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Biomedical subjects

M A Adson

Publications and source records attributed to M A Adson.

At least 73 records · Page 4Linked to original sources

Stromal invasion of cancer in pedunculated adenomatous colorectal polyps: significance for surgical management.

Fifty-three patients were treated for pedunculated adenomatous polyps that contained foci of invasive cancer confined to the stroma. This entity is a stage of malignant involvement intermediate between in situ carcinoma and frank infiltrative cancer that invades the muscularis mucosae. Metastases to regional lymphatics were not observed. Local removal of such lesions without regional lymphadenectomy is adequate treatment.

Adenocarcinoma↗

Regression of renal cell hepatic metastasis following removal of primary lesions.

Although spontaneous regression of metastatic renal cell carcinoma occurs it is so uncommon that it should not be considered the primary basis for recommending removal of the asymptomatic primary lesion. Such a recommendation should be made when other treatment modalitis are available to augment the factors influencing the patient-tumor interface. Spontaneous regression of a documented solitary liver metastatic lesion is reported. Removal of the residual hepatic lesion failed to prolong the patient's life.

Adenocarcinoma↗

Surgical treatment of hepatic metastases from colorectal cancers.

Follow-up data covering periods of two to 23 years have been collected on 60 patients who had resection of hepatic metastases for colorectal cancer. Multiple lesions were removed from 20 patients, and solitary lesions were excised from the other 40 patients. Only one patient died during hospital convalescence. No patient who had multiple lesions excised lived for five years. In contrast, 15 of the 36 patients eligible for five-year survival study who had resection of apparent solitary lesions lived for five years or more, and eight patients were alive without evidence of recurrence ten years or more after operation. These surprisingly favorable results of surgical treatment were analyzed in relation to results in patients who had biopsy specimens taken of lesions of comparable size and number, but no removal at the time of colonic resection. No patient in this control group lived for five years. Aggressive surgical treatment of apparent solitary hepatic metastatic lesions from colorectal cancer seems to be justified by the survival rate of surgically treated patients.

Adult↗

Patterns of total and ionized calcium and other electrolytes in plasma during and after general surgery.

Thirteen patients were studied during two hours of anaesthesia for abdmonial operations and for an hour post-operatively. Serial venous blood samples were taken for determination of plasma total and ionized calcium, acid-base variables, Na, K, Mg, PO4 total proteins and parathyroid hormone. One group of patients received 5 per cent dextrose/water and the other 5 per cent dextrose in Ringer's solution, at 250 ml per hour. Total and ionized calcium levels decreased toward the end of operation and an hour later, associated with respiratory alkalosis. Parathyroid hormone increased at the end of operation, as an effect of the decreased ionized calcium. The general effect was mild haemodilution with all the other electrolytes decreasing, as did total protein concentration.

Adult↗

Pantothenic acid, coenzyme A, and human chronic ulcerative and granulomatous colitis.

To investigate further an apparent relationship between chronic ulcerative and granulomatous colitis and pantothenic acid deficiency, colonic tissues obtained at the time of colectomy in 29 patients with these disorders were assayed for pantothenic acid and for coenzyme A (CoA) activity. For comparison, normal colonic tissues free of pathological lesions were obtained from 31 patients having colectomy for carcinoma or diverticulitis. Plasma, red blood cells, and colonic mucosa were assayed microbiologically for free and total pantothenic acid. The activity of CoA in colonic mucosa was determined by assaying the acetylation of sulfanilamide. Concentrations of free, bound, and total pantothenic acid in blood and in colonic mucosa did not differ between the two groups of patients. Bound pantothenic acid increased linearly with total pantothenic acid. Colonic mucosa concentrated free pantothenic acid to about 50 times the level of blood, and pantothenic acid in red cells was similar to the concentration in plasma. Compared to normal gut mucosa, CoA activity was markedly low in mucosa from patients with chronic ulcerative or granulomatous disease despite the presence of normal amounts of free and bound pantothenic acid. A block in the conversion of bound pantothenic acid to CoA in diseased mucosa is suggested.

Adult↗

Conventional splenorenal shunts. A reconsideration.

From 1961 to 1971, 73 central splenorenal and 66 portacaval shunts were done for cirrhotic patients who had bled from esophageal varices. Comparative analysis revealed low (3% and 2%, respectively) operative mortality for elective operations, equal (93%) effectiveness in control of variceal bleeding, but substantial diferences in the incidence of postshunt encephalopathy. For patients who had mimal hepatic dysfunction before operation, disabling disorders in mentation developed in 5% of patients who had splenorenal shunts, in contrast to 50% of patients who had portacaval shunts. Survival rates after the two shunts were nearly identical. Thus, the advantages of splenorenal shunts concern the quality of life but not the length of survival. These observations are considered in relation to available therapeutic alternatives.

Activities of Daily Living↗

Postoperative reflux gastritis.

The chief clinical features of forty-nine patients with the syndrome of reflux "alkaline" gastritis were epigastric pain, bilious vomiting, anemia, and the dumping syndrome. Separation of the symptoms of this syndrome from the symptoms of a multitude of other postgastrectomy syndromes is difficult, being complicated by a high incidence of emotional instability in these patients. Endoscopy remains the mainstay in diagnosis; among the characteristic endoscopic features are adherent mucus, edema, mucosal friability, and erosions, most severe on the gastric aspect of the stoma. The surgical treatment of choice is Roux-en-Y gastrojejunostomy accompanied by vagectomy.

Adult↗