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Biomedical subjects

M E Foster

Publications and source records attributed to M E Foster.

At least 73 records · Page 4Linked to original sources
PubMed1989

Early postoperative feeding--a continuing controversy in pyloric stenosis.

Two regimens of postoperative fluid management are currently used following pyloromyotomy. Both early or delayed feeding have their advocates. The present study reviews 127 infants managed by the early feeding regimen. Although vomiting was common (79%) early discharge (75% within 72 h) was followed by no adverse effects. Weight gain at 7 days was unaffected by postoperative vomiting. Early feeding and early discharge can be achieved without increase in morbidity and may be the preferred method of postoperative management.

Enteral Nutrition↗
PubMed1989

Suppression of malignancy in human lymphoid cell hybrids: the role of differentiation.

Human somatic cell hybrids were generated from fusions between a tumorigenic B-cell line, and mononuclear cells from a patient with low-grade B-cell lymphoma in which the neoplastic cells largely corresponded to cells at an intermediate stage of differentiation. The resulting hybrids and the parent cells were immunophenotyped, karyotyped and genotyped in an effort to determine whether the stage of B-cell development of the fusion partners was important in the suppression of malignancy. The majority of hybrids demonstrated suppression of tumorigenicity as measured in immunodeprived mice. Chromosome markers and immunoglobulin gene rearrangements found in the patient's neoplastic cells were also present in several of the hybrids. One of the tumorigenic hybrids retained specific chromosomes also found in the non-tumorigenic hybrids, but demonstrated an immunophenotype and genotype possibly associated with a subset of early B-cells. In the non-tumorigenic hybrids that retained most of the chromosomes from both parents there was evidence of plasmacytoid differentiation. These results suggest that the ability of B-lymphocytes to suppress malignancy in human lymphoid hybrids may be dependent on the corresponding stage of normal B-cell ontogeny, and that suppression is associated with differentiation.

B-Lymphocytes↗
PubMed1988

Clinical value of scrotal ultrasound in the investigation of scrotal pathology.

The investigation of scrotal swelling has been aided by the advent of scrotal ultrasound. We have reviewed 100 patients in whom 112 scans were performed. One quarter of this group presented with scrotal pain without swelling. Of these patients, 33% were shown to have normal testes on scan; the remainder all had benign disease. A similar number presented with scrotal pain and swelling and the majority were diagnosed on scan as having epididymitis. Nineteen patients were thought on clinical grounds to have tumours; 6 were proven at operation and all were correctly identified pre-operatively by scanning. Scrotal ultrasound is a useful investigation in the management of both painless and painful scrotal swellings.

Adolescent↗
PubMed1987

Follow-up after colorectal cancer--current practice in Wales and south west England.

The necessity for follow-up after curative resection of colorectal cancer remains controversial. Many studies have failed to demonstrate the increase in survival which might be anticipated when detailed follow-up methods are used. In the United Kingdom no single policy has evolved. This study has examined, therefore, the current follow-up practice of a large group of British surgeons. Six per cent carried out no routine postoperative follow-up and there was great variation in the methods used and the regularity of visits. There is a need for a rational policy based on controlled studies to determine whether follow-up is of benefit to the patient and to identify the most effective methods.

Colonic Neoplasms↗
PubMed1987

Pulmonary hypertensive effect of heparin and protamine interaction: evidence for thromboxane B2 release from the lung.

The characteristic pulmonary hypertensive effect of the heparin and protamine interaction has been studied in the isolated pig lung preparation using sequential autologous blood perfusate and dextran perfusate. A significant (p less than 0.001) increase in pulmonary artery pressure at constant flow was seen in 10 of 14 dextran and 12 of 15 blood perfusions. The average increase for dextran was 112 percent and for blood, 109 percent. Antihistamines did not inhibit the response. However, this was abolished in all 11 animals treated with aspirin. In 11 intact swine, thromboxane B2 blood levels increased significantly (p less than 0.01) from 0.46 +/- 0.38 ng/dl to 2.97 +/- 1.5 ng/dl. Thus, pulmonary hypertension associated with protamine reversal of heparinization is associated with prostaglandin release from the lung, and this does not require mediation of platelets or leukocytes.

Animals↗
PubMed1986

HRAS1-selected, chromosome-mediated transformants vary in phenotype in vitro and tumorigenic potential in vivo.

Transfection of mouse C127 cells with mitotic chromosomes isolated from a human EJ bladder carcinoma cell line gave rise, at high frequency, to foci of transformed cells. Independent, HRAS1-selected chromosome-mediated transformants displayed distinctive cellular morphologies in monolayer culture and colony-forming abilities in low-melting-point agarose. Subcutaneous inoculation of neonatally thymectomized, Ara-C-protected, total-body-irradiated CBA mice was used to compare the tumorigenic potential of each transformant. Significant quantitative and qualitative differences in tumorigenicity were found between transformants which correlated with differences in malignant phenotype observed in vitro. The sensitivity of the tumorigenicity assay is such that rare transformation events can be selected directly in vivo.

Animals↗
PubMed1986

The gross pathology and histological features of tumours produced by inoculation of human cell lines into immune-deprived mice.

Tumours were raised in both congenitally athymic ('nude') Swiss mice and in neonatally thymectomized, Ara-C-protected, whole-body irradiated CBA mice by subcutaneous inoculation of cells from a variety of cultured human lines. In both types of animal, tumours tended to grow massively at the site of inoculation, with some infiltration of adjacent tissues but only rarely with evidence of metastatic spread. Tumours derived from Burkitt's lymphoma (BL) lines or from EB virus-transformed lymphoblastoid cell lines (LCL) were all classified as high grade malignant lymphomas with a limited range of appearances on conventional histological examination. In the material studied there were no consistent features distinguishing BL-derived from LCL-derived tumours. Cell lines originating from other haematopoietic malignancies tended to produce tumours interpreted as immunoblastic lymphomas though there were distinctive characteristics in some cases, such as highly convoluted or pleomorphic nuclei in the cells of some tumours derived from T-cell leukaemia lines and plasmacytoid differentiation in tumours originating from myeloma lines. Malignant cell lines of epithelial origin gave rise to tumours with the histological appearances of anaplastic carcinomas readily distinguishable from the high grade lymphomas produced by haematopoietic cells.

Animals↗
PubMed1986

A clinical and experimental study of colostomy blood flow and healing after closure.

Colostomy blood flow and healing have been studied in both man and rat. Laser Doppler velocimetry (LDV) was used to measure flow and showed a significant difference between colostomy blood flow measured at 1 week and at more than 8 weeks after fashioning (p less than 0.002). Hartmann colostomies were constructed in rats and closed at 3 or 6 weeks later. There was a correlation between distal colonic (stump) blood flow and anastomotic bursting pressures 3 days after closure in the 3-week group (r = 0.080; p less than 0.01). Colostomies closed at 6 weeks were significantly stronger than those closed at 3 weeks (p less than 0.02). Collagen concentration in proximal (stoma) colon was higher in the 6-week group compared with the 3-week group prior to anastomosis. There was also a fall in the proximal collagen after anastomosis in both 3- (p less than 0.01) and 6-week groups (p less than 0.01). Poor blood flow measured by LDV and colonic collagen concentration may predict poor healing after colostomy closure. LDV is a non-invasive technique with clinical application in this field.

Aged↗
PubMed1986

Intraoperative antegrade lavage and anastomotic healing in acute colonic obstruction.

The management of acute distal colonic obstruction remains controversial. The advent of intraoperative colonic irrigation has allowed primary anastomosis to be performed in obstructed bowel. Fifteen patients, with acute distal obstruction due to carcinoma, diverticulitis or sigmoid volvulus were managed by primary resection and anastomosis. There were two leaks (14 percent) and the duration of operation was prolonged. In an experimental study of anastomotic healing after acute obstruction, intraoperative irrigation improved early anastomotic colonic collagen content (P less than 0.02) and perianastomotic proximal and distal collagen content (P less than 0.002, P less than 0.05). Intraoperative lavage is a useful technique to permit safer primary resection and anastomosis in obstructed colon.

Acute Disease↗
PubMed1986

Antiseptic toxicity in wounds healing by secondary intention.

The effects of two commonly used antiseptics for chronic ulcer care, chloramine T and chlorhexidine, on the biochemical and histological parameters of healing have been examined. The antiseptics were compared with saline when applied to 10 mm skin defects on Sprague-Dawley rats. Chloramine T significantly delayed the production of collagen and prolonged the acute inflammatory response compared with saline. Chlorhexidine did not differ from saline. We conclude that hypochlorite antiseptics may adversely affect healing by secondary intention and the antibacterial and desloughing action of agents should be carefully balanced against their toxic effect.

Animals↗
PubMed1985

Changing patterns in colostomy closure: the Bristol experience 1975-1982.

The results of colostomy closure in 113 patients (1975-1982) were examined to determine whether the identification of risk factors or improvements in surgical management had made this procedure safer. Overall mortality was low (0.9 per cent), but faecal fistulas occurred in 16.5 per cent and the incidence of wound infection was high (34 per cent). Comparison of the first and second 4 year periods shows recent improvements in the rates of wound infection (24 versus 51 per cent: P less than 0.01) and anastomotic leakage (10 versus 30 per cent: P less than 0.05). A long delay (greater than 6 months) between creation and closure of the colostomy was associated with an increased incidence of postoperative diarrhoea compared with shorter periods of defunction (38 versus 14 per cent: P less than 0.01). The morbidity of colostomy closure is decreasing but remains an important clinical problem.

Aged↗
PubMed1985

Hypovolaemia and healing in colonic anastomoses.

Colonic anastomotic leakage is more common following emergency resections than after elective operations. Transient hypovolaemia, which is more likely to occur during emergency surgery, has been shown to impair collagen metabolism in abdominal and skin wounds but its effect on colonic anastomotic healing has not been previously examined. Acute intra-operative loss of 10 per cent circulating blood volume in rats significantly impaired collagen concentration in both ileocolic (P less than 0.02) and colocolic (P less than 0.05) anastomoses measured on the third postoperative day. This degree of blood loss did not significantly affect early anastomotic strength. Hypovolaemia leads to tissue hypoxia, and this in turn may lead to impaired anastomotic healing. Measurement of tissue oxygen tension may predict poor healing by identifying inadequate intestinal perfusion. Colonic pTO2 measured in rabbits was significantly lower than in small bowel (37 +/- 18 mmHg versus 42 +/- 18 mmHg; P less than 0.001), and fell significantly in colon following 10 per cent blood loss (P less than 0.001). We conclude that adequate intra-operative fluid replacement during colonic resection and anastomosis is a prerequisite for successful healing.

Animals↗
PubMed1985

Do magnetic fields influence soft tissue wound healing?--A preliminary communication.

Magnetic fields have been considered for treating many ailments over man's history. There have been many anecdotal unsupported claims for successful treatment of soft tissue injury although reports have been more substantive in the orthopaedic field. The widespread clinical and veterinary use of a light self-adhesive magnetic foil in Europe prompted this trial of experimental wound healing. One hundred and sixty Sprague-Dawley rats had a linear 2.5 cm incision or a circular 1 cm skin defect made over the mid-dorsal spine. Equal numbers were randomised to receive either a magnetic foil or a dummy (control) dressing. At three, seven, 10 or 14 days linear wounds were distracted using a tensiometer; open defects were measured, excised and assayed for collagen content; 14-day wounds were examined histologically. Although wound tensile strengths increased and open wounds decreased in size with increase of hydroxyproline, there were no statistically significant differences between treated or control animals. Although easy to apply the alternate magnetic foil (giving 400 Gauss at 7 mm) conferred no statistically significant effect on soft tissue healing.

Animals↗
PubMed1985

Colonic ischaemia and anastomotic healing.

The leakage rate of colonic anastomoses may be as high as 13%. A good blood supply is of paramount importance. However tissue perfusion may be at risk in the elderly and in low colorectal anastomoses. We have tested the effect of isoxsuprine, an agent which reduces blood viscosity, and is an alpha-adrenergic antagonist and beta-adrenergic agonist, on the healing process in normal and ischaemic rat colon. Both bursting pressure and hydroxyproline concentration were significantly improved in compromised ischaemic colon in animals treated with isoxsuprine. Isoxsuprine may improve healing in poorly perfused colonic anastomoses.

Animals↗
PubMed1985

Functional aspects of ano-rectal vascularity.

The blood supply of the ano-rectum has been studied in cadaveric specimens by angiographic methods. The vascular anastomosis between the middle rectal and superior rectal vessels was found to be demonstrable on one side only. There appears to be a midline paucity of vessels in both the posterior and anterior rectal walls, and this may be important in the aetiology of anastomotic dehiscence in low anterior resection.

Anal Canal↗