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Biomedical subjects

V Moshakis

Publications and source records attributed to V Moshakis.

At least 19 recordsLinked to original sources
PubMed2000

Faecal calprotectin levels in a high risk population for colorectal neoplasia.

BACKGROUND: Faecal concentrations of the protein calprotectin have been found to be elevated in patients with colorectal neoplasia, suggesting that it might be used as a screening tool for colorectal cancer as well as adenomas. AIMS: To measure the sensitivity and specificity of faecal calprotectin for the detection of adenomas in high risk individuals undergoing colonoscopy. Also, to investigate between and within stool variability of calprotectin concentrations. SUBJECTS: A total of 814 patients planned for colonoscopy were included for the following indications: positive faecal occult blood test, 25; neoplasia surveillance, 605; newly detected polyp, 130; and family risk, 54. METHODS: Two faecal samples from each of two stools were analysed using the PhiCal ELISA test device (Nycomed Pharma AS). RESULTS: Adenoma patients had significantly higher calprotectin levels than normal subjects (median 9.1 (95% confidence interval 7.5-10.1) v 6.6 (5.6-7.4)mg/l). There was no significant decrease in calprotectin levels after polypectomy. Levels in cancer patients were significantly higher than those in all other subgroups (median 17.6 mg/l (11.5-31.0)). With a cut off limit of 10 mg/l, the sensitivity for cancer was 74% and for adenoma 43%. Corresponding specificity values were 64% for no cancer and 67% for no neoplasia (cancer+adenoma). Specificity varied from 71% for one stool sample to 63% for four samples. Stool variability was small, suggesting that two spots from one stool were as discriminative as two spots from each of two stools. CONCLUSIONS: The sensitivity and specificity of faecal calprotectin levels as a marker for colorectal adenoma and carcinoma justifies its use in high risk groups, but specificity is too low for screening of average risk persons. Lack of a decrease in levels after polypectomy may be due to a more widespread leucocyte migration into the intestinal lumen than that at the polyp site, and needs further investigation.

Adenoma↗
PubMed1996

Audit of general practitioner referrals to a surgical assessment unit: new methods to improve the efficacy of the acute surgical service.

A total of 653 referrals from general practitioners to an acute surgical service were audited prospectively over a period of 4 months. Middle-grade staff accepting these referrals were able to deal with 182 (27.9 per cent) of these cells without surgical admission. A further 189 (28.9 per cent) referrals were seen on a surgical assessment unit and were not admitted to a surgical ward. The resultant cost saving was approximately 10,000 pounds. This confirms that the ready provision of an experienced surgical opinion in combination with early assessment can reduce the number of unnecessary acute surgical admissions referred from general practitioners.

Acute Disease↗
PubMed1996

Four-year evaluation of a direct-access fibreoptic sigmoidoscopy service.

Over a 4-year period, a direct-access fibreoptic sigmoidoscopy service was evaluated prospectively. In all, 756 patients were referred (median age 58 years, range 18-91 years). The principal indications were rectal bleeding (45%) or change of bowel habit (28%); both features were present in 13%. Abnormalities were present in 68% of examinations. Major disease was identified in 22% (carcinoma 7.0%, adenoma 6.3%, inflammatory bowel disease 8.3%) and minor disease in 53% (haemorrhoids 36.8%, severe diverticular disease 10.9%, non-adenomatous polyp 3.4%, perianal disease 1.4%). In patients under 40 years of age, major disease was rare (one carcinoma, three adenomas). Of the patients, 21% underwent barium enema for incomplete examination or suspected additional disease. No additional major disease was identified, but one carcinoma found in a patient with stricture. These data show that a direct-access fibreoptic sigmoidoscopy service produces a high diagnostic yield and may be of value to both patients and general practitioners in expediting a clinical colorectal service.

Adolescent↗
PubMed1992

A drip is unnecessary after cholecystectomy.

A randomized controlled study of 93 patients undergoing a cholecystectomy was performed to examine the need for intravenous fluids in the postoperative period. Forty-five patients were randomized to have only oral fluid, and these patients suffered significantly less in the way of haemodilution as measured by changes in packed cell volume (P = 0.0001), haemoglobin (P = 0.0001) and urea (P = 0.036) than those who routinely received intravenous fluids. Although questionnaires at the time of discharge showed that patients themselves did not object to an intravenous infusion, recent studies linking deep vein thromboses to haemodilution, coupled with the findings presented here, provide an argument against their routine and often unconsidered use.

Adult↗
PubMed1984

Neoplastic invasion of the arterial wall and its modification by surgery: an experimental model.

Fragments of VX2 squamous carcinoma were transplanted into the femoral triangles of rabbits and the growth patterns of tumour invasion were compared in intact femoral arteries, ligated femoral arteries and in femoral arteriovenous (AV) anastomoses. Intact arteries were resistant to tumour; ligated arteries were invaded by tumour and, in most instances, destroyed; AV anastomoses were also invaded but some mural structures remained intact. The relative resistance of systemic arteries to neoplastic invasion appears to be due to a combination of the normal structure of the arterial wall and the normal dynamics of the arterial circulation. Infiltration is facilitated if arterial perfusion falls and/or the normal structure of the arterial wall is modified.

Animals↗
PubMed1983

The limitations of the dual radionuclide subtraction technique for the external detection of tumours by radioiodine-labelled antibodies.

A dual radionuclide subtraction technique for external detection of tumours has been evaluated to determine the viability of the method for use with radioisotope labelled antibodies. A number of external scintigraphic investigations have been carried out with 131I-labelled antibodies to carcinoembryonic antigen (CEA). The investigations were performed on patients with metastatic disease known to produce CEA. The dual radionuclide subtraction technique was used to account for the blood and tissue background. The 131I-labelled antibodies were found to localise in the metastatic lesions, but the subtraction technique using 99Tcm-labelled HSA and pertechnetate gave ambiguous results, which included the production of artefacts. The ambiguities noted in the clinical results were substantiated by experimental data, which highlight the unreliability of this technique.

Antibodies, Neoplasm↗
PubMed1983

Klinefelter's syndrome associated with breast carcinoma and Paget's disease of the nipple.

We describe a patient with Klinefelter's syndrome associated with multi-focal breast carcinoma and Paget's disease of the nipple. Reviewing the 16 previously documented cases in the world literature, it is apparent that patients with this syndrome have an increased incidence of breast carcinoma. There is no evidence to date to suggest that such tumour is morphologically or biologically different from breast cancer in females and normal men.

Adenocarcinoma↗
PubMed1982

The site of binding of anti-CEA antibodies to tumour CEA in vivo: an immunocytochemical and autoradiographic approach.

Radiolabelled affinity-purified antibody to carcinoembryonic antigen (CEA) was injected i.v. into immune-suppressed mice carrying xenografts of human breast carcinoma. Its distribution in the tumours was examined by a combination of immunocytochemistry and autoradiography. The antibody interacted predominantly with the CEA in the extracellular tumour space, rather than on the cell membrane or cytoplasm.

Animals↗
PubMed1981

Localization of human tumour xenografts after i.v. administration of radiolabeled monoclonal antibodies.

A mouse monoclonal antibody (LICR-LON/HT13) has been developed to a cell-surface antigen carried on a human germ-cell tumour xenograft (HX39). After radioiodination, the antibody localized in vivo preferentially in xenografted tumours as opposed to normal mouse tissue, whereas tumor uptake did not occur with normal mouse IgG or nonspecific monoclonal IgG. This selective localization could be abolished by simultaneous injection of an excess of the unlabelled LICR-LON/HT13. The kinetics of and factors influencing localization have been examined. Tumour weight was important in that the smaller the tumour the better the localization. LICR-LON/HT13 was found to localize also in other xenografted germ-cell tumours, but not in non-germ-cell tumour xenografts. Thus monoclonal antibodies are capable of selective in vivo localization of human tumours in an animal model, and their clinical value should now be assessed.

Animals↗
PubMed1981

Cellular distribution of monoclonal antibody in human tumours after i.v. administration.

Immune-suppressed mice carrying xenografts of several different types of human germ-cell tumours were injected with a radiolabelled monoclonal antibody (LICR LON/HT13) raised against membrane components of a human germ-cell tumour (HX39). Subsequent assessment of radioactivity in excised organs and tumours showed a selective accretion of antibody in the tumour. Quantitative autoradiography supported the results of radiolocalization observed in vivo in different tumours, and also showed that the antibody localized to viable tumour cells and in close association with their cell membrane. The vascular architecture of tumours was found to be an important factor governing antibody distribution. No localization occurred with radiolabelled normal mouse IgG.

Animals↗
PubMed1981

Localization of human breast-carcinoma xenografts using antibodies to carcinoembryonic antigen.

Affinity-purified antibodies to carcinoembryonic antigen (CEA) have been injected into immune-suppressed mice bearing xenografts of human breast tumours. It has been shown that the antibodies localized in the tumours but not in normal tissues. The degree of tumour localization correlates with the amount of tumour CEA, and is unaffected by levels of circulating CEA or CEA/anti-CEA immune complexes.

Adenocarcinoma↗
PubMed1981

Monoclonal antibodies to detect human tumours: an experimental approach.

The use of monoclonal antibodies which can be raised to antigens of choice offers a selective and specific approach for the detection of tumours both in vivo and at a cellular level in biopsy specimens. We demonstrate that a monoclonal antibody raised to human teratoma will localise in a teratoma, growing as a xenograft in immune-suppressed mice.

Animals↗