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Biomedical subjects

J Trowell

Publications and source records attributed to J Trowell.

At least 19 recordsLinked to original sources
PubMed1985

Histological features of sclerosing cholangitis in patients with chronic ulcerative colitis.

Primary sclerosing cholangitis was diagnosed radiologically in 16 of 681 patients (2.2%) with chronic ulcerative colitis in a follow up study at the gastroenterology unit in Oxford. On the basis of established histological criteria, the liver biopsy was considered diagnostic in only half of the cases. The histological findings in these cases were therefore reassessed to determine whether the accuracy of biopsy diagnosis could be improved. The most common specific histological feature was periductal concentric fibrosis of small interlobular bile ducts, even in the absence of inflammation. Other common features were bile ductular proliferation associated with diminution or absence of interlobular bile ducts. Degeneration of bile duct epithelium and diffuse infiltration of portal tracts by mononuclear cells and polymorphonuclear leucocytes were accompanying features. Piecemeal necrosis without rosette formation was found in about half the biopsies. When all these features were considered together a biopsy diagnosis of primary sclerosing cholangitis was established in 14 of 16 cases.

Adult↗
PubMed1982

Coronary disease.

Explore the source record for details and available documents.

Coronary Disease↗
PubMed1982

Possible effects of emergency caesarian section on the mother--child relationship.

This study was a pilot project to explore the mother-child relationship in a group of mothers delivered by emergency caesarian section and to compare them with a control group of mothers delivered by normal vaginal delivery. The mothers delivered by caesarian section had a period of amnesia after the birth so that their recollected first contact with their baby was later than the control group and at one month the mothers delivered by caesarian section had much less eye-to-eye contact with their baby. There were differences in attitudes and behaviour between the caesarian and control group of mothers at one month and at one year. The mothers delivered by caesarian section had more doubts about their capacity to care for their babies, were more depressed with symptoms and felt their babies did not become a person until later. There were no differences between the two groups of children in general behaviour and development although the babies delivered by caesarian section were larger and this difference persisted through to one year. This caesarian group of mothers found adjusting to the birth of their first baby and parenthood more difficult than the control group of mothers.

Adult↗
PubMed1981

HLA A and B locus antigens in patients with unexplained hepatitis following halothane anaesthesia.

HLA A and B locus antigens were determined in 17 patients who had recovered from unexplained hepatitis following halothane anaesthesia. The greatest deviations from expected frequencies were observed with A1, A11 and BW22, but these differences were not statistically significant when the P values were corrected for the number of antigens tested. Although a larger series might show such deviations to be significantly different, HLA typing is of no predictive value in determining those at risk to hepatitis following repeated halothane exposure.

Adult↗
PubMed1978

Hyperpigmentation of pernicious anemia in blacks. Report of three cases.

We investigated three black women who had anemia and skin hyperpigmentation. They were found to have pernicious anemia (PA) and normal adrenal functions. To our knowledge, this is the first report of skin hyperpigmentation of PA in black patients. This report reemphasizes the similarities in clinical features of PA and Addison's disease.

Addison Disease↗
PubMed1976

Alpha-1-antitrypsin deficiency and liver in adults.

Thirteen adult patients (aged 16 to 73 years) form 12 families are described with liver disease and alpha- 1- antitrypsin deficiency. Long-term observation of several of these patients suggests that the liver disease may be only slowly progressive, but review of possible factors aggravating this has failed to reveal any obvious clues. Progression to death from hepatic failure was the commonest outcome, but one patient developed a malignant hepatoma and two others died because of intraperitoneal haemorrhage due to ruptured cirrhotic nodules--a complication not hitherto described in association with this condtion. Diagnosis of alpha-1-antitrypsin deficiency was based on serological, histological, immunopathological and genetic studies. The most useful screening test in liver disease was found to be the demonstration of PAS positive globules in liver biopsy material which is diagn by immunofluoresence or immunoperoxidase, the latter being a superior technique. Serum estimation of alpha-1 -antitrypsin deficiency was performed by immunoelectropharetic and immunodiffusion techniques, the former being preferred because it gave more consistent results. Both methods, however, were of limited value since wide variations in the serum values are commonly found in normal and abnormal states. Genotyping was carried out using starch gel electrophoresis and although of value in family studies, its value as a diagnositc aid is limited because of technical difficulties and also because alpha-1-antitrypsin accumulation in the liver may be found in both homozygous and heterozygous states. It is suggested that adult liver disease associated with abnormalities in alpha-1-antitrypsin may be more common than has hitherto been reported. This condition should be systematically sought in all cases of liver disease of uncertain aetiology.

Adolescent↗
PubMed1975

Controlled trial of repeated halothane anaesthetics in patients with carcinoma of the uterine cervix treated with radium.

39 patients with carcinoma of the uterine cervix who were treated with radium and required repeated general anaesthetics were randomised to halothane and control groups. Their serum-alanine-aminotransferase (S.G.P.T.) levels were measured before each general anaesthetic, and those patients whose S.G.P.T. levels rose above 100 I.U. per litre were freed from the restriction determined by the initial allocation and treated as indicated clinically. None of the 21 patients in the control group had S.G.P.T. levels rising above 100 I.U. per litre. 4 out of 18 patients in the halothane group developed S.G.P.T. levels above 100 i.u. per litre before their third radium treatment. None of these had any symptoms or alteration in other liver-function tests, but liver biopsies in 2 of these patients showed changes characteristic of Hepatitis. Arbitrary selection of 18 out of the 39 patients would only give rise to the degree of abnormality observed in the halothane-treated group with a probability of about 0-02. In the patients studied who required repeated general anaesthetics at short time intervals, the monitoring of S.G.P.T. levels before each operation was useful screen for liver damage and may have reduced postoperative hepatic necrosis by preventing further anaesthetics with halothane when the liver was already damaged.

Adult↗