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Biomedical subjects

N Y Haboubi

Publications and source records attributed to N Y Haboubi.

At least 19 recordsLinked to original sources
PubMed2006

The importance of accurate pathological assessment of lymph node involvement in colorectal cancer.

This review presents an up-to-date analysis of the importance of accurate pathological lymph node staging in colorectal cancer. Lymph node staging is reliant on the technique of the surgeon and the pathologist as well as methods employed in the histopathology laboratory, and is vital for determining appropriate therapy. The significance of micrometastatic nodal disease is evaluated and new techniques for pathological evaluation are discussed. Recommendations for evaluation of lymph node status in colorectal cancer are provided based on current scientific evidence, and standardization of pathological dissection and laboratory handling is advocated.

Colorectal Neoplasms↗
PubMed2006

Coeliac disease and oats: a systematic review.

A systematic review of the literature related to the inclusion of oats in the gluten-free diet for patients with coeliac disease to assess whether oats can be recommended. A computerised literature review of multiple databases was carried out, identifying 17 primary studies, 6 of which met the criteria for inclusion in this review. None of the six studies found any significant difference in the serology between the oats and control groups. Two studies, however, identified a significant difference (p<0.001; p = 0.039) in intraepithelial lymphocyte counts between the oats and control groups. Oats can be symptomatically tolerated by most patients with coeliac disease; however, the long-term effects of a diet containing oats remain unknown. Patients with coeliac disease wishing to consume a diet containing oats should therefore receive regular follow-up, including small bowel biopsy at a specialist clinic for life.

Antibodies↗
PubMed2005

Simple excision and primary closure of pilonidal sinus: a simple modification of conventional technique with excellent results.

OBJECTIVE: Pilonidal sinus (PNS) is a common condition, which warrants surgical intervention. A number of surgical options have been suggested with variable recurrence rate. This study proposes a modification of a standard method. METHODS: A total of 51 patients with sacrococcygeal PNS were sequentially treated by the standard method devised by one Consultant Colorectal Surgeon (IA). The principle is based on: 1, after excising the PNS ensure obliteration of the natal cleft by releasing the fat pad from the gluteal fascia; 2, avoid tension and 3, encourage patients to lie on their back immediately after the operation. RESULTS: Follow-up was available from 51 patients ranging from 14 to 49 months. All patients were discharged within 48 h. There was only one recurrence, which was successfully treated. CONCLUSION: Our results suggest that PNS can be successfully treated by our hitherto undescribed method, patients can be discharged early and there is very low recurrence rate.

Adolescent↗
PubMed2005

Pigmented mesenteric lymphadenopathy in familial adenomatous polyposis - an unusual cause of intraoperative abandonment of ileo-anal pouch.

Familial adenomatous polyposis (FAP) is an autosomal dominant condition with near complete penetrance, characterised by the presence of numerous adenomatous polyps of the colon and rectum. Melanosis coli describes the brownish-black discolouration of the colon resulting from the accumulation of a granular pigment in the phagosomes of macrophages in the colonic lamina propria. The presence of melanosis pigment in pericolonic lymph nodes has been reported in patients with coincidental melanosis coli, following segmental colonic resection. We report a unique case of FAP with melanosis pigment in lymph nodes in the small bowel mesentery that initially prevented a restorative proctocolectomy but that resolved following a colectomy, subsequently facilitating formation of an ileo-anal pouch.

Adenomatous Polyposis Coli↗
PubMed2004

Appendicular intussusception into a polyp.

Intussusception of the appendix is a rare condition. We present the case of a 72-year-old woman with multiple polyps in the colon with an appendix completely intussuscepted into a polyp within the caecum. The clinical features, preoperative diagnosis, classification and treatment of this condition are discussed with reference to literature.

Aged↗
PubMed2004

Improved diagnostic accuracy of inflammatory bowel disease: a clinicopathological collaborative approach.

Although colonic biopsies have become a major source of information to the clinician investigating cases of inflammatory bowel diseases (IBD), there are still some difficulties in making definitive diagnoses. This article looks into these challenges and possible ways of dealing with them. We strongly recommend supplying the pathologist with full clinical, radiological and endoscopic information with the request form. The pathologist may then issue a preliminary working report, while the final report should be reached at the much needed regular clinicopathological conference.

Endoscopy, Digestive System↗
PubMed2004

Colonic neoplastic polyps: biopsy is not efficient to exclude malignancy. The Trafford experience.

The biological behaviour of the polyp depends entirely on its histological subtype. Adenomas are the classic precursors to carcinoma. Polyp biopsy can differentiate neoplastic (adenoma and carcinoma) from non-neoplastic polyps (hyperplastic, inflammatory, hamartomatous). Due to potential sampling error, biopsy does not always differentiate between adenoma and carcinoma. Our aim was to investigate the degree of this potential sampling error. We carried out a study to compare the results of biopsies vs. total tissue examinations in a cohort of 433 neoplastic polyps. In this study 18.5% of carcinomatous polyps show definitive malignant elements only when the entire polyp is presented to the pathologist. We have therefore adopted a special reporting template if the polypoidal tumour is either biopsied or incompletely excised. The study also showed that within adenomas there could be variance of architectural patterns between the biopsy and the whole specimen. In this series, biopsying malignant colonic polyps gives rise to 18.5% false negative results and therefore it is significantly less efficient in the diagnosis of malignancy compared to total polyp examination.

Adenoma↗
PubMed2004

Sclerosing mesenteritis with occult ileal perforation: report of a case simulating extensive intra-abdominal malignancy.

Sclerosing mesenteritis is a rare condition that is characterized by fibrosis affecting mainly small-bowel mesentery, which in extensive cases may mimic advanced intra-abdominal malignancy. Establishing the diagnosis in such cases is a clinical and histopathologic challenge. We report the successful management of a case of extensive sclerosing mesenteritis with occult ileal perforation, which was possibly the triggering cause. Severe complications occurred as a result of both the disease itself and its surgical treatment. Despite the complex course and life-threatening complications, a good prognosis can be expected. Although occasional recovery has been attributed to spontaneous regression and response to immunosuppressive therapy, a search for, and full eradication of, possible triggering focus is of paramount importance.

Abdominal Neoplasms↗
PubMed2003

Snaring of submucosal tumors of gastric fundus.

Submucosal tumors of the stomach are not uncommon. We present two cases of iatrogenic perforation after snaring large polyps in the gastric fundus. We discuss the probable etiology and review the literature regarding iatrogenic perforation in this location. Submucosal polyps situated in the fundus may produce pseudopedicle. Therefore, we recommend these be treated with caution, and a combined endoscopic and laparoscopic approach is suggested.

Aged↗
PubMed2002

Dysplasia in the ileoanal pouch.

Formation of an ileo-anal pouch is an accepted technique following colectomy in the surgical management of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). The configuration of pouches and anastomotic techniques has varied over the last two decades. The increased use of stapling devices in formation of the pouch-anal anastomosis avoids the need for endoanal mucosal stripping and may contribute to improved functional results, but leaves a 'columnar cuff' of residual rectal mucosa in situ. Concerns regarding the long-term safety of the ileo-anal pouch have been raised by reports of the occurrence of dysplasia in the pouch mucosa and 15 cases of adenocarcinoma. In UC, persistence of underlying disease in the residual rectal mucosa, anal transition zone and columnar cuff provides the site for development of dysplasia and malignancy. Pouchitis is unlikely to be a major cause of dysplasia or malignancy, as long-term follow-up of patients with Koch pouches has demonstrated. In FAP, any persistent rectal mucosa and mucosa of the small intestine is at risk of adenomatous dysplasia due to the genetic alterations causing the disease. Long-term surveillance should focus on all FAP pouch patients, and in UC patients should be directed towards the diagnosis of residual rectal mucosa in the area distal to the pouch anastomosis. Specialist histopathological opinion is essential in the diagnosis of dysplasia in the ileo-anal pouch.

Journal Article↗
PubMed2001

Are differences in stage at presentation a credible explanation for reported differences in the survival of patients with colorectal cancer in Europe?

Popular reporting of a comparison of cancer survival rates across 17 European countries, based on data collected by national and regional cancer registries, has left an impression of inadequate treatment of patients in the UK. A subsequent study has suggested that the poor survival rates reported for the UK can, in large part, be explained by more advanced stage at presentation. We believe this conclusion to be unsound and use this study as an example to illustrate the methodological difficulties which may arise during such international comparisons. As the NHS cancer plan aspires to achieve for the UK parity with the best cancer care in Europe, careful thought needs to be given to identifying countries with which the UK can usefully compare itself and the most appropriate indicators for this comparison.

Adenocarcinoma↗
PubMed2001

Detection of lymph node metastases in colorectal carcinoma.

The detection of lymph node metastases is the single most important prognostic factor for patients with colorectal cancer. This review outlines the difficulties and methods of detecting positive lymph node metastases in this disease. An outline of traditional diagnostic methods including preoperative ultrasound and cross sectional imaging techniques are evaluated alongside newer modalities including immunoscintography and PET scanning and intraoperative radioguided imaging. Pathological methods of detecting positive nodal disease using standard histopathological staging, enhanced lymph node harvesting and determination of micrometastases are also discussed.

Journal Article↗
PubMed2001

Non-specific colitis, is it a justifiable diagnosis?

OBJECTIVE: The terms non-specific and chronic colitis are often used by histopathologists. The aim of this study is to look into the validity of the label non-specific chronic colitis (NSCC), the consistency of its reporting, as well as its clinical usefulness in patients who, on review, have shown to have normal biopsies. METHODS: Colonic and rectal biopsies from 35 patients who presented with acute onset diarrhoea, were initially diagnosed as nonspecific chronic colitis (NSCC) by a number of pathologists in one Department, and were reviewed by an outside pathologist (NYH) without the knowledge of the clinical details. A previously described set of histological criteria in reporting colonic biopsies in inflammatory conditions were used. RESULTS: Normal biopsies were found in 13 of the 35 patients (37%). These patients recovered without clinical intervention. In a further seven patients there was active inflammation with no features of chronicity, in 12 patients there were features of chronicity, in two patients there were hyperplastic polyps, and in one patient there were features of solitary ulcer syndrome. CONCLUSION: NSCC was used, without consistency, to cover a variety of conditions, including normal biopsies, sometimes relaying a wrong message. We suggest that histological criteria for chronicity should be adhered to when this label is used and the term Non-Specific Colitis should no longer be used.

Journal Article↗
PubMed1998

The novel combination of fat clearance and immunohistochemistry improves prediction of the outcome of patients with colorectal carcinomas: a preliminary study.

To evaluate the significance of micrometastases in relation to survival rate, specimens from 48 colorectal carcinoma patients were analysed after fat clearance. The number and size of the lymph nodes harbouring metastases and the significance of micrometastases for patients' survival were assessed. We found that although the majority of metastatic lymph nodes (71.8%) were 5 mm or less in diameter, their size had no effect on survival. Immunohistochemical staining of lymph nodes revealed that 15 of 25 patients with Dukes' stage B diagnosed by routine staining had micrometastases, 86% of these lymph nodes being less than 5 mm in diameter. The survival rate of this subgroup was found to be considerably poorer than that of Dukes' stage B patients with no micrometastases. None of the three patients with Dukes' stage A carcinoma had micrometastases. Since most of the metastases and micrometastases occur in lymph nodes of 5 mm and less and can be easily missed by routine examination, we suggest that fat clearance and routine immunohistochemical analysis of Dukes' stage B improve the prediction of outcome of colorectal cancer patients.

Aged↗
PubMed1998

Localisation and semiquantitative assessment of hepatic procollagen mRNA in primary biliary cirrhosis.

BACKGROUND: Chronic liver disease is characterised by excessive deposition of collagen and other extracellular matrix proteins, produced mainly, but not exclusively, by activated hepatic stellate cells in the perisinusoidal space. In primary biliary cirrhosis (PBC) fibrosis is concentrated mainly around the portal tracts. AIMS: To examine the hypothesis that, in addition to hepatic stellate cells, portal tract fibroblasts might play a significant role in the deposition of collagen in PBC. METHODS: Fifty liver biopsy specimens from patients with PBC were studied. An in situ hybridisation technique was adapted to localise and measure semiquantitatively type I procollagen mRNA in formalin fixed, paraffin wax embedded sections, using an 35S labelled cRNA probe specific for the alpha 1 chain of rat type I procollagen. Hepatic fibrogenic activity was also assessed using serum type III procollagen peptide (PIIINP). RESULTS: In PBC, type I procollagen gene expression was significantly increased. Signal was localised mainly in and around inflamed portal tracts, to cells which had the appearances of portal fibroblasts. Signal activity in these cells correlated with the degree of portal fibrosis and inflammation and also with serum PIIINP concentrations. CONCLUSIONS: Results are consistent with the hypothesis that the excessive extracellular matrix, deposited within the liver in PBC, is synthesised not only by hepatic stellate cells but also by portal tract fibroblasts. The semiquantitative assessment of procollagen mRNA in liver biopsy specimens may provide a useful method of evaluating the rate of synthesis of collagen and therefore disease activity in patients with PBC.

Biomarkers↗