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Biomedical subjects

N A Shepherd

Publications and source records attributed to N A Shepherd.

97 records · Page 6Linked to original sources
PubMed1987

Restorative proctocolectomy with ileal reservoir: pathological and histochemical study of mucosal biopsy specimens.

Mucosal biopsy specimens from the ileal reservoirs of 92 patients who had undergone restorative proctocolectomy (12 with familial adenomatous polyposis, 78 with ulcerative colitis, and two with functional bowel disease) were studied. Chronic inflammation was found in almost all, as was villous atrophy of varying severity. Other changes included pyloric metaplasia and mucosal prolapse. Acute inflammatory changes and ulceration were less common but, when present, corresponded to the clinical condition of "pouchitis". A grading system was devised to score acute and chronic inflammatory changes. There was a significant increase in acute inflammatory scores in ulcerative colitis compared with those in familial adenomatous polyposis, and pouchitis was present only in patients who had had ulcerative colitis; the morphological features of pouchitis are similar to those seen in the colorectal mucosa in ulcerative colitis. Histochemical studies of mucin in the reservoirs of mucosa showed that there may have been a change from small intestinal mucin to colonic mucin.

Biopsy↗
PubMed1986

An assessment of inflammation in the reservoir after restorative proctocolectomy with ileoanal ileal reservoir.

The significance of inflammation of the mucosa of the ileal reservoir after restorative proctocolectomy is not known although in some cases it appears to be associated with symptoms when the condition has been referred to as pouchitis. This investigation has aimed to determined the prevalence of inflammation, to define pouchitis and to examine some factors which might be related to inflammation. Mucosal biopsies from the ileal reservoir were studied in 90 patients at up to 62 months after closure of the ileostomy. A histological grading system (0-6) was used to assess the severity of inflammation. Some degree of chronic and acute inflammation was found in 87% and 30% of cases respectively. The prevalence of a grade of 4 or more was 23% and 3.5%. There was a correlation between severity of chronic and acute inflammation. Severe histological acute inflammation (grade 4-6) was associated with sigmoidoscopic features of inflammation and with increased frequency of defaecation. Of 55 patients sigmoidoscoped by one clinician, 6 (11%) had pouchitis which was characterised by macroscopic inflammation of the reservoir, diarrhoea and a histological grade of 4 or more. The severity of chronic inflammation was not related to frequency of defaecation. Histological inflammation could not be correlated with the type of reservoir, residual volume after evacuation of a known volume of stool substitute introduced per anum into the reservoir or compliance of the reservoir. Acute inflammation was significantly more severe in patients with ulcerative colitis than in those with familial adenomatous polyposis.

Adenomatous Polyposis Coli↗
PubMed1985

A comparison of bipolar and monopolar diathermy probes in experimental animals.

The effects of monopolar and bipolar diathermy were studied in laboratory animals. The power required to coagulate transected vessels in air was established and the effect of immersion in saline and water during electrocoagulation was investigated. Tissue heat conduction from each type of probe was measured and compared. Tissue damage was assessed by light microscopy of histochemically stained sections. The bipolar system operated at a lower power output (13 W) with less heat conduction, and was unaffected by the surrounding medium.

Animals↗
PubMed1984

Unexpected inorganic elements in oral lesions: results of X-ray energy spectroscopy (XES) on particulate matter in paraffin sections.

X-ray energy spectroscopy (XES) of all particulate matter found by light microscopy in histological sections of 222 oral lesions revealed a much wider range of elements than expected from dental amalgam. Subsequent XES of a variety of endodontic materials, impression materials and toothpastes indicated possible sources for virtually all elements identified in the histopathological lesions. The range of materials identified is tabulated; histopathological lesions and probable source substances are correlated; light microscopic pointers to the elemental nature of particulate matter in sections are indicated--titanium and bismuth have characteristic appearances; possible implications of local implantation and large scale ingestion of such substances are discussed.

Barium Sulfate↗
PubMed1983

Solitary necrotic nodules of the liver simulating hepatic metastases.

Four cases are described in which solitary nodules were identified on the anterior aspect of the liver. These had characteristic histological appearances. Each had a necrotic core surrounded by a dense collar of hyalinised collagen, incorporating elastic fibres. While three of our patients had carcinoma elsewhere none had evidence of tumour in the liver. We do not believe that these lesions represent hepatic metastases. We suggest that they may be of traumatic aetiology or a sequel of previous infection.

Aged↗
PubMed1983

A case of congenital triple valve disease.

We report a case of congenital triple valve stenosis with dominant pulmonary valve disease, sparing the aortic valve, presenting at the age of 51 years with progressive shortness of breath and central cyanosis. At post mortem, no intracardiac right to left communication could be demonstrated.

Female↗