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Biomedical subjects

W T Cooke

Publications and source records attributed to W T Cooke.

At least 73 records · Page 4Linked to original sources

Oral manifestations of Crohn's disease.

In a systematic study of 100 patients with Crohn's disease, 100 with ulcerative colitis, and of 100 normal subjects matched for age, sex, and denture status, nine patients with Crohn's disease, two with ulcerative colitis, and one normal control were found to have oral lesions. In Crohn's disease, the macroscopic and histological appearances resembled those encountered elsewhere in the gastrointestinal tract and their incidence was related to the activity of the disorder. The lesions in the other two groups were different macroscopically and histologically. Production of salivary IgA was found to be reduced in Crohn's patients with active bowel disease. It is suggested that the occurrence of oral lesions in patients with Crohn's disease might represent a local immunological reaction to oral antigens.

Colitis, Ulcerative↗

Sequelae of colectomy and ileostomy: comparison between Crohn's colitis and ulcerative colitis.

A comparison is made of the immediate and long term mortality of colectomy and ileostomy between 73 patients who had Crohn's colitis and 442 who had ulcerative colitis. The immediate mortality in Crohn's disease is 4%. In ulcerative colitis it is 10%, chiefly because of the higher proportion of emergency operations. The late mortality in both groups is 10%, chiefly as a result of recurrence of Crohn's disease or the sequellae of colonic malignancy present at the time of colectomy for ulcerative colitis. A further comparison is made between the postoperative course of the 64 surviving patients with Crohn's disease and a comparable sample of 65 patients who had an ileostomy for ulcerative colitis in the same era. There was a similar incidence of postoperative septic complications in the two groups (35%). The readmission rate was twice as high in the Crohn's disease patients. Ileostomy reconstruction for mechanical complication was needed in 21 patients with Crohn's disease compared with 6 with ulcerative colitis. Further ileal resection was required for recurrent disease on another 25 occasions in the patients with Crohn's disease but never in those with ulcerative colitis. Long therm review graded the clinical status as excellent or good in 70% of those with Crohn's disease compared with 95% with ulcerative colitis.

Adult↗

Rickets, growth, and alkaline phosphatase in urban adolescents.

Calciferol therapy for 12 months in white, Asian, and West Indian schoolchildren resulted in a highly significant increase in height and weight when compared with schoolchildren not so treated. The rate of fall of serum alkaline phosphatase was similar in both the treated and untreated schoolchildren and in other children treated in hospital for rickets. Dietary studies on 9% of the total survey by weighed inventory methods showed a low average intake of vitamin D, while random estimates of 25-hydroxycalciferol levels on 6% of the children were less than 3.8 ng/ml in 40% of those studied (principally Asian). It was concluded that there was a significant problem of vitamin D deficiency among Asian and West Indian teenagers and that white children were also affected to a less degree.

Adolescent↗

Excisional surgery with ileostomy for Crohn's colitis with particular reference to factors affecting recurrence.

This paper reports the indications for, and results of, excision of the large intestine with ileostomy in 73 patients with Crohn's colitis who have been followed for a mean of nine years since resection. Sixty-four of them are still alive and all but two of the survivors are now in good health.However, 23 (33%) have developed recurrent Crohn's disease since resection. This is higher than that reported in many other series and may be due to differences in the length of follow up, the site and extent of colonic disease, the age of the patient at the time of excision with ileostomy, and differences in the pathological interpretation of the diagnosis of Crohn's disease. The high recurrence rate in this series lends caution to the view that the prognosis after excisional surgery and ileostomy for Crohn's colitis is as good as after the same operation for ulcerative colitis and should influence the decision when the alternative of medical or surgical management are being considered for patients with Crohn's colitis.

Adolescent↗

The jejunal cellular infiltrate in coeliac disease complicated by lymphoma.

Lymphocytes and plasma cells in the lamina propria and lymphocyte in the epithelium have been quantitated in jejunal biopsies from 18 patients with coeliac disease who developed lymphoma. In six patients two or more serial biopsies were available for study. Counts were compared with those obtained in 15 healthy controls and 30 other coeliacs, 15 of whom have been on a gluten-free diet for more than 12 months. Results showed that although the lymphoma patients have abnormal counts compared with controls, they differed from untreated coeliacs in that they had lower plasma cell and higher lymphocyte counts in the lamina propria and lower lymphocyte counts in the epithelium. Such changes tended to be present for up to five years before the diagnosis of lymphoma was made. The results suggest that the immunological status of coeliac patients with lymphoma differs from that of other coeliacs and it could represent a primary abnormality and also be relevant to the development of lymphoma.

Biopsy↗

Folates in human serum.

Constituent serum folates have been shown to be altered and in some cases raised in diseases in which total folate levels are known to be frequently decreased. Absorption experiments showed that orally administered folate analogues affect the folate pool in different ways. The stability of the 10-formyltetrahydrofolate level in normal subjects is demonstrated.

Administration, Oral↗