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Biomedical subjects

G Lee

Publications and source records attributed to G Lee.

At least 19 recordsLinked to original sources
PubMed2007

Local involvement of the urinary bladder in primary colorectal cancer: outcome with en bloc resection.

BACKGROUND: Colorectal cancers that adhere to the urinary bladder require en bloc partial or total cystectomy to achieve negative tumor margins. METHODS: This prospective study evaluated the outcome of combined bladder resection for carcinoma of the colon or rectum at a unit specializing in gastrointestinal cancer. RESULTS: Patients (n = 63) with colorectal tumors adherent to the bladder at operation and without distal metastases were followed. Fifty-eight patients (92%) had tumors of the sigmoid colon or upper rectum. Operative morbidity and mortality rates were 18% and 1.5%, respectively. Histological staging demonstrated bladder adherence in 46% (29/63) and invasion in 54% (34/63). Overall disease-specific survival was 54%, with a mean follow-up of 7.6 (range 5-12) years. Five-year survival for margin negative patients was 72% (26/36) and 27% (4/15) for node negative and positive tumors, respectively. The bladder was closed primarily in 48 patients and reconstructed by enterocystoplasty in five, with ten patients requiring urinary diversion. CONCLUSIONS: En bloc bladder resection for adherent or invading tumors of the colon and rectum achieves good local control, but an infiltrative extravesical margin denotes poor prognosis. The potential for cure in completely excised node negative tumors is good. Bladder reconstruction is achievable in most patients.

Adult↗
PubMed2006

Local involvement of the urinary bladder in primary colorectal cancer: outcome with en-bloc resection.

BACKGROUND: Colorectal cancers that adhere to the urinary bladder require en-bloc partial or total cystectomy to achieve negative tumor margins. METHODS: This prospective study evaluated the outcome of combined bladder resection for carcinoma of the colon or rectum at a unit specializing in gastrointestinal cancer. RESULTS: Patients (n = 63) with colorectal tumors adherent to the bladder at operation and without distal metastases were followed. Fifty-eight patients (92%) had tumors of the sigmoid colon or upper rectum. Operative morbidity and mortality rates were 18% and 1.5%, respectively. Histological staging demonstrated bladder adherence in 46% (29/63) and invasion in 54% (34/63). Overall disease-specific survival was 54% with a mean follow-up of 7.6 years (range 5-12). Five-year survival for margin-negative patients was 72% (26/36) and 27% (4/15) for node-negative and -positive tumors, respectively. The bladder was closed primarily in 48 patients and reconstructed by enterocystoplasty in 5, with 10 patients requiring urinary diversion. CONCLUSIONS: En-bloc bladder resection for adherent or invading tumors of the colon and rectum achieves good local control, but an infiltrative extravesical margin denotes poor prognosis. The potential for cure in completely excised node-negative tumors is good. Bladder reconstruction is achievable in most patients.

Adult↗
PubMed2006

South Australian adolescent ophthalmic sun protective behaviours.

AIMS: To study student's knowledge of the effects of sunlight on the eyes, as well as their sun protective behaviours. METHODS: In total, 640 [corrected] students aged 13-18 years were surveyed in South Australia, during August-September 2004, using a standardized previously used survey. Scores were calculated regarding knowledge about ultraviolet light, sunlight effects on eyes, as well as eye and body protection. Risk factor scores were produced for each student. The data were analysed by the analysis of variance (ANOVA), as well as the Cochran-Mantel-Haenszel methods. Results were compared to the same survey conducted in 1995 in Queensland Australia. RESULTS: This group demonstrated a moderate level of knowledge, similar to the 1995 survey. Students in the older age groups demonstrated significantly higher knowledge. The majority of students (74%) owned a pair of sunglasses; however, 44.5% almost never wore their glasses. The reported frequency of wearing sunglasses was significantly related to advertising, believing sunglasses protect the eyes, as well as personal, family, and peer attitudes towards wearing sunglasses. CONCLUSION: The results of our survey suggest no significant change in knowledge and behaviours of students, compared to the 1995 survey. We feel it is imperative that adolescents be made more aware of the damaging effects of sunlight and the benefits of eye protection. Health promotion campaigns should target the youth and consider that as a group, they are significantly influenced by the media, peers, and family attitudes.

Adolescent↗
PubMed2006

The plasma alpha-synuclein levels in patients with Parkinson's disease and multiple system atrophy.

alpha-Synuclein, a synaptic protein of unknown function, is a major component of Lewy bodies and may play a role in the pathophysiological process of Parkinson's disease (PD). In this study, we measured the plasma alpha-synuclein levels in 105 patients with PD, 38 patients with multiple system atrophy (MSA), and 51 age-matched controls. The alpha-synuclein level was significantly elevated in patients with PD (79.9 +/- 4.0 pg/ml, p < 0.001) and in those with MSA (78.1 +/- 3.5 pg/ml, p = 0.019) compared with the level in controls (76.1 +/- 3.9 pg/ml). The alpha-synuclein level was higher in patients with PD than in those with MSA (79.9 +/- 4.0 vs 78.1 +/- 3.5, p = 0.016). Our study demonstrated that the alpha-synuclein level in plasma is elevated in patients with PD and MSA.

Adult↗
PubMed2006

Primary splenic marginal zone lymphoma with bladder metastases mimicking interstitial cystitis.

We report the case of a 76-year-old patient with a past medical history of low-grade chronic lymphocytic leukaemia who presented with severe chronic bladder symptoms attributed to interstitial cystitis. She underwent cystectomy and ileal conduit formation after the failure of all conventional treatment. Bladder histopathology revealed primary splenic marginal zone lymphoma. Literature review shows the rarity of such non-hematopoietic visceral metastases. This may represent the first reported splenic marginal zone lymphoma with bladder involvement and highlights the clinical and histological similarities with interstitial cystitis.

Aged↗
PubMed2006

Effect of immature dendritic cell injection before heterotropic cardiac allograft.

Although dendritic cells (DCs) are unrivaled for initiation of immune responses, the immunomodulatory capacity of chemically fixed DC has not been thoroughly evaluated. We monitored the tolerogenic capacity of chemically fixed DCs using allogeneic heart transplantations. Bone marrow progenitors were differentiated into immature DCs which were then chemically fixed and injected intravenously into recipient mice at 14 days before allogeneic heart transplantation. Chemically fixed DCs markedly prolonged graft survival in the major histocompatibility complex (MHC) I/II mismatch cardiac transplantation (B6 --> B10.A; median survival time [MST] 12.5 days vs >70 days). T cells that encountered chemically fixed DCs showed attenuated apoptotic cell death and inactivated phenotypes after allogeneic heterotropic heart transplantation. Furthermore, when DCs from interleukin (IL)-10-/- mice were treated, the in vitro T-cell response was greater than that from IL-12-/- mice. We have suggested that the chemically fixed DCs may mediate peripheral T-cell tolerance, with therapeutic potential for allogeneic transplantation.

Animals↗
PubMed2006

Virus tropism, distribution, persistence and pathology in the corpus callosum of the Semliki Forest virus-infected mouse brain: a novel system to study virus-oligodendrocyte interactions.

The temporal course of cellular pathology in virus-infected oligodendrocytes in vivo is not well defined. Here we study these events in the mouse brain using a novel system in which large numbers of oligodendrocytes can be reproducibly infected. In the mouse, following extraneural inoculation, the A7(74) strain of the alphavirus Semliki Forest virus (SFV) is efficiently neuroinvasive and central nervous system (CNS) infection leads to predominantly perivascular lesions of immune-mediated demyelination. This study demonstrates that direct intracerebral inoculation with SFV A7(74) or the SFV1 vector results in dramatic, selective and widespread infection of the major white matter tract of the brain, the corpus callosum. Mature oligodendrocytes are the predominant cell type infected. Subsequent events are complex; early virus-induced necrotic death of infected cells is followed by apoptotic death of adjacent apparently uninfected cells. A strong inflammatory response and considerable myelin loss are evident from 10 days and virus-positive cells are not observed after this time. In contrast, in athymic nu/nu mice, in the absence of T-cell responses, no inflammatory infiltrates are observed and virus-infected cells persist for over 30 days with extensive vacuolation but less demyelination. The change from an early destructive to a potentially persistent infection of oligodendrocytes is likely to reflect activation of innate immune responses. Activation of peripheral innate defences by inoculation of poly I : C prior to CNS virus infection abrogates the widespread corpus callosum infection. This widespread infection of the corpus callosum provides a novel in vivo system in which to study virus-oligodendrocyte interactions.

Alphavirus Infections↗
PubMed2006

Rapidly changing pulmonary infiltrates.

Pulmonary eosinophilia responds very quickly to steroid treatment. Chronic pulmonary eosinophilia is common in middle aged females. We report on a patient who presented with subacute onset of shortness of breath, severe weight loss associated with a rise in the peripheral eosinophil count. She was treated successfully with steroids resulting in complete resolution of the pulmonary infiltrates.

Aged↗
PubMed2005

Case report: cystitis glandularis mimics bladder tumour: a case report and diagnostic characteristics.

We report a rare case of a 26-year-old patient presented with 3-week history of frank haematuria and suprapubic discomfort. Investigations revealed a tumour arising from the bladder wall and histology demonstrated cystitis glandularis. The literature review highlights the rarity of cystitis glandularis presented in such manner. Our radiographic and endoscopic images can also assist future diagnosis of the condition especially in patients in such age groups.

Adult↗
PubMed2005

Thermo-expandable intra-prostatic stent in the treatment of acute urinary retention in elderly patients with significant co-morbidities.

We assess the use of thermo-expandable intra-prostatic stent (Memokath, Engineers and Doctors A/S, Denmark) for the treatment of acute urinary retention (AUR) in men with significant co-morbidities for transurethral resection of prostate (TURP). We evaluate the pre- and post-operative complications, duration of stents in-situ and patients quality of life after the stent insertion. Patients with significant co-morbidities presenting with AUR were selected, who were unfit for TURP. The co-morbidities included ischaemic heart disease, congestive heart failure, and chronic obstructive pulmonary disease. The exclusion criteria were bladder tumour and atonic bladder. The Memokath stents were inserted using a flexible cystoscope under local anaesthesia. The patients were followed up at 3 and 6 months after the procedure and the ones who remained alive were asked to complete self-administered questionnaires and IPSS scores. Fifteen men with acute urinary retention were recruited for stent insertion with the mean age of 87 years. No peri-operative complications were recorded. Three patients died after the insertion with functional Memokath in-situ. Nine patients had good functioning stents post-operatively, and remain catheter free up to 30 months after the procedure. The mean duration of stent life was 18 months. Three long-term complications were detected, including stent migration and prostate overgrowth. The Memokath is a good option for frail elderly patients presenting with AUR. The procedure is safe and has minimal long term complications. The stent also provides a sustained good quality of life for patients and avoids the necessity of long term catheterisation.

Acute Disease↗
PubMed2005

Paraesophageal lymph node metastasis from prostatic adenocarcinoma in a patient with esophageal squamous carcinoma.

SUMMARY. Esophageal squamous carcinomas induce regional immune suppression in the domain of the tumor while the global immune system remains intact. We report a patient with a squamous esophageal carcinoma, who was discovered at esophagectomy to have paraesophageal lymph node metastases from a prostatic adenocarcinoma. No other sites of metastatic disease were identified. This supports the concept that regional immune suppression by esophageal squamous cancers facilitates growth of metastases in the local lymph nodes.

Adenocarcinoma↗
PubMed2004

A study of bone mineral density in women with forearm fracture in Northern Ireland.

A group of Northern Ireland women aged 40-75 years of age with low-trauma forearm fracture were studied to determine the incidence of such fractures and the prevalence of osteoporosis in this fracture population. A total of 1,147 subjects were identified in 1997 and 1998 throughout Northern Ireland following low-trauma forearm fractures, as well as 699 residents in the Eastern Health and Social Services Board (EHSSB), enabling calculation of the annual incidence rate of new low-trauma forearm fractures at 2.69/1,000 population aged 40-75. A total of 375 participants consented to have bone mineral density (BMD) measurements undertaken at the femoral neck, spine, and forearm using a Lunar Expert bone densitometer. Osteoporosis at the femur was present in 14% of women, at the spine in 29%, and at the forearm in 32%. A total of 45% were osteoporotic at one or more measured sites, but only 18% were on treatment for osteoporosis. Additional significant risk factors identified included an early menopause in 24.5% and current or previous corticosteroid use in 13%. Only 1.6% received information on treatment of osteoporosis at the time of fracture. Increased awareness is needed in both primary and secondary care including fracture services to improve treatment of women with low-trauma fracture.

Adult↗
PubMed2004

Resonant crossover of terahertz loss to the gain of a Bloch oscillating InAs/AlSb superlattice.

Terahertz absorption in waveguides loaded with InAs/AlSb super-superlattice mesas reveals a frequency dependent crossover from loss to gain that is related to the Stark ladder produced by an applied dc electric field. Electric field domains appear to be suppressed in the super-superlattice composed of many very short segments of superlattice, interrupted by heavily doped InAs regions. Resonant crossover is indicated by an increase in terahertz transmission as the Stark splitting or Bloch frequency determined by the applied dc electric field exceeds the measurement frequency.

Journal Article↗
PubMed2004

Efficacy and pitfalls of fine needle aspiration in the diagnosis of neck masses.

BACKGROUND: Fine needle aspiration biopsy (FNAB) is now well established in the assessment of cervical masses. The purpose of the present study is to review the efficacy of this procedure, as well as to identify any pitfalls that may limit its usefulness. METHODS: One hundred and ninety aspirations of neck masses performed over a recent five-year period were reviewed. The definitive diagnosis of the mass was determined in each case by review of the patients' case notes. RESULTS: Thirty seven per cent of all neck lumps were malignant. The most common cause for a false-negative result, in the case of a carcinomatous mass when an adequate sample had been obtained, was a cystic neoplasm. One quarter of all cystic lateral cervical masses not considered suspicious for malignancy by FNAB turned out to be malignant. CONCLUSION: Repeating FNAB in cases where the original result is negative for carcinoma may increase the sensitivity of FNAB in the detection of cystic carcinomas.

Adenoma↗
PubMed2004

Case report: sarcomatoid carcinoma arising from the ureter: a rare case and a treatment dilemma.

We report an interesting case of a patient with sarcomatoid carcinoma arising from the left ureter who presented with left iliac fossa pain. The diagnosis was based on CT and histological findings. To our knowledge, this is the first case of sarcomatoid carcinoma arising from the ureter reported. The literature review also highlights the rarity and the poor prognosis of the disease despite aggressive interventions.

Aged↗
PubMed2004

Neither sildenafil nor vaginal estradiol improves endometrial thickness in women with thin endometria after taking oral estradiol in graduating dosages.

PURPOSE: To determine if sildenafil improves endometrial thickness better than vaginal estradiol (E2) in women with a history of thin endometria. METHODS: Women failing to attain an 8 mm endometrial thickness on either the oocyte retrieval cycle or their first frozen embryo transfer (ET) despite an oral graduated E2 regimen were treated again with graduated oral E2 and were also randomly assigned to vaginal sildenafil or vaginal E2 therapy. Endometrial thickness was compared between the groups. RESULTS: Neither vaginal E2 nor sildenafil significantly improved endometrial thickness or blood flow in the subsequent frozen ET-cycle. CONCLUSIONS: These data fail to corroborate previous claims that 25 mg sildenafil four times daily intravaginally can improve endometrial thickness.

Administration, Intravaginal↗