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Biomedical subjects

J L Channer

Publications and source records attributed to J L Channer.

16 recordsLinked to original sources
PubMed1993

Villous adenoma of the bladder.

A case of villous adenoma of the bladder associated with cystitis glandularis of intestinal type is described. Only three villous adenomas have been reported to date, of which two were also accompanied by cystitis glandularis. The lesion can be confused with polypoid hyperplasia in cystitis glandularis. Neutral mucins, acidic sulphomucins, and sialomucins were identified within the villous adenoma and adjacent areas of cystitis glandularis. It is suggested that the villous adenoma may form an intermediary stage in the development of some of the primary adenocarcinomas of the bladder arising in metaplastic intestinal mucosa.

Adenocarcinoma↗
PubMed1992

Rectal endosonography accurately predicts depth of penetration in rectal cancer.

Sixty-three patients with primary rectal adenocarcinomas have been examined prior to surgery with rectal endosonography (ES). Maximum depths of tumour penetration measured endosonographically have been compared with subsequent maximum depths measured on the fixed resected specimen (n = 30) and the histological slide (n = 61). In both cases there was a good degree of correlation between the ultrasonic estimations of depth and the histological ones (r = 0.36, p = 0.05, CI = 95% and r = 0.46, p less than 0.001, CI = 99% respectively). In 12 cases ultrasonic depths of tumour were also measured in the laboratory and then compared with depths from fixed (n = 12) and fresh specimens (n = 5) with a good correlation (r = 0.75, p = 0.005, CI = 99% and r = 0.79, p = 0.036, CI = 95% respectively). Rectal endosonographic estimation of rectal cancer depth of invasion is an accurate measure of tumour penetration and may help distinguish between fixation due to inflammatory tissue and tumour fixity.

Adenocarcinoma↗
PubMed1990

A study of the effect of introducing a restrictive cervical screening policy on laboratory workload and cervical cancer detection rates.

This study examines the effect of a change in screening policy on the detection rate of severe dyskaryosis. During 1987 a total of 423 cases of severe dyskaryosis were identified by the Avon Screening Programme. Eleven per cent of these abnormal smears were repeat smears taken without clinical indication within the recommended 5 year recall period (interval smears). In a comparable control group of negative smears 31% were interval smears. Twenty-five per cent of the dyskaryotic interval smears (3% of the total severely dyskaryotic smears) were taken within 3 years of the previous negative smear, compared with 50% of the control group. By discouraging opportunistic smears within 5 years of the previous smear, the laboratory workload could be reduced by 30%, or within 3 years of the previous smear by 15%. There is, however, a risk of 11% and 3% respectively of missing a significant lesion (severe dyskaryosis).

Cell Nucleus↗
PubMed1989

Preoperative assessment of mesorectal lymph node involvement in rectal cancer.

One hundred patients with rectal adenocarcinoma were examined preoperatively with rectal endosonography (ES) and 50 were also examined with computed tomography (CT). ES predicted mesorectal lymph node involvement with an accuracy of 83 per cent, sensitivity of 88 per cent, specificity of 79 per cent, positive predictive value of 78 per cent and negative predictive value of 89 per cent. CT in comparison had an accuracy of 57 per cent, sensitivity of 25 per cent, specificity of 91 per cent, positive predictive value of 75 per cent and negative predictive value of 53 per cent. No particular histological architectural feature could be identified as responsible for false positive diagnosis though nodal size was significantly larger in the true positive and false positive group when compared with the true negatives (P less than 0.001 and P less than 0.01 respectively).

Adenocarcinoma↗
PubMed1989

Perioperative blood transfusion increases the risk of recurrence in colorectal cancer.

A retrospective study was conducted on 519 patients undergoing curative resection for colorectal carcinoma between 1969 and 1980. Recurrence was diagnosed in 214 patients (41.2 percent), 179 of whom (34.5 percent) had received blood transfusions and 35 of whom (6.7 percent) had not (P less than .001). Exclusion of the right-sided colonic tumors still showed that recurrence was more common in transfused than nontransfused patients (135 [47.2 percent] vs. 25 [22.5 percent]; P less than .001). Recurrence in patients transfused only during surgery (N = 201) was higher than in nontransfused patients (P less than .001) and, similarly, all patients transfused during surgery (N = 297) had an increased risk (P less than .001). Among patients with rectal cancer, transfusion increased the risk of recurrence in those treated by abdominoperineal resection (P less than .02), but this was not the case in those treated by sphincter-saving resection (P = .2). Hierarchical log linear analysis of all dependent factors (Dukes' stage, histologic grade, age, sex, site, elective, or emergency procedure) showed that Dukes' stage and blood transfusion had the most significant effects on the development of recurrence (chi 2 = 54.04, df = 6, P less than .0001 and chi 2 = 13.93, df = 3, P less than .003). The risk of recurrence following curative surgery for colorectal cancer is markedly increased by blood transfusion on the day of operation.

Adult↗
PubMed1989

The detection and evaluation of locally recurrent rectal cancer with rectal endosonography.

Eighty-five patients treated surgically for rectal cancer have been followed up by conventional clinical examination, sigmoidoscopy, and endosonography. Local recurrence was diagnosed in 22 patients. Nineteen of these had either sigmoidoscopic or digital evidence of recurrence and three were diagnosed solely by endosonography. In all cases endosonography gave additional information on which to base management decisions. Routine use of endosonography should allow the detection of early recurrence in a larger number of patients.

Adult↗
PubMed1988

Cardiomyopathy in the Kearns-Sayre syndrome.

The Kearns-Sayre syndrome is a mitochondrial myopathy characterised by ptosis, chronic progressive external ophthalmoplegia, abnormal retinal pigmentation, and cardiac conduction defects. A unique case is reported in which there was rapid development of progressive congestive cardiac failure that required cardiac transplantation. A review of published reports of mitochondrial myopathy shows that a minority of cases (less than 20%) have cardiac involvement. This had previously been limited to abnormalities of cardiac conduction with progressive heart block. Myocardial biopsy has, however, shown ultrastructural evidence of a generalised mitochondrial disorder which hitherto has not been associated with a functional deficit.

Adult↗
PubMed1987

Preoperative staging of local invasion in rectal cancer using endoluminal ultrasound.

Digital examination is the most commonly used method of assessing local invasion in rectal cancer, but it is highly subjective and accuracy is related to surgical experience. The use of transrectal ultrasound in the preoperative staging of rectal cancer has been assessed in 51 patients with histologically proven rectal cancers. Results showed a high degree of correlation when compared with postoperative histopathology (r = 0.91, P less than 0.001). Invasion beyond the muscularis propria was predicted with a sensitivity of 97%, specificity of 92% and predictive value of 97%.

Carcinoma↗
PubMed1986

Pre-operative assessment of local invasion in rectal cancer: digital examination, endoluminal sonography or computed tomography?

Forty-four patients with primary rectal cancers and six patients with benign rectal lesions were examined pre-operatively digitally, with endorectal sonography (ELU) and also computed tomography (CT). Digital examination of the rectal cancers had an overall accuracy of 68 per cent and predicted invasion beyond the muscularis propria with a sensitivity of 68 per cent, specificity of 83 per cent, positive predictive value of 100 per cent and negative predictive value of 46 per cent. In comparison CT had an accuracy of 82 per cent, sensitivity of 86 per cent, specificity of 62 per cent, positive predictive value of 91 per cent and negative predictive value of 50 per cent. ELU was the most reliable indicator of local invasion in rectal cancer when compared with postoperative histopathology with an accuracy of 91 per cent, sensitivity of 94 per cent, specificity of 87 per cent, positive predictive value of 97 per cent and negative predictive value of 78 per cent.

Aged↗
PubMed1986

Endorectal sonography: laboratory and clinical experience in Bristol.

The normal echographic pattern produced by the colon and rectum has been investigated in vitro. Five basic ultrasonic layers or interfaces have clearly been identified; a first echogenic layer produced by the mucosa, then an echopoor layer representing the mucosa and muscularis mucosae, an echogenic layer which was submucosa, echopoor layer which was muscularis propria and an echogenic layer which was either pararectal fat or serosa. The effectiveness of endoluminal ultrasound (ELU) in the pre-operative staging of rectal cancer has been assessed in a group of 67 patients who were also, where possible, graded by digital examination and in some cases computer aided tomography (CT) (33 patients). Digital examination had an overall accuracy of 50% and could predict invasion beyond or confinement to the rectal with an accuracy of 64%. ELU is a highly accurate method for staging local invasion and when compared to post-operative histopathology had an overall correlation coefficient of 0.88 (p less than 0.001) (Rank Spearman). Our overall accuracy was 91% and it could predict invasion beyond the muscularis propria with a sensitivity of 96%, specificity of 94% and positive predictive value of 98%. In the cohort studied by both radiological techniques ELU was more accurate than CT where overall accuracy was 79%, sensitivity was 84%, specificity was 63% and the positive predictive value was 88%.

Humans↗
PubMed1986

The endosonic appearances of normal colon and rectum.

With the increasing use of transrectal sonography, accurate preoperative staging of rectal cancer requires correct identification of the normal ultrasonographic appearances of the colon and rectum. Fifteen rectal and colonic specimens have been studied in vitro to define the normal anatomy. Five distinct ultrasonic layers have been identified; a first echogenic layer that corresponds to the mucosa, a second echopoor layer made up of mucosa and muscularis mucosae, a third echogenic layer that is submucosa, a fourth echopoor layer that is muscularis propria, and a fifth echogenic layer made up of serosa and perirectal fat.

Colon↗
PubMed1985

Smooth muscle proliferation in the hilum of superficial lymph nodes.

A retrospective survey to study hilar smooth muscle proliferation was performed on 410 superficial lymph nodes from 130 patients. Smooth muscle proliferation of variable degree was found in a total of 32 patients, affecting both inguinal and axillary nodes. A slight predominance of inguinal lesions was noted, and a higher proportion of nodes from male patients was affected. The smooth muscle proliferation was not age related nor was it associated with metastatic carcinoma. An association between smooth muscle proliferation and prominent hilar vascularity was found. In individual cases where several nodes had been removed, there was a tendency for more than one node to show smooth muscle proliferation, suggesting that there is a locally acting diffusible aetiological agent. We think the smooth muscle proliferation we have described is of vascular origin, and that it may reflect a previous inflammatory reaction.

Adolescent↗