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Biomedical subjects

R J Goodall

Publications and source records attributed to R J Goodall.

15 recordsLinked to original sources

Evaluation of the expression levels of nm23-H1 mRNA in primary breast cancer, benign breast disease, axillary lymph nodes and normal breast tissue.

Expression levels of nm23-H1 were evaluated in a variety of normal benign and malignant breast tissues by Northern and slot blot. Tissues from 153 patients presenting with palpable breast lesions were studied: 132 primary infiltrating breast cancers, 9 pure duct carcinoma in situ lesions, a phyllodes tumor, 9 benign lesions and 2 local recurrences of carcinoma. In addition to lesional tissue, 49 samples of macroscopically normal breast tissue, 37 axillary lymph nodes and 9 samples from patients undergoing cosmetic reduction mammoplasty were studied. Sets of normal breast tissue, primary tumor and lymph node tissue from individual patients were available for comparison in 37 cases. A wide range of gene expression was detected in the various tissue types. The highest levels of expression were detected in malignant samples with in situ carcinomas being associated with the highest levels of gene expression. The expression levels of nm23-H1 in normal breast tissue were lower than the corresponding tumors from the same patients (p < 0.0005). Benign breast lesions (including 6 fibroadenomas) had levels of gene expression approximating those of the normal tissue samples. Normal axillary lymph nodes had significantly lower levels of nm23-H1 expression than nodes with metastatic deposits (p < 0.03). No significant association was observed between nm23-H1 expression levels and axillary node status in patients with infiltrating carcinoma, although there was a slight trend toward lower nm23-H1 mRNA levels in the node negative group.(ABSTRACT TRUNCATED AT 250 WORDS)

Blotting, Northern↗

Early experience with laparoscopic herniorrhaphy: results after the first 60 procedures.

The results of the first 60 consecutive laparoscopic hernia repairs performed in Calderdale are presented. These results are encouraging as recovery from surgery is much quicker and allows a shorter hospital stay and a speedier return to work than conventional operations. The laparoscopic procedure takes longer to perform, although this does not seem unacceptable once experience is gained. At present it remains quite expensive and further reductions in hospital stay will need to be achieved to ensure that there is no overall increase in the financial resources required.

Adolescent↗

Bleeding after endoscopic sphincterotomy.

A total of 194 patients who underwent 235 endoscopic sphincterotomies for common bile duct (CBD) stones were reviewed with respect to bleeding after the procedure. Evidence of bleeding was found in 21, but was occult in 7. Of the 14 patients with overt bleeding, 6 required operation and 2 died. There was also one death prior to surgery. Early consultation with surgical colleagues, observance of the usual surgical criteria for upper gastro-intestinal haemorrhage and the use of non-absorbable suture material to achieve haemostasis may reduce the morbidity and mortality of this complication of endoscopic sphincterotomy.

Adult↗

Effective of highly selective vagotomy upon the lower oesophageal sphincter.

Recently highly selective vagotomy has been suggested as both a cause of gastro-oesophageal reflux and a potential cure. This study was designed to investigate whether this operation produced any change in the resting pressure or the length of the lower oesophageal sphincter in patients undergoing highly selective vagotomy. A group of patients undergoing truncal vagotomy and drainage were also studied for comparison. No alteration in the resting pressure or length of the lower oesophageal sphincter was noted after either operation. It is therefore unlikely that interference with the sphincter is responsible for post-vagotomy reflux.

Esophagogastric Junction↗

Relationship between asthma and gastro-oesophageal reflux.

Twenty patients with bronchial asthma who also had gastro-oesophageal reflux were investigated. The severity of their reflux was graded using symptom score of heartburn and regurgitation and by the following investigations: barium swallow and meal, fibreoptic endoscopy and biopsy, manometry and pH monitoring of the distal oesophagus, and an acid infusion test. Full lung function studies were performed and patients were entered into a double-blind crossover study using cimetidine to control their reflux in order to assess beneficial effects with respect to their respiratory problems. Eighteen patients completed the study. Significant improvements were seen in reflux and night time asthmatic symptoms, both these indices being measured on a scoring system. Home monitoring of peak flow values showed a statistical improvement for th last peak flow reading of the day. Fourteen patients felt that their chest symptoms had significantly improved during the cimetidine period.

Adult↗

Clinical correlations in the diagnosis of pulmonary embolism.

This study of 73 patients with the clinical diagnosis of thromboembolism has shown that the pulse rate, respiratory rate, and arterial partial pressure of carbon dioxide have discriminatory value in identifying the group of acutely ill patients who are most likely to have pulmonary embolism. In contrast, the clinical diagnosis of deep venous thrombosis, PaO2 chest radiography and electrocardiography which are all essential to patient management have no such value. In this series, only 29% of the patients had a pulmonary arteriogram positive for thromboembolism, but the mortality rate in this group was 33%. Pulmonary perfusion scanning has been shown to be a useful and accurate screening investigation and should be routinely employed prior to pulmonary angiography if the patient is stable hemodynamically.

Adolescent↗

Assessment of the rapid pullthrough technique in oesophageal manometry.

The lower oesophageal sphincter pressure was measured by infusion manometry using the rapid pullthrough technique in two studies designed to evaluate this technique. The first study performed was an assessment of its reproducibility in individual subjects on separate occasions. We conclude that the rapid pullthrough technique does not give reproducible results. The second study compared the lower oesophageal sphincter pressure obtained by this technique with that by the standard station pullthrough technique. We conclude that the results are not comparable.

Esophagogastric Junction↗

Effect of Nissen fundoplication on competence of the gastro-oesophageal junction.

The changes produced by the Nissen fundoplication were measured in 12 patients, who required surgery to control their reflux oesophagitis. The gastro-oesophageal junction of each patient was studied before and three months after operation by station pullthrough manometry and prolonged pH monitoring of the distal oesophagus. All patients were free from reflux symptoms post-operatively. The Nissen fundoplication resulted in a significant increase in the pressure, but not the length, of the lower oesophageal high pressure zone. A greater proportion of this zone was situated in the abdomen postoperatively. Prolonged pH monitoring showed a significant improvement in all the measured indices of acid reflux. Nissen fundoplication restores competence to the gastro-oesophageal junction as judged by manometry and pH monitoring. This kind of study should be performed to document the efficiency of other anti-relfux procedures.

Adult↗

The reproducibility of the station pullthrough technique for measuring lower oesophageal sphincter pressure.

The results are presented of two studies of the station pullthrough technique for lower oesophageal manometry. The first part of the work is an assessment of the reproducibility of this technique using both an infused tube system and a system of subminiature, intraluminal strain gauge transducers. The second part of this report describes a study into the effect that the position of the recording hole on the probe may have in relation to the measured pressure for the lower oesophageal sphincter.

Adult↗