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Biomedical subjects

E W McDermott

Publications and source records attributed to E W McDermott.

15 recordsLinked to original sources
PubMed1992

Perforation through undiagnosed small bowel involvement in primary thyroid lymphoma during chemotherapy.

A case is described of fatal perforation of the small bowel through an area of undiagnosed secondary involvement from primary thyroid lymphoma during treatment by chemotherapy. There is a known association between primary thyroid lymphoma and gastrointestinal metastases. To avoid this lethal complication, a specific search should be made for gastrointestinal involvement before chemotherapy is started in patients with advanced thyroid lymphoma.

Aged↗
PubMed1992

Patient recovery following cholecystectomy through a 6 cm or 15 cm transverse subcostal incision: a prospective randomized clinical trial.

The effect of incision length on patient recovery following cholecystectomy has not been investigated previously. In this study, 30 patients with symptomatic gallstones were randomized to cholecystectomy through a 6 cm or 15 cm transverse subcostal incision. Postoperative hospital stay was significantly shorter in the 6 cm incision group (median 3 days vs 5 days; P = 0.0069 Mann-Whitney U-test). In the 6 cm group analgesic requirements were reduced (median 2.5 vs 4.5 intramuscular opiate injections per patient) and recovery of depressed postoperative pulmonary function (FVC and FEV1) was faster (3% difference between groups on day 1 and 7% on day 3), although these differences did not achieve statistical significance. These results suggest that the length of incision may influence patient recovery following elective cholecystectomy. This has important implications as surgery carried out through shorter and less traumatic incisions may offer a cost-effective alternative to laparoscopic cholecystectomy. Moreover, some surgeons may find mini-laparotomy cholecystectomy easier to adopt than laparoscopic techniques.

Adult↗
PubMed1992

Cathepsin D concentration in breast cancer cytosols: correlation with disease-free interval and overall survival.

Cathepsin D (CD) is an aspartyl protease implicated in cancer metastasis. In this study of 331 patients, we show that patients with primary breast carcinomas containing high concentrations of CD have a significantly shorter disease-free interval (chi-square = 4.28, P < 0.05) and overall survival (chi-square = 7.7, P < 0.01) than patients with low concentrations. CD as a prognostic marker for overall survival was equally valuable for women younger (chi-square = 4.39, P < 0.05) and older (chi-square = 3.97, P < 0.05) than 50 years. CD was also a significant prognostic marker for overall survival within the estradiol receptor (ER)-positive subgroup of patients (chi-square = 5.79, P < 0.025), but not in the ER-negative subgroup. Patients with tumors containing high concentrations of CD and low concentrations of ER had shorter disease-free intervals (chi-square = 15.1, P < 0.001) and lower overall survival (chi-square = 20.9, P < 0.001) than patients with high concentrations of ER but low concentrations of CD.

Biomarkers, Tumor↗
PubMed1992

Dietary alcohol intake does not increase the incidence of experimentally induced mammary carcinoma.

There is considerable evidence from epidemiological studies that even moderate dietary alcohol intake increases the risk of breast cancer in women. The aim of this study was to test the hypothesis that dietary alcohol intake increases the incidence of mammary carcinoma in a rodent model. Two matched groups of female Sprague-Dawley rats were given 7,12-dimethylbenz[a]anthracene 15 mg by gavage when 50 days old. One group of 20 animals was given dietary ethanol at a dose of 4.4 g/kg/day in their drinking water. The incidence of tumors was significantly less in the group given ethanol (P less than 0.001). In those developing tumors, there was no significant difference between the two groups in the mean number of tumors per animal, the tumor growth rate or the time to the appearance of the first tumor. This study fails to support the hypothesis established by previous epidemiological studies.

Animals↗
PubMed1992

Mammographic needle localisation of impalpable breast lesions.

Refinements in mammography have led to an increased number of needle localised breast biopsies for impalpable breast lesions. This paper review 139 needle guided biopsies from June 1986 to December 1990 in 132 patients. Forty four patients (32%) biopsied had malignant lesions the vast majority (91%) of which were reported as either non-invasive or invasive less than 2 cm in diameter. Fourteen patients in this group had ductal carcinoma in-situ. When compared with 100 consecutive palpable breast carcinomas during the same period, needle localised biopsies had a higher proportion of non-invasive lesions and fewer were associated with lymph node involvement. Needle guided breast biopsy detects carcinoma at an earlier stage and may reduce morbidity and mortality from breast cancer.

Biopsy, Needle↗
PubMed1991

Familial juvenile polyposis coli and colorectal cancer.

A 40-year-old mother and her 7-year-old son underwent colectomy for polyposis coli. Both colectomy specimens contained predominantly juvenile polyps. The mother's specimen also had numerous tubular adenomas and one 5-cm severely dysplastic villous adenoma without invasive carcinoma. Foci of adenomatous change in juvenile polyps were present in the son's specimen. The histologic features of both cases suggest a sequence of change from juvenile polyps to adenomatous polyps to cancer.

Adenomatous Polyposis Coli↗
PubMed1991

Quantitative cytochemistry of glucose-6-phosphate dehydrogenase in benign and malignant breast tumours.

Glucose-6-phosphate dehydrogenase (G6PD) activity was quantified cytochemically in mammary epithelial cells within frozen tissue sections from 38 patients with breast cancer and 44 with benign breast disease. G6PD activities were measured under atmospheres of both N2 and O2. The mean (S.E.) G6PD value 2.5 (0.23) IE U/min measured in N2 in mammary epithelial cells from the group of malignancies was significantly greater than that of 1.6 (0.37) IE U/min in the benign group (P less than 0.001), but there was considerable overlap between individual values. G6PD measured in O2 was detectable in 84% of malignancies compared to only 14% of benign biopsies and the group mean of 1.3 (0.18) IE U/min in the former was significantly greater than that of 0.35 (0.20) IE U/min in the latter (P less than 0.001). Significant correlations between G6PD activities measured in N2 and O2 were observed in both groups. The techniques present a sensitive method of identifying increases in G6PD activity in mammary epithelial cells and provide an assay that in a majority of cases permits the separation of malignant from benign tissues.

Adenofibroma↗
PubMed1990

Premorphological metabolic changes in human breast carcinogenesis.

Malignant breast tissue is characterized by morphological and metabolic changes when compared with normal breast tissue. In this study, the cytochemical measurement of glucose-6-phosphate dehydrogenase (G6PD) activity was used to detect abnormal metabolism in breast tissue and to determine whether abnormal metabolic activity precedes morphological change during human breast carcinogenesis. Normal and benign breast tissue, morphologically normal tissue from cancer-containing breasts, and malignant breast tissue were studied. In malignant tissue, mean(s.e.m.) G6PD activity was significantly increased when compared with normal and benign tissue (9.69(2.3) versus 27.02(1.7) mean integrated extinction (MIE) x 100, P less than 0.01). G6PD activity was increased in morphologically normal tissue from cancer-containing breasts when compared with normal and benign breast tissue from breasts with no known cancer (27.02(1.7) versus 18.42(2.6) MIE x 100, P less than 0.05). These findings suggest that metabolic abnormalities precede morphological changes in breast carcinogenesis. Abnormal metabolism can be detected widely within a cancer-containing breast. The detection of such abnormality may prove helpful in identifying patients at high risk of developing breast cancer.

Adult↗
PubMed1989

Effect of mechanical bowel preparation on anastomotic integrity following low anterior resection in dogs.

To assess the effect of mechanical bowel preparation on anastomotic integrity after low anterior resection, 36 mongrel dogs were randomized to have low anterior resection with or without mechanical bowel preparation. All dogs received prophylactic antibiotics and anastomotic integrity was assessed on the ninth postoperative day by barium enema, inspection of anastomoses for defects after careful excision at laparotomy, and anastomotic bursting pressures. Bursting pressures were significantly higher (P less than 0.005) in the group with bowel preparation. Anastomotic defects were present in 13 per cent of animals with bowel preparation and 47 per cent without bowel preparation (P = 0.057). Pelvic abscess and death from peritonitis occurred in 6 per cent of the group with bowel preparation and 29 per cent of the unprepared group. Mechanical bowel preparation significantly enhanced anastomotic integrity and reduced complications in this model.

Anastomosis, Surgical↗
PubMed1989

Role for prazosin in reducing the development of rabbit intimal hyperplasia after endothelial denudation.

Intimal hyperplasia is the universal response to endothelial denudation and occurs after a variety of vascular procedures. In a proportion of cases the smooth muscle cell proliferation may lead to stenosis of the blood vessels. These vessels exhibit increased sensitivity to noradrenaline that can be reduced by the alpha 1-adrenergic antagonist prazosin. Because the alpha 1-adrenergic receptor and platelet-derived growth factor (which promotes vascular smooth muscle cell proliferation) act through the same metabolic pathway, it was postulated that alpha 1-adrenergic blockade might reduce the development of intimal hyperplasia. Twenty-eight New Zealand White rabbits underwent endothelial denudation of the aorta using a Fogarty balloon catheter. Test rabbits were treated with prazosin from the day of operation until they were killed. All rabbits were killed either 1 or 4 weeks after endothelial denudation. Intimal hyperplasia in cross-sections of the aorta was measured using an X-Y digitizer and was standardized in terms of percentage luminal reduction. Prazosin-treated rabbits had significantly less luminal reduction at 1 week (0.75(1.8) versus 9.7(3.1) per cent, mean (s.d.), P less than 0.001) and at 4 weeks (14.7(4.4) versus 25.3(12.8) per cent, P less than 0.05) than control rabbits. It is concluded that prazosin caused a major reduction in the development of intimal hyperplasia.

Animals↗