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Biomedical subjects

R C Williamson

Publications and source records attributed to R C Williamson.

At least 127 records · Page 7Linked to original sources
PubMed1990

Erythrocyte stearic acid desaturation in patients with colorectal carcinoma.

The erythrocyte stearic:oleic acid ratio (saturation index) was investigated as a means of differentiating between control subjects (n = 146) and patients with benign (n = 48) and malignant (n = 117) colorectal disease and patients undergoing postoperative follow-up after curative resection (n = 49). Erythrocyte fatty acid profiles were determined by gas liquid chromatography. Neither age, sex, Dukes' stage, nor degree of differentiation of the tumors had a significant effect on the erythrocyte saturation index. The erythrocyte saturation index was lower in patients with primary and recurrent colorectal cancer compared with control subjects and patients with inflammatory bowel disease or benign colonic polyps (P less than 0.0001). The erythrocyte saturation index was not found to be useful in the postoperative follow-up of these patients. Using both saturation index and age as a means of differentiating between patients with primary colorectal cancer and control subjects gave a sensitivity of 67 percent and a specificity of 81 percent.

Adult↗
PubMed1990

Complications of choledochal cysts in adulthood.

Choledochal cyst is a well-recognised entity, presenting primarily in infants and young children. Where symptoms are delayed until adulthood, associated hepatobiliary pathology may complicate the presentation. These problems may be aggravated by previous treatment with bypass surgery rather than resection. We report seven cases from our recent experience presenting with complications in adulthood. These included cholangitis, hepatic abscess, pancreatitis and malignancy within the cyst. Two patients presented during pregnancy. These complications and their implications for management are discussed.

Adenoma, Bile Duct↗
PubMed1990

Fatal duodenocaval fistula resulting from a giant peptic ulcer. Case report.

Duodenocaval fistula is exceedingly rare. Penetrating trauma, gunshot wounds and toothpick perforation of the duodenum are known aetiological factors. Two recent case reports have implicated radiation-induced ulceration of the duodenum. We describe the first case of duodenocaval fistula resulting from a giant peptic ulcer of the descending duodenum.

Duodenal Ulcer↗
PubMed1989

Hypoplasia of defunctioned rectum.

The adaptive response of the large bowel to surgical defunction in man is essentially unknown, although in the rat there is progressive hypoplasia and a reduced propensity to experimental carcinogenesis. Mucosal biopsies were taken from the upper rectum completely defunctioned by a proximal stoma from 2 months to 5 years earlier in 11 patients and from 14 controls without abdominal operations or disease. Samples were established in organ culture and, after 16 h, crypt cell production rate (CCPR) was determined by a stathmokinetic technique. Crypt morphometry was also undertaken. CCPR in defunctioned large bowel was less than half that of controls: (mean (s.d.)-1.96 (0.68) versus 4.65 (0.54) cells crypt-1 h-1, P less than 0.0001). Likewise, crypt length was 24 per cent lower (0.34 (0.05) versus 0.44 (0.04) mm, P less than 0.0001) and crypt width was 38 per cent lower (0.04 (0.01) versus 0.07 (0.01) mm, P less than 0.0001). Rectal defunction causes profound and persistent hypoplasia in man.

Adult↗
PubMed1989

Sialic acid in colonic mucin: an evaluation of modified PAS reactions in single and combination histochemical procedures.

Two new histochemical procedures for detecting sulphated and non-sulphated sialomucin in colonic mucosa were assessed: the saponification-Alcian Blue pH 1-periodic acid-phenylhydrazine-Schiff method (KOH-AB pH 1-PAPS) and the mild periodic acid modification of this (KOH-AB pH 1-mPAS). Using normal colonic mucosa obtained from 11 non-cancer patients, the mPAS and PAPS techniques were tested for specificity and reproducibility for staining sialic acid, either alone or in combination with Alcian Blue. A spectrophotometric method was devised to quantify the uptake of both Schiff and Alcian Blue stain by sections. At low temperature and pH 5.5, the mPAS procedure had improved specificity over the PAPS procedure, and after saponification it could be used to stain O-acetyl-substituted sialic acid. When used in combination with Alcian Blue at pH 1, however, underestimation of the sialic acid content occurred owing to interference between Alcian Blue and Schiff dyes. Interference was even greater with KOH-AB pH 1-PAPS procedure for both sialic acid and sulphate components. We conclude that caution must be exercised in interpretation of the staining results obtained with these new combination methods and that more accurate information on the sialic acid and sulphate content of colonic mucin is obtained by staining serial sections with the mPAS technique and Alcian Blue pH 1 alone.

Colon↗
PubMed1989

Perioperative blood transfusion increases the risk of recurrence in colorectal cancer.

A retrospective study was conducted on 519 patients undergoing curative resection for colorectal carcinoma between 1969 and 1980. Recurrence was diagnosed in 214 patients (41.2 percent), 179 of whom (34.5 percent) had received blood transfusions and 35 of whom (6.7 percent) had not (P less than .001). Exclusion of the right-sided colonic tumors still showed that recurrence was more common in transfused than nontransfused patients (135 [47.2 percent] vs. 25 [22.5 percent]; P less than .001). Recurrence in patients transfused only during surgery (N = 201) was higher than in nontransfused patients (P less than .001) and, similarly, all patients transfused during surgery (N = 297) had an increased risk (P less than .001). Among patients with rectal cancer, transfusion increased the risk of recurrence in those treated by abdominoperineal resection (P less than .02), but this was not the case in those treated by sphincter-saving resection (P = .2). Hierarchical log linear analysis of all dependent factors (Dukes' stage, histologic grade, age, sex, site, elective, or emergency procedure) showed that Dukes' stage and blood transfusion had the most significant effects on the development of recurrence (chi 2 = 54.04, df = 6, P less than .0001 and chi 2 = 13.93, df = 3, P less than .003). The risk of recurrence following curative surgery for colorectal cancer is markedly increased by blood transfusion on the day of operation.

Adult↗
PubMed1989

Use of a modified N-nitrosoproline test to show intragastric nitrosation in patients at risk of gastric cancer.

Intragastric nitrosation has been implicated in the pathogenesis of gastric cancer and in precancerous conditions such as pernicious anaemia and the post-gastrectomy state. Intragastric nitrosation was assessed in at-risk patients by N-nitrosoproline (NPRO) excretion using both a conventional and a modified test. Twenty-four hour urinary excretion of NPRO was measured after oral administration of sodium nitrate (300 mg) and L-proline (500 mg) as an indirect indicator of intragastric nitrosation. In the conventional test no differences in intragastric nitrosation were found between at-risk patients and controls. In the modified test the loading dose of sodium nitrate was omitted and urinary NPRO levels were found to be significantly increased in Polya partial gastrectomy patients (P = 0.003) and post-vagotomy patients (P = 0.03) compared to controls. In pernicious anaemia patients NPRO levels were also higher than in controls but just failed to reach statistical significance. This study has confirmed that hypochlorhydria results in increased intragastric nitrosation, thus facilitating the formation of potentially carcinogenic N-nitroso compounds.

Adult↗
PubMed1989

The value of angiography in the surgical management of pancreatic disease.

Selective visceral angiography should help to determine the nature and extent of pancreatic lesions and their suitability for resection. Between 1980 and 1987 coeliac and superior mesenteric angiograms were obtained in 76 patients considered for pancreatic resection. Anomalous arterial anatomy was delineated in 25%. Among arterial abnormalities observed in 42 patients (55%), increased or decreased vascularity and displacement were of limited diagnostic value, but encasement correctly predicted cancer in 18 of 21 cases and irresectability in nine of these. When present (17%), invasion or occlusion of the portal or superior mesenteric vein was even more accurate, indicating cancer in 12 of 13 cases and irresectability in 11 of these. Hepatic metastases were only detected in 7 of 15 patients (47%). Overall, angiography confirmed the diagnosis in 54%, localised the lesion in 64% and correctly forecast irresectability in 58%. Misleading data were obtained in five patients. There were no complications.

Adolescent↗
PubMed1989

Reappraisal of partial ileal bypass for the treatment of familial hypercholesterolemia.

Eleven patients with heterozygous familial hypercholesterolemia (type IIa) were treated by partial ileal bypass. Postoperatively, mean total cholesterol levels fell by 26% at 1 month, and then rose steadily to 20% below preoperative levels of 20-24 months. The rise in cholesterol levels was due in part to an increase in high density lipoprotein (HDL) cholesterol with a resultant improvement in the HDL:LDL ratio (LDL, low density lipoprotein). Five patients had refractory hypercholesterolemia and were treated with lovastatin. One of them was treated with a combination of lovastatin and LDL-apheresis. All patients experienced diarrhea which improved with time, but two patients required reversal of their bypass for intractable gas bloat syndrome. Each received lovastatin to control recrudescence of hypercholesterolamia following reversal. Ten patients are alive and well, but one patient died after a myocardial infarction 55 months postoperatively. The advent of lovastatin and other HMG COA reductase inhibitors is likely to decrease the use of partial ileal bypass to treat familial hypercholesterolemia.

Adult↗
PubMed1989

Clinical experience with CA-50 in the serum of carcinoma patients.

A radioimmunoassay was used for the detection of the human carcinoma-associated antigen CA-50 in the serum of 60 normal subjects, 236 patients with benign disease and 482 patients with carcinomas of different type. Serum levels in all normal subjects and 220 of 236 patients (93%) with benign disease were below 17 units/ml, while 269 of 482 patients (56%) with carcinoma had CA-50 levels above 17 units/ml. This tumour marker may prove useful in the diagnosis and monitoring of patients with various carcinomas.

Antibodies, Monoclonal↗
PubMed1989

Evaluation of the therapeutic use of radioactive monoclonal antibodies C242 and C215 in transplanted murine tumours.

The therapeutic roles of monoclonal antibodies C242 and C215 labelled with 131I were investigated in transplanted mammary carcinomas. Fragments (10 mg) of mammary tumour from (A x Pc) F1 hybrid mice were implanted subcutaneously in 72 mice of the same strain. Twelve mice were injected with 131I-C242 starting from day 12 following tumour implantation, and eight out of 12 survived for 60 days. By contrast all but one of 36 control mice died within the same time period (P less than 0.0001). Twelve mice were injected with 131I-C215. Seven out of the 12 were alive at 60 days whilst all but 1 of 36 control animals had died (P less than 0.0001). In this study targeted immunotherapy using 131I-labelled antibodies C242 and C215 inhibited tumour growth and prolonged survival. Measurements of tumour area showed a 27-39 percent reduction in the mice receiving the radiolabelled conjugates C242 and C215 (P less than 0.004 and P = 0.028 respectively).

Animals↗