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Biomedical subjects

P Watson

Publications and source records attributed to P Watson.

At least 253 records · Page 14Linked to original sources
PubMed1988

Hereditary nonpolyposis colorectal cancer--Lynch syndromes I and II.

HNPCC is an autosomal dominantly inherited disorder with proclivity to early onset colorectal cancer in the absence of multiple polyps of the colon. There is a predilection for proximal colonic location (70 per cent) and an excess of synchronous and metachronous colorectal cancers. HNPCC is subdivided into Lynch syndrome I, which is restricted to site-specific colon cancer susceptibility, and Lynch syndrome II, which shows all of the features of Lynch syndrome I, but in addition, patients are at inordinately increased risk for carcinoma of the endometrium, ovary, and other anatomic sites. The frequency of HNPCC is conservatively estimated to be 4 to 6 per cent of the total colorectal cancer burden. Because of the fact that the family history is underreported almost uniformly in medical practice, we believe that the true frequency of this disease may be much greater. Heterogeneity may be extant with respect to tumor association, in that in certain Lynch syndrome II kindreds, carcinoma of the pancreas, kidney, breast, and other anatomic sites may predominate. Knowledge of the natural history of HNPCC predicates surveillance and management strategies. Thus, because of the early onset of and proximal predilection for colorectal cancer, we recommend initiation of colonscopy at age 25 and annually thereafter. We also recommend guaiac testing of the stool at least twice a year. In the case of Lynch syndrome II, in addition to colonscopy, we recommend intensive surveillance for the endometrium, including aspiration biopsies. Other targeted organs, depending on the tumor spectrum in the family, should be given priority attention. Because of an excess of synchronous and metachronous colorectal cancer in HNPCC, subtotal colectomy with ileorectal anastomosis is the treatment of choice for initial colorectal cancer. In women presenting with initial colorectal cancer who have completed their families, consideration should be given to prophylactic hysterectomy and bilateral salpingo-oophorectomy at the time of surgery for colorectal cancer. Needed are biomarkers of acceptable sensitivity and specificity for the genotype, because HNPCC lacks premonitory physical signs. We believe that increased knowledge about colorectal cancer etiology and carcinogenesis can be attained through the study of families prone to the Lynch syndromes.

Adult↗
PubMed1988

Tumor variation in three extended Lynch syndrome II kindreds.

Lynch syndrome II is characterized by an autosomal dominantly inherited susceptibility to early onset colon cancer with proximal predominance, an excess of synchronous and metachronous colonic cancer, carcinoma of the endometrium, ovary, and multiple primary cancer excess. Knowledge of the full tumor spectrum in this disorder(s) remains elusive. Cancers that are uncommon in this disease, but present in three extended Lynch syndrome II families, included brain tumors, carcinoma of the bile duct, duodenum, the urological system, and breasts. Long-term followup of these families (as long as two decades) provided the opportunity to trace in depth this tumor spectrum. Full scrutiny of cancer of all anatomic sites in the absence of biomarkers of high sensitivity and specificity to the cancer-prone genotype will be necessary to comprehend more clearly whether these (or other) cancer sites are integral to this disorder, whether common environmental exposures are involved and, finally, whether chance can explain these cancer associations.

Adolescent↗
PubMed1987

Fluorescein angiography in the differential diagnosis of sclerokeratitis.

Anterior segment fluorescein angiography has been used in the investigation of patients with sclerokeratitis. This showed that corneal thinning or destruction was associated with non-perfusion of the episcleral vasculature. The changes arose either as a result of a systemic vasculitis in seropositive individuals or were induced by surgery to the eye. Infiltrative forms of sclerokeratitis were commoner in seronegative patients and were less often associated with vascular shutdown.

Cornea↗
PubMed1987

Prostate cancer.

Prostate cancer is the most frequent malignancy in elderly men. Common presentations include asymptomatic prostate nodules, unexplained bone pain or bladder outlet obstruction. Histologic grading clearly influences the prognosis. Either potency-saving subcapsular prostatectomy or radiation therapy is effective in treating localized disease. New prospects for hormonal therapy of metastatic prostate cancer include antiandrogens and gonadotropin-releasing analogs.

Age Factors↗
PubMed1986

Heterogeneity in a colonic carcinoid tumor.

This report describes a colonic carcinoid tumor in which three, and possibly four, distinct cell types are distinguishable on the basis of their ultrastructure and granule morphology. These cell types closely resemble the normal endocrine cells of the large bowel, both in appearances and in relative frequency. The mixed composition of this tumor may have arisen either by parallel differentiation of distinct cell types, or by sequential maturation of one cell type.

Carcinoid Tumor↗
PubMed1986

Preinduction cervical ripening with sequential use of prostaglandin E2 gel.

Two hundred patients received a prostaglandin E2-containing gel for preinduction cervical ripening. The gel was administered every 6 hours until a Bishop score greater than or equal to 7 was obtained or the attending physician deemed induction necessary. Forty-eight percent of the patients labored "spontaneously" after one or more gel applications. The average cumulative change in Bishop score with sequential application of the gel was 2.7. Sequential application of the prostaglandin gel proved no more effective in the process of preinduction cervical ripening than single application of the gel with a similar period of observation.

Cervix Uteri↗
PubMed1986

Preterm deliveries in twin pregnancies in Oxford.

The incidence of preterm delivery among twin maternities in Oxford between 1973 and 1983, was 39.4%. Preterm delivery was more common in MZ than DZ twins, and this was associated with higher incidence of spontaneous rupture of the membranes associated with monozygosity.

England↗
PubMed1986

Antiproliferative effect of mismatched double-stranded RNA on fresh human tumor cells analyzed in a clonogenic assay.

Colony growth in soft agar was used to identify human tumors that were sensitive to the direct antiproliferative effects of mismatched dsRNA (Ampligen). The results suggest that different human solid malignancies vary significantly in their sensitivity to Ampligen. Tumors with 50% or more of their surgical specimens showing sensitivity included carcinoid, glioblastoma, and carcinomas of the kidney, and lung. Resistant tumors (less than 15% sensitivity) included sarcomas and colo-rectal carcinomas. Overall, 42% of the tumor specimens studied showed a 50% or greater reduction in tumor cell colony formation after a single initial treatment with Ampligen (250 micrograms/ml). Interestingly, one patient's tumor which was de novo sensitive to interferon (IFN), but emerged as IFN-resistant following IFN therapy, remained sensitive to Ampligen. Thus, a clonogenic assay may prove useful in identifying human tumors and individuals for clinical trials with Ampligen, including patients resistant to IFN.

Base Composition↗
PubMed1983

A comparison of prostaglandin E2 gel and prostaglandin F2 alpha gel for preinduction cervical ripening.

The unfavorable cervix remains a major obstacle to the successful induction of labor. Reported are results from an ongoing study of topical prostaglandin preparations used to effect preinduction cervical ripening. The current study compares the efficacy of 40 mg of prostaglandin (PG) F2 alpha versus 5 mg of PGE2, applied to the cervix in a methyltylose gel the night before attempted induction of labor. A prospective double-blind protocol was used similar to that which previously established the efficacy of the 5 mg of PGE2 preparation versus placebo at this institution. Results indicate the superiority of the PGE2 preparation as measured by change in Bishop score, Pitocin requirement, rate of cervical dilatation, and percentage of failed inductions. Cesarean section rates were similar in the two study groups, and no fetal or maternal morbidity was attributable to the preinduction ripening technique.

Cervix Uteri↗
PubMed1983

Cervical ripening with intravaginal prostaglandin E2 gel.

Ripening of the cervix by intravaginal application of a prostaglandin-containing gel is evaluated. Thirty patients with an unfavorable cervix needing labor induction were studied in a double-blind, prospective fashion. The prostaglandin gel proved superior to placebo in ripening the cervix (P less than .05), reducing induction failures (P less than .025), diminishing the oxytocin dosage necessary for induction (P less than .05), and lowering the rate of cesarean section (.05 less than P less than .1). One hundred fifty additional patients with varying Bishop scores and differing clinical situations were also studied. There were 35 cesarean sections (23.3%), nine failed inductions (6%), a spontaneous labor rate of 46%, and an average Bishop score change of 2.5. Twenty patients with premature rupture of the membranes and an unfavorable cervix received a modified gel containing 2.5 mg of prostaglandin E2. Average Bishop score change was 2.9, and there was a 55% incidence of spontaneous labor.

Adult↗
PubMed1981

Positional vertigo and nystagmus of central origin.

Four cases are described illustrating the clinical features of positional vertigo and nystagmus due to posterior fossa tumors and a case of obstructive hydrocephalus. In these cases positional vertigo was the first and only presenting symptom of central nervous system disease. One case of subependymoma of the fourth ventricle and one with hydrocephalus had characteristic symptoms of benign positional vertigo; each showed positional nystagmus of the benign paroxysmal type.

Adult↗
PubMed1981

Effects of treadmill running on oxidative capacity of regenerated skeletal muscle.

The purpose of the present study was to examine the effects of treadmill running on the oxidative capacity of regenerated rodent skeletal muscle. The soleus, plantaris, and gastrocnemius muscles were removed under general anesthesia from one hindlimb of young female rats (N = 15). The visible "white" portion of the latter muscle was minced into 1 mm3 fragments and autotransplanted leaving both the tibial and sural nerves intact. Six animals were treadmill run daily beginning 4 days post-surgery. Intensity and duration were progressively increased such that by day 45 the animals were running 1 h at 21.5 m . min-1 up a 15% grade, The regenerated muscle homogenates had a significantly lower capacity for maximal pyruvate + malate oxidation and smaller mass relative to the contralateral gastrocnemius. The exercise program significantly increased these parameters, tending to normalize the values. Some factor associated with exercise stimulated recovery from the muscular trauma.

Animals↗