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Biomedical subjects

Frank A Frizelle

Publications and source records attributed to Frank A Frizelle.

At least 19 recordsLinked to original sources
PubMed2006

Inflammatory bowel disease and the lung: is there a link between surgery and bronchiectasis?

PURPOSE: One-third of patients with inflammatory bowel disease (IBD) has extracolonic manifestations. Inflammatory bowel-associated pulmonary disease is one of the less commonly recognized and more recently described manifestations. Here, we report the experience of our patients with inflammatory bowel-associated bronchiectasis. METHODS: A retrospective analysis of case notes of patients with IBD and respiratory manifestations was undertaken. Relevant demographic, clinical, radiological, and pulmonary physiology laboratory results were reviewed. RESULTS: Ten patients with IBD and bronchiectasis were identified. Eight developed respiratory symptoms after surgery for IBD. Five of the ten had ulcerative colitis. Their lung function abnormality is mild to moderate in severity. Small airways disease (forced expiratory flow between 25-75% is <50%) was evident in seven of the ten patients. CONCLUSIONS: This preliminary study supports an association between surgery for IBD and development of symptomatic lung disease, particularly bronchiectasis, in susceptible patients. The pulmonary manifestations of IBD in some patients may only become clinically significant after surgery and the withdrawal of medical treatment.

Aged↗
PubMed2006

Caspase recruitment domain-containing protein 15 mutations in patients with colorectal cancer.

The caspase recruitment domain-containing protein 15 (CARD15) plays a crucial role in mediating the innate immune response. Mutations within this protein have been shown to be independent risk factors for the development of Crohn's disease in Caucasians. As Crohn's disease patients are at increased risk of developing sporadic colorectal cancer, it is conceivable that genetic variability within CARD15 may also play a role in determining susceptibility to this gastrointestinal malignancy in individuals without Crohn's disease. This hypothesis is supported by the findings of two case-control studies that found the frequencies of CARD15 mutations were significantly elevated in Polish and Greek colorectal cancer patients. Given the results of these previous studies, we examined whether the high incidence of sporadic colorectal cancer observed in New Zealand Caucasians was due to mutations within CARD15. To answer this question, we genotyped 133 colorectal cancer patients and 201 Caucasian controls for R702W, G908R, 1007fs, and P268S. Chi(2) Testing found that the combined frequency of R702W, G908R, and 1007fs was significantly elevated in colorectal cancer patients compared with controls (P = 0.001; odds ratio, 2.8; 95% confidence interval, 1.5-5.4), but no association was detected between tumor behavior or age of disease onset and CARD15 mutations in our colorectal cancer cohort. This study is the first to explore the link between CARD15 mutations and colorectal cancer in New Zealand Caucasians. Our results strongly suggest that CARD15 influences susceptibility to colorectal cancer, but we have found no evidence to indicate that CARD15 mutations predict the clinicopathologic characteristics of this disease.

Colorectal Neoplasms↗
PubMed2006

Primary peritonitis in adults: is it time to look for a better diagnostic classification?

BACKGROUND: The occurrence of primary peritonitis is rare. The experience of a single institution and the definition of this disease are reviewed. METHODS: A retrospective audit of primary peritonitis at a single institution was undertaken. Age, sex, clinical presentation, initial diagnosis, imaging and blood tests, comorbidities, recent medical intervention, surgical treatment and operative findings, antibiosis, bacterial isolates, the course of hospital treatment and follow up, including later diagnoses, were reviewed. RESULTS: The audit was carried out at Christchurch Hospital between January 1998 and March 2005. A total of 115 patients were identified with a diagnosis of non-specific peritonitis, of which five patients were identified with a diagnosis of primary peritonitis. All were women aged 22-38 years. Three had undergone a caesarean section in the last 3 months. The details of these cases are presented in detail. CONCLUSION: Five cases of primary peritonitis are reported, and from a review of published work, a classification of primary peritonitis is suggested, which more clearly identifies the cause of the disease.

Adult↗
PubMed2006

Malignant progression of anal intra-epithelial neoplasia.

BACKGROUND: Anal intra-epithelial neoplasia (AIN) is believed to be a precursor to squamous cell carcinoma of the anus. The risk of developing anal cancer in patients with AIN, although known to occur, has been thought to be relatively low. This study reviews our experience with AIN, reviewing the incidence and risk factors for development of invasive malignancy and the outcome of present management strategies. METHODS: This study examined a cohort of 72 patients identified from a prospective database with AIN from a single institution between January 1996 and December 2004. A single pathologist examined all pathological specimens. RESULTS: There were 72 patients (52 women) and the median age was 49 years (range, 18-81 years). We identified progression of AIN to invasive malignancy in eight patients despite undergoing surveillance. Regression following treatment or biopsy was seen in 25 patients. Four patients required stomas for incontinence following treatment. CONCLUSION: This study has shown a high rate of progression to invasive malignancy (11%) with AIN despite surveillance. The patients at risk of developing squamous cell carcinoma were the immunocompromised and those with genital intra-epithelial field change. Treatment of AIN has significant complications and despite treatment, invasive cancers do occur. Decisions made for treatment of AIN can affect treatment choices if invasive malignancy develops.

Adolescent↗