosis. From 1937 to 1959, displaced intracapsular fractures at St. Luke's Hospital were generally treated by closed reduction and Smith-Petersen nail fixation. From 1948 to 1952, 22 per cent of these fractures failed to unite, but from 1952 to 1959, 44 per cent failed to unite. Many of the failures were due to the Smith-Petersen nail backing out. These poor results inspired another device which might provide better fixation and prompted the use of the telescoping Pugh nail. From 1955 to 1971, the telescoping Pugh nail was used in 256 displaced intracapsular fractures with known end results. Ninety per cent united, and avascular necrosis was seen in 17 per cent of the united fractures. Since many of the patients with avascular necrosis has no pain, they were considered satisfactory results. Subtracting these 17 per cent of 256 patients with displaced intracapsular fractures of the femoral neck may be evaluated as examples of satisfactory results with the Pugh nail.

Aged↗
PubMedDate not supplied

Epiphyseal osteochondroma of the anterior cruciate ligament.

An 8-year-old Black boy complained of pain, swelling, and a decreased range of motion in the knee. One arthrotomy operation was reported to show a normal knee joint. Six months later, a second arthrotomy demonstrated an osteochondroma growing from the epiphysis into the anterior cruciate ligament. Epiphyseal osteochondroma should be added to the working differential diagnosis on children with effusion and decrease of knee motion.

Bone Neoplasms↗
PubMedDate not supplied

Aneurysmal bone cyst of the cervicodorsal spine.

A 23-year-old woman with paraparesis and bladder atonia of one week's duration demonstrated lytic destruction of the anterior elements of C7, D1, and D2, with gibbus deformity at C7. The tumor was excised in August 1975 through an anterior approach and the cervical spine was reconstructed with a five-level, fibular strut bone graft. Several weeks later a posterior fusion was performed. The patient was placed in a halo jacket for three months, at which time solid fusion was achieved. The final pathologic diagnosis was aneurysmal bone cyst. The patient obtained full neurologic recovery after surgery and has had no sequelae or recurrence to date. Involvement of several adjacent cervical vertebrae by an aneurysmal bone cyst is unusual, and a comparable case is rarely reported.

Adult↗