Search PubMed⌕ Search

Biomedical subjects

W H Isbister

Publications and source records attributed to W H Isbister.

At least 91 records · Page 5Linked to original sources
PubMed1986

Colorectal polyps: an endoscopic experience.

Between April 1975 and December 1985, 870 colonoscopies were performed and 803 colorectal polyps were managed endoscopically. Thirty-nine per cent of the polyps were metaplastic polyps. The majority (59%) of polyps less than 5 mm in diameter were metaplastic polyps. Of the adenomatous polyps 63% were tubular, 32% were tubulovillous and 5% were villous histologically. Sixty-two per cent of all polyps were found in either the sigmoid colon or rectum. There was a higher proportion of tubulovillous adenomata (32%) than reported previously. Twenty-two patients had polypoid carcinomata and eight were removed endoscopically; four were subsequently referred for surgical excision because of 'incomplete' removal but no residual tumour was found. Fifty-three per cent of patients examined had more than one polyp. Fourteen of 19 patients who presented with a single polyp were found to have further polyps when examined subsequently and 29 of 39 patients with multiple index polyps had more polyps at follow-up. Perforation occurred in three patients, and two patients required blood transfusion following endoscopic polypectomy. It is suggested that total colonoscopy should be undertaken in all patients with polypoid disease because of the distribution of polyps found. It is further suggested that the findings of this study may be related to the high incidence of colorectal carcinoma in New Zealand.

Colon↗
PubMed1985

Patients with acute abdominal pain: white cell and neutrophil counts as predictors of the surgical acute abdomen.

Two hundred and fifty-two patients with acute abdominal pain were admitted to Wellington Hospital during three consecutive months in 1982. The prevalence of the surgical acute abdomen in these patients was 35%. There was no significant difference in performance between the peripheral blood white cell count (WCC) and neutrophil count (NC) when used as diagnostic tests of surgical acute abdomen. Neither test is sufficiently sensitive or specific to be a good predictor of surgical acute abdomen. It is recommended that the WCC be used sparingly and interpreted as a continuously distributed rather than dichotomous diagnostic test. There is no advantage in using the NC.

Abdomen, Acute↗
PubMed1985

Survival following resection for colorectal cancer. A New Zealand national study.

The crude overall five-year survival rate for New Zealand patients with colorectal cancer treated surgically was 42 percent. Less than 50 percent of patients with Stage I and Stage II tumors survived ten years. Women survived longer after surgery than men. It was not possible to determine a biologic cure rate because postmortem data were not available.

Colonic Neoplasms↗
PubMed1985

An automated method for leucocyte adherence inhibition testing.

The detection of anti-tumour cell-mediated immunity in cancer patients by the leucocyte adherence inhibition test was reported in 1974. The test has since been variously described as capricious, non-reproducible and invalid. These criticisms may be related to the critical and difficult to reproduce washing procedure of the original test. In order to overcome this, an automated assay has been developed. The apparatus devised allows replicate samples to be tested concurrently. It consists of 30 X 100 microliter syringes whose barrels have been extended by nylon cones (1500 microliter) and whose plungers move synchronously. Suspensions of washed peripheral blood leucocytes with serum and tumour antigen are incubated in the syringes. Non-adherent cells are washed from the syringes by fully withdrawing their plungers and allowing entry of 1,000 microliter of saline from the cones. The effluent containing non-adherent cells is collected and automatically counted. A one-way analysis of variance using a statistical package for the social sciences (SPSS) programme for the syringe, wash and drainage volumes indicates that the variance between syringes is so small that sub-division of the syringes into control and test groups is justified. The crudity of the prototype, however, results in variations between volumes aspirated on successive occasions. Preliminary clinical studies show that 13/15 patients have a test result which correlates with their Mantoux status.

Antigens, Neoplasm↗
PubMed1984

Changes in the pattern of disease managed by general surgeons in New Zealand, 1940-80.

Changes in the pattern of disease managed by general surgeons in New Zealand, were assessed for the period 1940-80, using the public hospital admission and cancer incidence data of a representative selection of diseases. During the forty-year period, there was an increase in the incidence of four of the five cancers studied, and an increase in admission rate for non-specific abdominal pain, head injury (indicated by skull fracture), peripheral arterial disease (indicated by aortic aneurysm), gall-stone disease and pancreatitis, large bowel disorders and breast diseases. There was a decline in admission rate for appendicitis, stomach disorders and goitre.

Abdomen↗
PubMed1984

Peritoneal neutrophilia: a potential indicator of the surgical acute abdomen.

The percentage of neutrophils in a peritoneal cell sample (PNP), obtained at operation, was measured in 250 patients who underwent urgent laparotomy because 'the surgical acute abdomen' (SAA) was suspected. The PNP was substantially higher in patients with confirmed SAA than in others and is potentially a very sensitive and very specific test of SAA. If the PNP was available as a diagnostic test for patients with acute abdominal pain, there might be a significant reduction in unnecessary and delayed laparotomies.

Abdomen, Acute↗
PubMed1983

Appendicectomy drains: a case controlled study.

Between January 1967 and January 1971, 323 patients underwent appendicectomy at the Royal Brisbane Hospital. Intraperitoneal and wound drains were used in 53 of these patients, and these were matched with 53 control patients. There were more complications in drained than non-drained patients, although there were more wound problems in the latter group. Twenty-seven patients developed infective complications after drain removal. The drained patients remained in hospital four days longer than their controls. It is suggested that drains were removed before suppuration had time to take place. It is recommended that drains be left in situ for at least ten days.

Abscess↗
PubMed1983

Sex differences in subsite incidence of large-bowel cancer.

A review of patients with large-bowel cancer at a major New Zealand hospital showed an excess of right-sided colonic tumors in females compared with males. These observations stimulated analysis of the National Cancer Registry registration data for large-bowel cancer for the whole of New Zealand in the years 1972 to 1975 (4678 patients). Rates for each site were calculated and age-standardized, using world population figures. The findings confirmed that females have a higher incidence of right-sided colonic cancer and males a higher incidence of rectal cancer and showed a significant trend in this direction from the ascending colon toward the rectum. The observed differences between males and females suggest differences in the etiology of the tumor and should be taken into account in assessing modalities and outcomes of treatment.

Colonic Neoplasms↗
PubMed1983

The EEA stapler in colorectal surgery: a Wellington experience.

The EEA stapler has been used at Wellington Hospital in 83 patients. The use of the instrument in 72 patients with colorectal disease is described. Fifty-one patients had malignant disease. Prior bowel preparation and perioperative antibiotics were used routinely. A 'low' anastomosis was performed in 26 patients. Complications relating to the integrity of the anastomosis occurred most frequently in low rectal cases and did not appear to be influenced by the presence or absence of a diverting colostomy. Tumour clearance was compromised (less than two centimetres) in 10 out of 23 patients with 'low' tumours. Two staple line recurrences occurred in this group.

Colon↗
PubMed1983

Microcomputers in surgery: a data file and analysis program.

A microcomputer based patient data file and analysis system is both feasible and useful. One such system is described in this paper. The advantages and disadvantages of the system are discussed. It may be used in many patient-related specialties and will enable practitioners not only to file their data but more importantly to analyse it so that they can improve their performance and cost-effectiveness. It is the author's belief that few realize the potential of the microcomputer in clinical practice and many are put off computing and computerized recording and data analysis because of the size and the difficulties that most experience with larger minicomputer-based facilities.

Colonoscopy↗
PubMed1982

Cancer of the stomach in New Zealand: 1970-74.

A total of 1,891 new cases of cancer of the stomach occurred in New Zealand (1971 population 2,862,631) in the five years 1970-74. There was a higher incidence in men than women and in Maoris compared to Europeans. The disease had declined in incidence by about 50% in 20 years. Most of the cancers occurred in the distal stomach and were described as adenocarcinomas. Seventy percent of the patients had a lymph node metastases or advanced disease at the time of diagnosis. Only 39% were able to have resectional surgery and in 57% specific therapy was not given. The estimated crude five year survival rate of all patients was 7.8% (relative rate 10.2%) and the crude five year survival rate after resectional surgery was 18.7% (relative rate 24.7%). The most important variables affecting survival were the stage of the disease and the age of the patient.

Age Factors↗
PubMed1981

Cholecystectomy and cancer of the large bowel.

A matched case control study was conducted in order to determine the association between previous cholecystectomy and the development of large bowel cancer. One hundred and sixty men and 145 women presenting with large bowel cancer were studied. One control was selected for each case matched according to age, sex and date of admission. The medical records for each patient in the study were reviewed for evidence of previous cholecystectomy. No association was found among male patients, but for women an estimate of relative risk of 2.7 was obtained for patients who had had previous cholecystectomy. This association was largely a consequence of the fact that 10 female patients with rectal cancer had had a previous cholecystectomy compared with only of their controls. It is possible that carcinogenic breakdown products of bile salts are most concentrated in the distal portion of the large bowel, but it is difficult to explain why the association should be confined to women only.

Cholecystectomy↗
PubMed1980

Flexible fibreoptic sigmoidoscopy--an alternative to colonoscopy?

The results of 166 colonoscopic examinations are reported with particular reference to site and nature of the lesion identified. One hundred and fifty-five polyps and 13 colorectal cancers were found, 62 polyps and five cancers being beyond 50 cm from the anal verge. It is suggested that the number of lesions beyond the reach of a flexible fibreoptic sigmoidoscope would be unacceptably high and that there can be no justification for the purchase of such an instrument as an alternative to a full length colonoscope. Whilst the fibreoptic instrument does have advantages as a sigmoidoscope its cost will preclude its widespread use in New Zealand at the present time.

Carcinoma↗
PubMed1979

Colorectal cancer in New Zealand: a Wellington study.

A retrospective study of three hundred patients with colorectal cancer seen during a five-year period at Wellington Hospital is presented. The age incidence, anatomical distribution, tumour stage and incidence of intestinal obstruction differ from those reported in most other series. There is no correlation between delay in presentation and Dukes stage. It is suggested that colorectal cancer is a more aggressive disease in New Zealand than it is elsewhere in the world. The dangers of translating disease satistics from one country to another are emphasized.

Age Factors↗