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Biomedical subjects

A M Cuthbertson

Publications and source records attributed to A M Cuthbertson.

At least 37 records · Page 2Linked to original sources
PubMed1980

The treatment of fistulas following irradiation damage.

Fistulas following irradiation treatment of uterine cancer present special problems. They are seldom isolated injuries. Because of the depressed response of connective tissue, direct repair can seldom be carried out. For rectovaginal fistulas a defunctioning colostomy is the usual first stage, and this may in time result in spontaneous closure. Repair can only be achieved by carefully planned operations where non-irradiated tissue is used to close the defect.

Colostomy↗
PubMed1980

Regional lymph node and stromal immunomorphology in colorectal carcinoma and relation to tumour spread.

A quantitative morphometric study of lymphocyte patterns in the stroma and regional lymph nodes was made in 509 cases of colorectal adenocarcinoma and 17 non-invasive adenomas. An increase in the perivascular lymphocytes, and in the size of lymph nodes, germinal centres and paracortical areas was most obvious in 'localized' invasive tumours and significantly more in Dukes' stage B than in stage C. Stage C1, defined as cases where the primary tumours were confined to the wall but with lymph node spread, showed hardly any perivascular lymphocyte aggregates, although in the regional lymph nodes there was relative paracortical, i.e. T-lymphocyte, hyperplasia. It is concluded that the presence of cuffs of perivascular lymphocytes at the tumour edge, and the increased size of tumour-free regional lymph nodes together with the relative and absolute abundance of germinal centres (B-lymphocyte) and paracortical areas (T-lymphocyte), are stage dependent. This is most obvious in stage B. These morphological expressions of host immunoreactivity may well reflect favourable anti-tumour mechanisms.

Adenocarcinoma↗
PubMed1980

Mucinous colorectal carcinoma: immunopathology and prognosis.

A total of 519 colorectal carcinomas were examined for the presence or absence of mucinous differentiation by means of microscopical morphometry. Of these, 28% had objectively measurable amounts of mucinous tumour epithelium. Tumours with > 50% mucinous areas (14%) had significantly poorer prognosis than non-mucinous in stages A and C, while mucinous differentiation did not correlate with prognosis in stages B and D. Lymph nodes regional to mucinous tumours had significantly less paracortical response, and those with < 50% mucinous differentiation, significantly less perivascular lymphocyte cuffing at the tumour margins. These lymph node and stromal compartments are putative T-lymphocyte areas, and hence our findings suggest that mucinous tumours are either less stimulatory or perhaps inhibitory of cell-mediated immunity.

Adenocarcinoma, Mucinous↗
PubMed1980

Lymphoid hyperplasia: a major prognostic feature in 519 cases of colorectal carcinoma.

The size of the regional lymph nodes, germinal center, and paracortical areas, and the degree of perivascular lymphocyte cuffing (PLC) at the edges of 519 carcinomas of the large bowel have been analyzed microscopically and assessed quantitatively. Hyperplasia of these lymphoid areas, defined as relative or absolute size exceeding the median for the tumor stage, has been related to cancer-specific survival data for each of Dukes' Stages A, B, and C, and for disseminated disease commonly referred to as Stage D. Germinal center hyperplasia was associated with a major survival advantage in Stage B (P = 0.003) and in Stage C (P = 0.04) if present in tumor-involved lymph nodes. Paracortical hyperplasia related favorably to survival in Stages B and C; in Stage C such hyperplasia was most favorable if present in tumor-involved lymph nodes (P = 0.009). PLC related to favorable survival data only in Stage B. Lymphoid hyperplasia showed no correlation with survival in Stages A and D.

Adenocarcinoma↗
PubMed1978

Local excision of carcinomas of the rectum, anus, and anal canal.

Local resection has a place in the treatment of selected patients with carcinoma of the rectum, anus and anal canal. Selection depends on the ability of the surgeon to assess accurately the stage of the tumour. Favourable lesions are those which are small, exophytic, and mobile on the surrounding tissues. A transphincteric approach has been advocated for these tumours, but this seems unnecessarily destructive. The present series consists of 18 highly selected patients who were treated by transanal local removal. There have been two recurrences, one of which has been treated by abdominoperineal resection and the other by further local excision. All of these patients were diagnosed clinically as suffering from carcinoma before operation. Patients who had a preoperative diagnosis of carcinoma and were later found to have benign adenomas, and patients who were diagnosed as benign and later found to have histological malignancy, have been excluded.

Adenocarcinoma↗
PubMed1977

Strangulated para-ileostomy hernia.

Para-ileostomy hernia is an uncommon cause of bowel obstruction following ileostomy. Two cases are reported that demonstrate the difficulty in diagnosis and the high morbidity associated with this condition. Early recognition and repair of the uncomplicated and strangulated hernia are recommended.

Aged↗
PubMed1977

Sequential antitumour immunoreactivity and carcinoembryonic antigen levels as a guide to prognosis in colorectal carcinoma.

Twenty-five patients with colorectal carcinoma were tested for blood-lymphocyte anti-tumour cytotoxicity and carcinoembryonic antigen (CEA) levels at three-monthly intervals for eighteen months or more after resection, and examined clinically every three to six months. Twelve of the patients were followed for two years and one for four years. The six patients whose tumours recurred showed positive blood lymphocyte antitumour cytotoxicity and elevated plasma CEA levels at some time from six months after operation, usually well before the recurrence was clinically detectable.

Adenocarcinoma↗
PubMed1976

Correlation of regional lymph node in vitro antitumor immunoreactivity histology with colorectal carcinoma.

Lymph nodes from resected specimens of human colorectal carcinoma were investigated for in vitro lymphocyte cytotoxicity against primary cultures of autologous tumor cells. Regional lymph node lymphocytes were cytotoxic in 32 of 142 cases (23%). Altogether 200 nodes were examined and the cytotoxicity correlated directly with sinus histiocytosis, seen in 43 nodes from 35 cases, and with hyperplasia of B- and T-lymphocyte areas combined, seen in 92 nodes from 65 cases. Lymph nodes with combined B- and T-cell hyperplasia were significantly more common in cases of good tumor differentiation. The findings suggest that sinus histiocytosis and hyperplasia of both major lymphocyte populations are morphological expressions of in vitro antitumor immunoreactivity in the regional lymph node.

B-Lymphocytes↗
PubMed1975

Prophylactic use of gentamicin in colonic and rectal surgery.

A double-blind trial was performed to test whether a single intramuscular injection of 80 mg of gentamicin would significantly reduce the incidence of septic complications of elective colonic and rectal surgery. The gentamicin was given at the time of anaesthetic premedication, the operations were performed by either of two surgeons, and the patients were followed up by an independent investigator. Eighty patients satisfactorily completed the trial. There was no significant difference in the incidence of postoperative wound infection, intraperitoneal abscess formation and faecal fistula between the 41 patients who received the gentamicin and the 39 who received the placebo. However, the mortality was significantly lower in the gentamicin group, in which there was only one death.

Abscess↗
PubMed1975

Pull-through resections for carcinoma of the rectum.

Pull-through operations have been undergoing evaluation as a treatment for carcinoma of the rectum in several centres. Functional results at one and two years have been between 1960 and 1970, which enables a five-year follow-up. Forty-eight of these were palliative procedures, with a mean survival time of nine months. Only 11 patients were Dukes A cases and none of these have died from their disease. One hundred and five were Dukes B, with a 73% five-year survival. The Dukes C cases had only a 22% five-year survival. The main problems have been related to the blood supply to the exteriorized distal colon.

Adult↗