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Biomedical subjects

S D Woods

Publications and source records attributed to S D Woods.

17 recordsLinked to original sources
PubMed1991

Early and late surgical complications of subtotal oesophagectomy for squamous carcinoma of the oesophagus.

The use of stapling devices in oesophagogastric anastomosis has markedly reduced the incidence of anastomotic leakage, but may be associated with a higher incidence of stricture formation. The purpose of this study was to review the incidence, morbidity, management and outcome of leakage and stricture in patients undergoing subtotal oesophagectomy. Seventy-two consecutive patients with proven squamous carcinoma of the thoracic oesophagus who underwent subtotal oesophagectomy and gastric pull-up with stapled anastomosis were studied. Thirty-six patients had the anastomosis constructed using the EEA size 25 mm circular stapler (group 1). Thirty-six patients had oesophagogastric reconstruction using the EEA size 28 mm circular stapler (group 2). Data were collected prospectively, but the groups were not randomized. One clinical/radiological anastomotic leak (3%) occurred using the 25 mm gun (group 1), but no dehiscence was demonstrated in group 2. There was no 30-day mortality, but two patients died before leaving hospital (overall hospital mortality rate, 3%). Early complications included anastomotic bleed, respiratory failure, chylothorax, transient bilateral recurrent laryngeal nerve palsy, and severe chest infections. After surgery, the patients were followed up at 1 month, at 3 months and then at 3-monthly intervals up to 1 year. Stricture formation occurred in 11 patients in group 1 and only four patients in group 2 (chi 2 test P less than 0.05). All benign strictures presented within 6 months of surgery. These strictures were satisfactorily treated by endoscopic dilatation. Two patients (one from each group) suffered anastomotic recurrence of their tumour at 8 and 10 months respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed1990

Adenocarcinoma of the cardia: treatment by thoracoabdominal R3 radical gastrectomy.

The complications and mortality rate of R3 radical gastrectomy using a left thoracoabdominal approach were studied in 38 patients with adenocarcinoma of the gastric cardia. There were two hospital deaths and two anastomotic leaks. There was a high rate of complications following surgery (subphrenic abscess, eight; severe chest infection, five; aspiration pneumonia, two; wound infection, two; and reactivation of tuberculosis, one). The hospital stay ranged from 11 to 39 days (median 21 days). Thirty-five patients had microscopic evidence of serosal involvement (S2). Thirty-three of the patients had lymph node metastases and 17 patients had involvement of N2 nodes. Four patients had histological evidence of residual suture line tumour, but only two of these returned with recurrence at the anastomosis. Follow-up (median 3 years) revealed that splenic artery nodal involvement (N2) did not worsen the prognosis after radical resection. Despite a high complication rate, thoracoabdominal radical gastrectomy is associated with an acceptable perioperative mortality rate, adequate symptom palliation and encouraging medium-term survival. The left thoracoabdominal approach gives excellent exposure for radical resection of cancer of the gastric cardia and should be the procedure of choice for curative resection of this tumour.

Adenocarcinoma↗
PubMed1990

Deoxyglucose lumped constant estimated in a transplanted rat astrocytic glioma by the hexose utilization index.

The lumped constant (LC) for calculating the regional glucose (glc) metabolic rate by the deoxyglucose (DG) method was estimated in a transplanted rat glioma and normal rat brain. First, the hexose utilization index (HUI) was measured at 1.5, 3.0, and 4.5 min in right hemisphere glioma implants and uninvolved contralateral hemisphere following bolus intravenous injections of [3H]DG and [14C]glucose. At these times, the glioma HUI values were 0.639, 0.732, and 0.712, respectively, and the coordinate left hemisphere values were 0.432, 0.449, and 0.418. Second, the volumes of distribution of DG and glucose were determined to be 0.436 and 0.235 in glioma implants and 0.402 and 0.237 in left hemisphere, respectively. Third, following simultaneous intracarotid injections of [3H]DG and [14C]glucose, the ratio K1/K1 was 1.1 in glioma grafts and 1.3 in left hemisphere. With these values for HUI, volume of distribution, and K1 ratio, the LC in this rat glioma was estimated to be 2.1 times higher than the left hemisphere LC (p less than 0.02). These results suggest that measurement of brain tumor CMRglc using a normal brain LC may significantly overestimate the true tumor CMRglc.

Animals↗
PubMed1989

Delayed return of gastric emptying after gastroenterostomy.

A retrospective study of patients having gastroenterostomies was undertaken to identify predictive factors for the development of postoperative delayed return of gastric emptying (DRGE). A total of 322 consecutive patients underwent 324 gastroenterostomies; 35 experienced delayed return of gastric emptying. Regression analysis demonstrated preoperative obstruction to be the most significant factor (P less than 0.001). Vagotomy was not an independent variable. Age, sex, size of stoma, anastomotic technique, albumin and experience of the operator were not significant factors. Gastroenterostomy in the presence of 'gastric atony' was likely to produce DRGE. In all, 86 per cent of cases resolved spontaneously. Only one case of DRGE was found to have a mechanical cause. Most patients were supported by parenteral nutrition but, with a knowledge of the identified risk factors, more thought could be given to establishing a route for jejunal feeding at the time of surgery.

Adolescent↗
PubMed1989

Intrathoracic stapled anastomosis after oesophagectomy for cancer.

Fifty consecutive oesophagectomies for cancer are reported which were performed using a two-stage technique with an intrathoracic stapled anastomosis. The oesophagus was resected through a right thoracotomy. Continuity was restored using orthotopic stomach, mobilized through an abdominal incision and anastomosed to the oesophagus at the apex of the thorax. No deaths occurred within 30 days, but two patients died without leaving hospital. Routine contrast study revealed no anastomotic leaks. Major complications were: chylothorax (one), transient bilateral recurrent laryngeal nerve palsy (one), anastomotic bleed (one), respiratory failure (one) and brain abscess (one). Four upper resection margins contained tumour (all in middle third tumours). With this technique, a reliable anastomosis can be made high in the chest. The amount of oesophagus removed is comparable with that obtained with the 'three-stage' or transhiatal procedures. The problem of occult submucosal spread in oesophageal tumours remains.

Adult↗
PubMed1987

Aggressive angiomyxoma of the female pelvis.

A 42 year old female presented with a 6 year history of a perineal mass. Clinically it had all the features of a perineal hernia. Two previous attempts to repair the 'hernia' had been performed. At operation an aggressive angiomyxoma of the female pelvis was identified and resected via an abdomino-perineal combined approach. The case is discussed with reference to the literature.

Adult↗
PubMed1986

Leiomyoma of Meckel's diverticulum.

Meckel's diverticulum is a common developmental abnormality of the midgut which may present clinically because of complications. This report describes an unusual clinical presentation of a patient with a large leiomyoma of a Meckel's diverticulum.

Adolescent↗
PubMed1986

Gastric rupture following cardiopulmonary resuscitation.

Three cases are reported in which gastric rupture occurred during cardiopulmonary resuscitation. Precipitating factors are considered and discussed with reference to the literature. This condition has been considered to be rare. Its occurrence greatly adds to the morbidity and mortality of the underlying disease. Possible precautions to limit its occurrence are discussed.

Aged↗
PubMed1985

Eye movements and the enhancement of edges.

A mathematical examination of retinal photochemistry leads to a hypothesis for Mach band phenomena based on eye movements. This retinal model suggests why minimally distinct borders fade under eye fixation and agrees qualitatively with subjective measures of border contrast as a function of overall field luminance.

Eye Movements↗
PubMed1983

The effect of filtration on the loss of abnormal cervical cells in specimen preparation for automated cytology.

The UCLA monolayer procedure is used to produce a preparation of cervical epithelial cells for automated cytology. We investigated the nylon mesh filtration step of the procedure to determine if it altered the proportion of abnormal epithelial cells in the specimen. The proportion of such cells was found to be significantly lower (P less than 0.05) in the final specimen retained by a 10 micron nylon mesh filter than in the filtrate, which has been routinely discarded in our studies. The filtrate specimen is contaminated by large numbers of polymorphonuclear leukocytes, however, making it unusable for automated cytology at present. The implications of our findings for the cost effectiveness of classifier performance are considered, and the implications of the results for further improvements in specimen preparation are discussed.

Cell Separation↗
PubMedDate not supplied

Hypoxia and tachycardia during endoscopic retrograde cholangiopancreatography: detection by pulse oximetry.

Oxygen saturation and pulse rate were recorded using pulse oximetry during 50 consecutive endoscopic retrograde cholangiopancreatography (ERCP) examinations. Oxygen saturation dropped to below 90% in 22 patients at some point during the procedure. Multiple regression analysis revealed that increasing age and weight were the most significant variables in predicting tachycardia or hypoxia. These problems cannot be reliably predicted or detected clinically. The use of a pulse oximeter during ERCP is recommended.

Adult↗