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Biomedical subjects

B Cranley

Publications and source records attributed to B Cranley.

17 recordsLinked to original sources
PubMed1997

Adenomyoepithelioma of the breast.

Adenomyoepithelioma is a rare disorder characterised by simultaneous proliferation of ductal epithelium and myoepithelial cells. It is more common in salivary glands or skin, and only rarely found in breast tissue. Adenomyoepithelioma of the breast was first described in 1970 by Hamperl. Since then, approximately 55 cases have been described in the literature; the largest review, by Tavassoli in 1991, reported 27 of these cases. Because of the small number of cases reported, the natural history of adenomyoepithelioma of the breast remains uncertain. We report a further case which was treated by local excision, and follow-up for two years has revealed no evidence of local recurrence or metastatic spread.

Adult↗
PubMed1989

Acute presentation of cystic fibrosis in an adult.

The case history of a female patient presenting at the age of 25 with cystic fibrosis is described. Despite longstanding significant respiratory symptoms, she did not attend hospital until she was 23 and then failed to appear for further investigations and treatment. At the age of 25, she was admitted with a severe lower respiratory tract infection and respiratory failure. Within 5 days, acute intestinal obstruction developed which was unresponsive to conservative therapy. At laparotomy the small bowel was obstructed just proximally to the ileocaecal valve by solid faecal material. Post-operatively, the diagnosis of cystic fibrosis was confirmed by quantitative pilocarpine iontophoresis tests. The literature is reviewed regarding the adult presentations of cystic fibrosis and the recommended treatment for distal intestinal obstruction syndrome. The presence of adult cystic patients within the community is emphasized.

Acute Disease↗
PubMed1986

Canine mucosal antrectomy.

Our primary aim was to determine whether mucosal antrectomy decreases postcibal serum gastrin and gastric acid secretion. In four dogs with proximal gastric vagotomy and a Heidenhain pouch, mucosal antrectomy decreased the integrated postcibal serum gastrin response from a mean +/- SEM of 2.0 +/- 0.2 ng X h/mL before antrectomy to 0.8 +/- 0.1 ng X h/mL after antrectomy, while it decreased postcibal output of hydrochloric acid from the pouch from 9.5 +/- 3.3 mEq/7 h (9.5 +/- 3.3 mmol/7 h) to 4.3 +/- 2.2 mEq/7 h (4.3 +/- 2.2 mmol/7 h). However, these decreases were temporary in two of the four dogs. In five additional dogs without vagotomy, the distal, antral, mucosal gastrin level increased from 1 +/- 1 micrograms/g of tissue before mucosal antrectomy to 5 +/- 1 micrograms/g of tissue after the antrectomy. Moreover, gastrin and G cells were present in corporal mucosa transferred to the antrum in three of five dogs after the antrectomy, where none had been present in the corporal mucosa before the antrectomy. The conclusion was that mucosal antrectomy decreased serum gastrin and hydrochloric acid output from the stomach, but that these changes were counteracted in part by hyperplasia of residual G cells and G-cell neogenesis after the operation.

Animals↗
PubMed1985

Further evidence supporting the existence of the celiac artery compression syndrome.

A 23-year-old man presented with prolonged postprandial epigastric pain and an epigastric bruit with systolic and diastolic components, the intensity of which decreased with inspiration as demonstrated by abdominal phonography. Arteriography demonstrated significant narrowing of the origin of the celiac artery. At operation, the origin of the celiac artery was found to be constricted by fibers of the median arcuate ligament of the diaphragm, and this ligament was divided. Intraoperative flow measurements demonstrated an increase in blood flow through the main branches of the celiac axis, after division of the ligament. Four years following successful surgery, the patient has continued to be in good health without symptoms, and the bruit has remained absent. Further abdominal arteriography has demonstrated the normality of the celiac artery. We believe this to be a well-proven case of the "celiac artery compression syndrome."

Adult↗
PubMed1985

Tone of canine ileocolonic junction: topography and response to phasic contractions.

We wished to define the physiology of the canine ileocolonic sphincter (ICS) and to examine function in relation to the region's anatomy. Prolonged recordings of tone at the ICS were made from seven dogs with isolated ileocolonic loops, and the effects of ileal and colonic distension on sphincteric tone were assessed. In acute experiments, pull-through pressures were measured at the ICS, and the location of the high-pressure zone was related to the region's anatomy. Basal tone at the ICS of approximately 30 cmH2O was confirmed; tone was augmented by colonic and ileal distension. The high-pressure zone was always centered on the anatomic ICS, but it extended into the adjacent ileum and colon for a total length of 2.0 cm (range 1.5-3.0 cm). Phasic contractions contributed to the maintenance of tone at the ICS, and a coordinated pattern of phasic contractions appears to contribute to the sphincteric properties of the region.

Animals↗
PubMed1983

The Kock reservoir ileostomy: a review of its development, problems and role in modern surgical practice.

The Kock continent ileostomy reservoir was designed in an attempt to overcome many of the problems associated with the conventional ileostomy. An account is given of the technical developments of this procedure since its inception. An intussusception valve within the reservoir is necessary for continence. However, valve failure is a common problem and the developments in construction which have helped to overcome this are described. The major complications associated with the continent ileostomy are discussed in detail, and an attempt is made to define its present role in the treatment of inflammatory disease of the colon.

Adult↗
PubMed1983

Ileal reservoirs: an experimental study of motility in the Kock and triplicated pelvic ileal pouches.

Motor activity in the Kock ileostomy reservoir and the triplicated pelvic ileal reservoir was studied experimentally in dogs and compared with normal terminal ileum under identical conditions. Despite claims to the contrary, both reservoirs possessed significant motor activity under basal conditions and on filling. This was reduced, however, compared with normal terminal ileum. The design of the Kock reservoir does not seem to have any distinct advantages over the triplicated ileal reservoir which may be used either as an abdominal or pelvic pouch.

Animals↗
PubMed1983

A clinico-physiological comparison of ileal pouch-anal and straight ileoanal anastomoses.

The ileal pouch-anal anastomosis improves clinical results after colectomy and mucosal proctectomy compared to the straight ileoanal anastomosis. The question was what physiologic changes brought about by the pouch led to the improvement. Among 124 patients who had had ileoanal anastomosis, 25 volunteered for a detailed clinicophysiologic evaluation. Fourteen had had the ileal pouch-anal operation a mean of 8 months previously, and 11 had the straight ileoanal operation a mean of 25 months previously. Both groups of patients had satisfactory anal sphincter resting pressures (mean +/- SEM, pouch = 68 +/- 8 cm H2O, straight = 65 +/- 9 cm H2O, p greater than 0.05) and neorectal capacities (pouch = 278 +/- 26 ml, straight = 233 +/- 36 ml, p less than 0.05), and all could evacuate spontaneously. However, the pouch patients had a more distensible neorectum (delta V/delta P pouch = 9.5 +/- 1.3 ml/cm H2O, straight = 4.9 +/- 0.9 ml/cm H2O, p less than 0.05) and smaller amplitude neorectal contractions (pouch = 36 +/- 5 cm H2O, straight = 90 +/- 13 cm H2O; p less than 0.05). We concluded that the pouch-anal anastomosis increased the distensibility of the neorectum and decreased its propulsive drive, and so improved clinical results.

Adult↗
PubMed1983

Enhancing the anti-dumping effect of Roux gastrojejunostomy with intestinal pacing.

We wondered whether Roux gastrojejunostomy alone or with intestinal pacing would slow gastric emptying and ameliorate the dumping syndrome after truncal vagotomy and subtotal distal gastrectomy. In five conscious dogs with vagotomy and distal gastrectomy, the Roux loop alone slowed gastric emptying of 100 ml 5% glucose instillates, but not of 100 ml 25% glucose instillates, while pacing the loop backwards slowed emptying of both. Pacing also decreased the postcibal hemoconcentration and hyperglycemia found after the 25% instillates. However, pacing did not alter the postprandial hyper-GIP-emia (gastric inhibitory peptide) and hyperinsulinemia found in Roux gastrectomy dogs, suggesting that pacing worked by slowing emptying of glucose rather than by releasing enteric hormones. Although pacing did not stimulate jejunal action potentials (contractions), the greater the number of action potentials occurring during pacing, the more the slowing (r = .738, p less than .001). We concluded that the combination of Roux gastrojejunostomy and pacing ameliorated postgastrectomy dumping in dogs. The tests provide a basis for treating humans with postgastrectomy dumping.

Animals↗
PubMed1982

The pelvic ileal reservoir: an experimental assessment of its function compared with that of normal rectum.

The function of the 3-loop pelvic ileal reservoir as an alternative to total proctocolectomy and ileostomy is assessed experimentally in dogs and compared with normal rectum under identical conditions. No difference was found between the pelvic ileal reservoir and normal rectum in their ability to maintain continence. The efficiency of evacuation, however, is significantly better in normal rectum (P less than 0.01). Observations made over a prolonged period of time suggest that frequency of defecation, tenesmus and incomplete evacuation are persistent problems with an ileal reservoir. The results of the experiments concur with clinical findings that satisfactory continence may be achieved by using the ileal reservoir but that it does not possess the ability of normal rectum to evacuate completely. Hence the frequent need for self-catheterization.

Animals↗
PubMed1981

The Kock ileostomy reservoir: an experimental study of methods of improving valve stability and competence.

The performances of four valve designs which have been used in clinical practice in the Kock continent ileostomy reservoir were examined and compared to four further modifications in an experimental study on dogs. It was found that a stable valve could be consistently produced by subjecting the gut, which forms the valve, to deep seromuscular diathermy and by excluding in mesentery completely from the intussusception. Construction of the valve with the autosuture GIA Stapling device shortened the operating time considerably but did not improve on valvular stability.

Animals↗
PubMed1980

Exploration of the common bile duct--the relevance of the clinical picture and the importance of peroperative cholangiography.

A series of 500 cholecystectomies performed over a 7-year period was reviewed retrospectively. The reliability of preoperative clinical features such as jaundice and pancreatitis was assessed in determining the presence of choledocholithiasis, and was found to be of limited value. Investigations such as intravenous cholangiography and liver function tests were found also to be inaccurate in the detection of common duct stones as was the appearance of the duct at operation. The usefulness of the peroperative cholangiogram in the detection of common duct stones that would otherwise have been overlooked is emphasized. Common duct stones would have remained undetected in 25 per cent of patients with choledocholithiasis. Despite the use of routine peroperative cholangiography common duct stones were overlooked in 11.25 per cent of patients who underwent exploration.

Adult↗