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Biomedical subjects

C R Houghton

Publications and source records attributed to C R Houghton.

At least 19 recordsLinked to original sources
PubMed1996

Abdomino perineal repair of pulsion enterocele.

OBJECTIVES: To review the techniques, results and complications of the combined abdomino perineal repair and mersilene mesh sacrocolpopexy. METHODS: From March 1988 to December 1993; 45 cases of pulsion enterocele were treated by a combination of the Zacharin type abdomino perineal repair and mersilene mesh sacrocolpopexy. Forty cases were followed from between 1 month and 18 months (mean 5.95 months). The notes were reviewed retrospectively. RESULTS: There were 3 recurrences (7.5%). Complications were not insignificant: wound infection in 3, urinary tract infection in 6, bowel dysfunction in 8, ventral hernia, vaginal stricture necessitating surgical release, and brachial nerve plexus injury occurred once. In one patient a peritoneal cyst developed necessitating laparoscopic aspiration. CONCLUSIONS: The combined abdomino perineal and sacrocolpopexy procedure offers the restoration of normal anatomy and the relief of the symptoms of prolapse in 92.5% of patients. The complication rate is significant and it should be undertaken as a secondary procedure.

Abdomen↗
PubMed1995

Increased expression of the NME1 gene is associated with metastasis in epithelial ovarian cancer.

The genetic events involved in the development of metastases of epithelial ovarian cancer are largely unknown. One gene postulated to play a role in tumour metastasis suppression is NME1 (nm23-H1), and an inverse relationship between NME1 expression and metastatic potential has been observed for some solid tumours. In this study we have investigated the levels of mRNA expression of the 2 isoforms of the NME gene, NME1 and NME2. A maximum of 45 tumours samples from 33 patients were available for Northern blot analysis. We observed variable levels expression of NME1 and NME2 mRNA. The average level of NME1, but not NME2, mRNA expression was statistically higher in metastatic biopsies when compared with primary tumour biopsies. To examine the possible tumour suppressor gene role of NME1 in ovarian tumours, 76 patients were investigated by Southern blot analysis to determine the rate of allelic deletion. Allele loss at 5 other chromosome 17 loci (D17S5, TP53, NF1, D17S74, D17S4) was also evaluated for many of these 76 patients. Allele loss was observed in 22/30 (73%) informative patients at the NME1 locus. We also observed high rates of allele loss at the other loci evaluated. No correlations with clinical stage, histological subtype or patient survival were observed in either mRNA or DNA analyses. We have established that tumour progression in ovarian cancer is accompanied by over-expression of the NME1 gene; however, despite high rates of allele loss at the NME1 locus, the concept that NME1 may be a candidate tumour suppressor gene in ovarian cancer cannot be confirmed by this study.

Base Sequence↗
PubMed1994

An assessment of the value of serum CA 125 measurements in the management of epithelial ovarian carcinoma.

The records of 223 patients with epithelial ovarian carcinoma treated at Westmead Hospital and King George V Hospital between 1985 and 1991 were studied retrospectively to compare CA 125 levels with the clinical course of their disease. CA 125 parameters and established predictors of disease were compared using a Cox multivariate analysis to determine their relative prognostic value. The CA 125 trend was the most significant variable followed by the FIGO stage. The initial CA 125 level and nadir CA 125 level, although significant when considered alone, were not significant independent variables. The threshold for a raised CA 125 level was also considered and we propose that a lower level of 15 u/ml may be more useful as a cutoff when following patients with a known history of ovarian carcinoma. The rationale for this is that patients in our study with a nadir level in the intermediate range (15-35 u/ml) invariably developed recurrent disease.

Analysis of Variance↗
PubMed1993

Ketorolac.

Explore the source record for details and available documents.

Aged↗
PubMed1992

The influence of maternal age on cesarean section rates.

Caesarean section rates have risen in recent years and this has led to concern. Significantly different Caesarean section rates have been reported between different teaching hospitals. This study compares the Caesarean section rates between 2 Sydney teaching hospitals draining populations from different areas of Sydney. Raw figures showed significantly different Caesarean section rates (22.5% at Royal North Shore Hospital compared with 18.3% at Westmead Hospital). Each hospital has a significantly different case mix when maternal ages are compared. When Caesarean section rates were corrected for maternal age and parity, there was no significant difference. As maternal age is an important factor influencing Caesarean section rates, future reports on obstetric services should consider this factor in making comparisons.

Adult↗
PubMed1992

Primary adjunctive whole abdominal radiotherapy in epithelial ovarian cancer: results of 10-years' experience.

During a 10-year period from January 1, 1979, 59 patients out of a total of 203 undergoing definitive treatment for epithelial ovarian cancer were managed with primary adjuvant whole abdominal radiotherapy after initial cytoreductive surgery. The median survival of this group was 53 months. The serious morbidity rate was approximately 8% with 4 laparotomies for bowel complications and 1 death following radiation related liver failure. This form of adjuvant therapy in appropriately selected patients with minimal residual disease merits further evaluation against other forms of therapy such as systemic or intraperitoneal chemotherapy.

Abdomen↗
PubMed1990

Persisting cyclical uterine bleeding in patients treated with radical radiation therapy and hormonal replacement for carcinoma of the cervix.

Radical radiation therapy used for carcinoma of the cervix will ablate ovarian function. Since January 1986, our policy has been to administer oral combination oestrogen-progesterone replacement hormonal therapy to all premenopausal patients undergoing radical radiation with or without synchronous chemotherapy, for invasive cervix cancer. Five out of 22 (23%) such patients unexpectedly experienced between one and four episodes of cyclical per vaginal bleeding after the completion of radiation therapy. Bleeding episodes occurred in the absence of persistent tumor or radiation reaction, and suggest persisting endometrial response to exogenous hormonal stimulation. Uterine activity was temporarily retained in these five patients despite a minimal endometrial surface dose of between 4800 and 6490 cGy. The limited number of cycles before bleeding spontaneously ceased may represent the slow death of endometrial cells subsequent to radiation or radiochemotherapy treatment, and has not previously been described. In view of the paucity of data on the radiosensitivity of normal endometrium, we have carefully examined these patients who appear to have retained endometrial sensitivity to hormonal stimuli after radical radiation-chemotherapy for uterine cervix cancer.

Adult↗
PubMed1990

The role of bowel surgery in the primary treatment of epithelial ovarian cancer.

Between January 1, 1979 and May 1, 1988, 24 of 192 patients treated for epithelial ovarian cancer underwent bowel surgery during primary therapy. It was found that survival was independent of this variable and depended largely upon the amount of residual disease following laparotomy. There was a major complication rate of 8% after primary bowel surgery, and this did not protect against the subsequent development of bowel obstruction. In conclusion, it is felt that bowel resection and anastomosis should only be undertaken if the patient is to be left with minimal or no macroscopic disease at completion of surgery.

Adult↗
PubMed1989

Amplification of c-ras-Ki oncogene in human ovarian tumours.

Amplification of the c-ras-Ki oncogene has been the most consistent finding reported in studies on oncogene activation in ovarian cancer, but for the most part the studies have been small and the results conflicting. In order to determine whether amplification occurred de novo in primary tumours or was associated with tumour progression and metastasis, 81 tumour samples from different sites in 26 patients with ovarian tumours and 7 xenografted ovarian tumour cell lines were assayed. Amplification of c-ras-Ki occurred infrequently and was apparent in a single metastatic site in a patient with poorly differentiated serous cystadenocarcinoma of the ovary. Ten-fold amplification of the c-ras-Ki oncogene was also evident in a benign ovarian fibroma. Amplification of the c-ras-Ki oncogene is rare in ovarian tumours and does not appear to play a fundamental role in tumor development or progression.

Blotting, Southern↗
PubMed1989

Cervical carcinoma: a comparison of four potential biochemical tumor markers.

A longitudinal study of circulating immune complexes (CIC), cancer antigen 125 (CA125), carcinoembryonic antigen (CEA) and a sub-fraction of the TA-4 squamous cell carcinoma tumor-associated antigen (SCC) has been undertaken in 38 patients with cervical carcinoma. Pre- and post-treatment values have been compared with those obtained in well-defined clinical remission and relapse phases of their disease. Each tumor marker was assessed in terms of "lead time" before clinically obvious recurrent disease became evident. The data from the four subjects with adenocarcinoma of the cervix gave equivocal results and no firm conclusions could be drawn. However, for the 34 patients with squamous cell carcinoma the medium value (data was skewed) for SCC was elevated above normal in the presenting pretreatment sera (4.5 ng/ml) and significantly fell to 2.5 ng/ml post-treatment (P less than 0.01). A similar pattern was not apparent for CIC, CEA, or CA125 data. When results were examined for an individual patient, of those with recurrent squamous cell lesions who died, 12/24 demonstrated elevated, and rising SCC values before clinical evidence of the disease and a further 6 (25%) at the time recurrence was clinically evident. This information gave lead times of between 2 and 52 months (median 13 months) for 75% of patients. Only 1 subject had values which remained in the normal range (less than 2 ng/ml) even though their disease was progressive. Similarly of the subjects still in clinical remission 8/9 had values within the normal range. The data for CIC, CA125, and CEA were not individually useful as a marker. Furthermore, combining the data from all analytes to give a panel of potential markers did not improve the prognosis already evident with SCC alone. It has therefore been concluded that SCC is a useful biochemical marker of the progression of squamous cell carcinoma of the cervix.

Adenocarcinoma↗
PubMed1988

Ovarian carcinoma: abdominopelvic irradiation following reexploration.

Twenty patients with ovarian cancer, who following reexploration were left with residual disease nodules of less than 2 cm diameter, received abdominopelvic irradiation. Of these patients 18 had previous chemotherapy. Fifteen patients completed treatment, 13 of whom had prior chemotherapy. Six of the 18 patients with invasive tumors were alive and disease free 18-53 months postradiotherapy, while only 4 patients had died at the time of follow-up. No patient with residual nodules greater than 1 cm remained disease free. There was no difference in outcome between patients with microscopic or macroscopic less than 1 cm residuum. Complications were acceptable with 3/20 (15%) developing treatment-related intestinal obstruction.

Adenocarcinoma↗
PubMed1988

Malignant melanoma of the vulva. Australian experience.

Malignant melanoma is an uncommon but aggressive tumor, and the vulva seems to have an increased predisposition for developing it. Vulvar melanoma appears to behave similarly to truncal melanoma, but its later presentation, due to its less accessible and less visible site, gives the false impression of more aggressive behavior. In spite of that the survival, stage by stage, is not markedly different from that of truncal melanoma. Traditionally it has been treated in the same manner as vulvar squamous cell carcinoma, with extreme but often therapeutically inadequate radical surgery. For lesions less than 0.75 mm in depth, wide excision with a 2-cm margin is adequate. Deeper lesions require radical local excision and bilateral groin lymphadenectomy through separate incisions.

Adolescent↗
PubMed1987

SCC tumour marker and its relationship to clinical stage in squamous cervical cancer.

Serum from 103 patients with histologically proven squamous cell cervical carcinoma were analysed for the presence of tumour marker, SCC antigen. Although values ranged between 0.2-109.7 ng/ml the majority of cases (75%) fell below 7.9 ng/ml. There was no relationship between SCC antigen values and clinical stage. The high false negative rate (29%) of this marker in patients with proven disease would preclude its use as a diagnostic screen.

Antigens, Neoplasm↗
PubMed1983

Bowel complications in the management of ovarian cancer.

In a consecutive series of 163 patients referred with malignant ovarian tumours there were 24 (14.7%) who developed major bowel complications; 21 patients were operated upon for bowel obstruction and had a mean survival time of 8.1 months; 8 of the 24 patients are alive with cancer and 4 are alive without evidence of residual tumour. It is concluded that laparotomy is indicated when bowel complications occur in patients with ovarian carcinoma.

Female↗