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Biomedical subjects

D A Hudson

Publications and source records attributed to D A Hudson.

At least 109 records · Page 6Linked to original sources
PubMed1990

Malignant melanoma of the external ear.

Twelve patients with primary melanoma of the external ear were treated during a 10-year period. Ten patients were males. Median melanoma depth was 2.1 mm and seven patients had lesions deeper than 2 mm. Eight of 12 lesions were either Clark level IV or V. Six patients had wedge excisions of the primary lesion and all developed recurrent disease (local: three). Six patients underwent wide excision and none developed local recurrence. All patients with primary disease less than 2 mm are alive. Only two of seven patients with lesions deeper than 2 mm have survived. The definitive excision for melanoma of the ear should encompass wide margins despite the cosmetic consequences. Lesser procedures inevitably lead to local recurrence. Melanoma deeper than 2 mm penetration on the ear in our series had a poor prognosis.

Adult↗
PubMed1990

Subungual melanoma of the hand.

Thirteen patients with subungual melanoma on the fingers had a mean delay before diagnosis of 1.2 years. Four patients presented with local recurrence after inadequate initial treatment and two presented with systemic metastases. Mean primary subungual melanoma thickness was 6.1 mm. and nine patients had Clark level IV or V disease. All patients underwent digital amputation. Two of seven patients who had localised disease initially are alive at 29 and 44 months. One of four patients who had locally recurrent melanoma is alive at 36 months. Both patients with systemic disease at presentation died. Advanced disease and delayed presentation contributed to the poor prognosis of subungual melanoma in our patients.

Adult↗
PubMed1989

Calcaneal fractures in children.

Eight patients with 9 calcaneal fractures were reviewed. Of the fractures 6 were intra-articular and 3 extra-articular, but in children this distinction appears to have little relevance to treatment or prognosis. While these fractures are relatively uncommon in children, clinical suspicion is important in making the diagnosis, since the presentation may be subtle. The overall prognosis in children is excellent.

Calcaneus↗
PubMed1989

Acute colonic pseudo-obstruction. Current diagnosis and management.

Twenty-nine patients with acute colonic pseudo-obstruction were treated over a 6-year period. All had gross abdominal distension which followed either serious systemic illness (23 cases), major surgery (4) or trauma (2). The predominant radiological features were disproportionate segmental or localised dilatation of the caecum and proximal colon, with a relative paucity of distal colonic gas. The correct diagnosis was established and mechanical obstruction excluded in the majority of cases (24) by contrast enema examination. In the remaining 5 cases the diagnosis was made on colonoscopy (4) or at laparotomy (1). Successful colonoscopic decompression was achieved in 2 of 4 cases. Eight patients underwent laparotomy and 3 of 4 patients with caecal perforation and peritonitis died. Two of 21 patients treated conservatively died. Persistence of colonic distension beyond 72 hours, caecal diameter greater than 12 cm or overlying abdominal tenderness indicates urgent decompression. Caecostomy is the advised procedure in patients with non-perforated caecal distension. Prompt recognition and treatment of the condition should eliminate delay in decompression and minimise the risk of caecal perforation.

Acute Disease↗
PubMed1988

Acute large bowel obstruction complicating acute pancreatitis.

We have reported a rare case of acute large bowel obstruction complicating acute pancreatitis. The diagnosis of pancreatitis is often initially not considered in such patients, and is established only at laparotomy. The splenic flexure is the most common site of large bowel involvement. A proximal defunctioning colostomy is the preferred primary management.

Acute Disease↗
PubMed1988

Strangulated obturator hernia: can mortality be reduced?

We describe two patients with strangulated obturator hernia to enhance clinical awareness of the varied presentations of this uncommon hernia, which occurs especially in elderly women with either recurrent abdominal pain or partial intestinal obstruction, a positive Howship-Romberg sign, and an absent thigh adductor reflex. Early laparotomy for unexplained bowel obstruction is essential to avoid the complications associated with strangulated obturator hernia.

Aged↗
PubMed1987

Fractures of the triquetrum.

The commonest carpal fractures are those of the carpal scaphoid. Triquetral fractures are relatively uncommon, but when present, often go undiagnosed or are misdiagnosed as lunate fractures. Clinical suspicion and careful evaluation of the appropriate radiographs, especially an oblique view, should ensure the diagnosis.

Adult↗
PubMed1987

Persistent hyperamylasemia in a patient with ascites.

There are several different causes of persistent hyperamylasemia. We have presented a case of macroamylasemia, which accounts for a significant percentage of such cases. Awareness and early laboratory confirmation of this condition may promote more cost-effective management and lessen patient morbidity.

Adult↗
PubMed1986

Colchicine selectively inhibits lactase expression by rat enterocytes.

One early aspect of enterocyte differentiation involves the appearance of digestive enzymes in the brush border membrane during cell migration from intestinal crypts onto villi. Present experiments describe how small amounts of colchicine selectively affect this particular aspect of enterocyte development. Oral ingestion of approximately 50 micrograms colchicine per day halves lactase activity in intestinal homogenates without affecting sucrase, maltase or alkaline phosphatase activities. This inhibition, which is completely reversible, takes about 48 hr to become complete. Further analysis of this effect by quantitative cytochemistry shows colchicine to reduce the maximal rate at which lactase activity appears in the brush border membrane. This reduction takes place without substantially affecting enterocyte migration rate or the time taken to fully complete lactase development. The possibility is discussed that small amounts of colchicine can selectively inhibit lactase biosynthesis in both crypt and mature villus enterocytes.

Animals↗
PubMed1986

Isolated traumatic dislocation of the radial head in children.

Isolated traumatic dislocation of the radial head in children is not as rare as sometimes supposed. Attention to detail in radiographic interpretation is the key to diagnosis. Early closed reduction and immobilisation in an above-elbow plaster in 90 degrees of flexion and full supination for three to six weeks is recommended. Seven cases are presented, two of which were treated operatively and had unsatisfactory results. The applied anatomy, management and complications are discussed.

Child↗
PubMed1977

A new experimental system for the study of the pathogenesis of coeliac disease.

A method is described for the differential removal of epithelial cells from human intestinal-tissue specimens. Epithelial cells can be freed of contaminating cells such as erythrocytes, and on the basis of microscopic appearance, dye exclusion tests, and short-term survival in defined media are viable. The experimental system can be used to investigate the differential cytotoxic effects,if any, of specific gluten components upon cells from normal subjects and coeliac patients.

Adult↗
PubMed1976

Non-specific cytotoxicity of wheat gliadin components towards cultured human cells.

Chromatographically separated fractions of a proteolytic digest of wheat gliadin were assayed for cytotoxic properties using cultured human embryonic intestinal, lung, kidney, adrenal, and HEp-2 cells. In all cell types noxious effects were observed microscopically over a 24 h period. The most active fraction was that previously shown to produce xylose malabsorption in subjects with coeliac disease, disruption of lysosomes, and inhibition of morphological recovery of cultured mucosa from a patient on a gluten-free diet.

Adrenal Glands↗
PubMed1968

The ontogeny of electrical activity associated with absorption of solutes across the developing small intestine of the chick (Gallus domesticus).

1. Electrical potentials across the developing intestine of the chick were measured in vitro 3-4 days before and up to 32 days after hatching.2. Embryonic intestine had a very high endogenous p.d. (serosa positive to mucosa) which decreased up to hatching. This decrease continued during intestinal maturation, reaching a basal level several days after hatching.3. Transfer potential differences were caused only by the actively transferred hexoses both in embryonic and post-embryonic intestine. These potentials decreased concomitantly with the decrease in the endogenous p.d. Kinetic analysis showed that the ;apparent K(m)' of glucose for the glucose transfer p.d. generating mechanism did not change over the period of hatching.4. Both the embryonic and post-embryonic transmural p.d. either in the presence or absence of metabolizable hexose was dependent upon aerobic metabolism.5. The transmural p.d. of hatched chick small intestine (with and without hexoses) was linearly related to log(10)[Na(+)] of the mucosal fluid. The magnitude of the glucose transfer p.d. both in embryonic and post-embryonic small intestine, however, was not lowered by decreasing the mucosal [Na(+)].6. Amino acid transfer potentials were of small magnitude at all stages of development.

Amino Acids↗
PubMedDate not supplied

Staged TRAM breast reconstruction: combining the advantages of tissue expansion with surgical delay.

The TRAM flap has become the gold standard in breast reconstruction but suffers from the disadvantages of poor color match, different texture, and impaired sensation compared to the normal breast. This study reports on a two-stage procedure to address these problems. The first stage consists of insertion of a tissue expander and surgical delay of the TRAM flap. The second stage consists of removal of the tissue expander and transposition of a deepithelized TRAM flap into the tissue expanded cavity. (The capsule is excised.) Four cases of breast reconstruction are reported. The advantage of this procedure is that it offers the benefits of tissue expansion, viz., normal color match, texture, and sensation, and in addition, reconstruction is achieved with autologous tissue by a pedicled TRAM flap. The vascularity of the TRAM is enhanced by a surgical delay procedure.

Adult↗