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Biomedical subjects

P Sherlock

Publications and source records attributed to P Sherlock.

At least 55 records · Page 3Linked to original sources
PubMed1977

Feasibility of fecal occult-blood testing for detection of colorectal neoplasia: debits and credits.

A screening program for colorectal cancer and adenomas has been applied to 6,579 mostly asymptomatic men and women age 40 years and older utilizing fecal occult-blood testing followed by investigation of patients with positive slides by air-contrast barium enema and colonoscopy. A control population of 7,325 patients had sigmoidoscopy only and no occult-blood testing. Approximately 1% of the patients had positive slides; most patients had only one or two slides positive. Approximately 50% of patients with positive slides had significant neoplastic lesions, including 23 patients with large adenomas and 7 patients with cancers. Pathological staging of cancers was more favorable in the screened asymptomatic group as compared with the control group. Neoplastic lesions seen on sigmoidoscopy in screened patients who had negative fecal occult-blood tests included 2 cancers and 15 large adenomas. Reasons for false negativity include possible conversion of initially positive slides to negative. Screening for colorectal cancer and adenomas with fecal occult-blood testing appears to be feasible approach with good patient compliance, and manageable rate of positive slides productive of a high percentage of neoplastic lesions. The number of false-positives seems to be low. False negativity has been observed and will require further study.

Adenoma↗
PubMed1977

Detecting early colon cancer.

Techniques enabling detection of early colon cancer already exist, but to be more productive in terms of improving survival they must be applied in a meaningful sequence and repeated regularly in high-risk patients. Positive findings in specific screening steps based on well-known risk factors in colon cancer always call for aggressive follow-up. The advantages and disadvantages of the various techniques are discussed.

Barium Sulfate↗
PubMed1977

Carcinoembryonic antigen in colonic lavage.

Colonoscopic lavage was performed for assay of carcinoembryonic antigen (CEA) concentration in patients with small and large colonic adenomas, in patients with adenocarcinoma of the colon, and in normal controls. CEA concentration was considerably higher in colonoscopic lavage as compared to plasma. CEA concentration in normal controls and in patients with colonic adenomas less than 1 cm in size were not significantly different. CEA concentrations in patients with colonic adenomas greater than 1 cm in size and in patients with adenocarcinoma of the colon were significantly higher than those observed in patients with small adenomas and in the normal controls. In all except 2 patients, plasma CEA concentrations were normal. Assay of CEA concentrations in colonic lavage may have potential application in the further assessment of the mucosa at risk for colon adenomas and for colon cancer. It does not appear to be accurate enough for diagnosis of colon cancer in individual patients.

Adenocarcinoma↗
PubMed1976

The role of upper gastrointestinal endoscopy in patients with cancer.

The last decade has seen considerable advance in the application of fiberoptic endoscopy to the diagnosis and management of patients with cancer. Forward and side-viewing instruments have been developed that have complete tip control, potential for obtaining directed biopsies, brush and lavage cytology, and for aspiration of material for assay of enzymes and tumor-associated antigens. These features have provided a high degree of diagnostic capability in the esophagus, stomach, and duodenum. Accurate histologic diagnoses require multiple biopsies and brush cytology from each lesion. Lavage cytology has been useful in selected patients, especially those with diffusely infiltrating lesions. Brush cytology has been especially helpful in patients with stenotic esophageal cancer. These techniques have also provided a diagnosis in a high percentage of patients with lymphoma involving the stomach. Endoscopy has also been very useful in patients with nongastrointestinal cancer who have major gastrointestinal problems such as bleeding stress ulcers or monilial esophagitis.

Biopsy↗
PubMed1976

Radioautographic observations of a 19-month-old ileal conduit.

The influence of an altered environment of the cellular kinetics and histological appearance of ileal mucosa used as a urinary bladder was investigated in a patient with a conduit of 1 year and 7 months' duration. After injection of 10 mc of 3H-TdR, multiple biopsies were taken spanning a 3-day period. No increase in inflammatory cell numbers was seen and villous atrophy was minimal. A generation time or total cell cycle time of 36 hr was observed, with a G1 phase of 22 hr and an S phase of 11 hr. At 1 hr 2.4 3H-TdR-labeled cells per crypt column and a mitotic index of 1.4% were obtained. The complet labeled mitosis curve obtained on the epithelial cells of the 19-month-old ileal conduit mucosa demonstrated a retention of the kinetics and histological characteristics of normal ileal mucosa, contrary to previously documented findings.

Autoradiography↗
PubMed1975

Carcinoma complicating Crohn's disease. Report of seven cases and review of the literature.

Seven cases of adenocarcinoma complicating Crohn's disease are reviewed. In three of the patients, small bowel cancers developed in association with reginal enteritis. In four patients, carcinoma of the colon was superimposed on Crohn's colitis. In two of these, the adenocarcinoma infiltrated chronic colocutaneous fistulas. Review of the literature shows an increasing number of reports of carcinoma complicating Crohn's disease, with a total of 36 cases of small bowel cancer and 30 cases of colon cancer previously reported. The significane of these and our own cases is discussed. The possibility of carcinoma must be kept in mind by clinicians following patients with Crohn's disease. Adenocarcinoma complicating Crohn's disease occurs at a younger age, on the average, and in areas similar to the distribution of Crohn's disease rather than the usual distribution of the cancer. Preoperative diagnosis is difficult, but changes in the nature of chronic fistulas should be investigated.

Adenocarcinoma↗
PubMed1975

Beneficial effect of human growth hormone on stress ulcers.

Human growth hormone was effective in healing erosions and controlling hemorrhage in six of eight patients with stress ulcers. This approach was based on known beneficial effects of growth hormone on nucleic acid and protein synthesis, demonstration of deleterious effects of stress on nucleic acid and protein synthesis, and demonstrated protective effects of growth hormone on animals subjected to stress. Bleeding cessation within 24 hours of its administration in two patients suggests the possible role of additional mechanisms involved in hemostasis. In a comparable group of eight patients with stress ulcer hemorrhage not treated with this agent, six died with continued bleeding. This high mortality represented the usual outcome in our patients with stress ulcer hemorrhage. These observations need to be extended to additional patients with stress ulcers in a larger randomized study.

Blood Chemical Analysis↗