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Biomedical subjects

J V Lever

Publications and source records attributed to J V Lever.

17 recordsLinked to original sources

Experimental pancreatic cancer in the Syrian hamster: effect of cholecystectomy.

Because cholecystectomy stimulates hypertrophy and hyperplasia in the hamster pancreas, its effect on experimental pancreatic carcinogenesis was studied in this animal model. Forty female Syrian hamsters underwent cholecystectomy, while 40 others underwent sham operations. Two weeks later, 30 hamsters undergoing cholecystectomy and 30 hamsters undergoing sham operations received 4 weekly subcutaneous injections of N-nitroso-bis (2-oxopropyl) amine (BOP) (10 mg/kg). Remaining hamsters (n = 20) received equal volumes of 0.9% saline solution. A further 10 hamsters (controls) underwent no surgery and received no injections. Thirty weeks after the first BOP or saline injection the pancreas of hamsters that had undergone cholecystectomy was only 3% heavier than that of sham-operated animals, and there was no difference in the incidence of pancreatic cancer between BOP-treated hamsters that had undergone cholecystectomy and those that had undergone sham operations. In this study, cholecystectomy had no influence on BOP-induced pancreatic carcinogenesis in the Syrian hamster.

Animals↗

Proliferative and metastatic potential of exfoliated colorectal cancer cells.

Exfoliated colorectal carcinoma cells were obtained by lavage of 27 freshly resected tumor-bearing segments of human bowel with the use of either Hartmann's solution or medium 199. The tumor cells were isolated from the lavage fluid on Nycodenz (Nyegaard, Oslo, Norway) columns. Their proliferative and metastatic potentials were investigated by their ability to incorporate tritiated thymidine ([3H]dThd) and by their ability to form experimental pulmonary tumors following iv injection into immune-deprived stain A mice. Tumor cells from 7 of 12 patients incorporated [3H]dThd as detected by autoradiography of the cells. Pulmonary nodules of colorectal carcinoma were seen in a single mouse after iv injection of tumor cells from 6 of 17 patients and were histologically distinct from spontaneous lung cancers seen in 3 other animals. No tumors were seen in 12 immune-deprived mice receiving tissue culture medium 199 only. Thus exfoliated colorectal carcinoma cells can undergo further division and might give rise to implantation metastases in humans.

Animals↗

Fine needle aspiration cytology.

Fine needle aspiration cytology is an inexpensive, atraumatic technique for the diagnosis of disease sites. This paper describes the technique and illustrates how it may be applied to the management of tumours throughout the body. The limitations of the method, the dangers of false positive reports, and the inevitability of false negative diagnoses are emphasised. In a clinical context the method has much to offer by saving patients from inappropriate operations and investigations and allowing surgeons to plan quickly and more rationally. It is an economically valuable technique and deserves greater recognition.

Abdominal Neoplasms↗

Audit of closed synovial biopsy in the diagnosis of inflammatory joint disease.

In a prospective study, the clinical features and synovial histopathology of 78 patients with joint disease were compared. Nineteen patients had early rheumatoid disease, 19 chronic rheumatoid, 17 chondrocalcinosis or osteoarthritis, 10 persistent monoarthritis and 14 other miscellaneous arthropathies. After semiquantitative assessment of the degree of inflammatory infiltration, increase in vascularity, synovial hypertrophy and ulceration and fibrin deposition biopsies were categorized as either normal, or slightly or severely abnormal. The highest incidence of severely abnormal biopsy was in patients with chronic rheumatoid disease and miscellaneous forms of arthritis. Major histological abnormalities were uncommon in osteoarthritis, chondrocalcinosis and persistent monoarthritis. Generally, histology was of little help in differential diagnosis, but in early rheumatoid disease there was a relationship between the clinical degree of knee joint disease and the category of histological change. In these patients, general disease activity was reassessed at least 18 months after biopsy. All those with severely abnormal biopsies had persistent or severe persistent rheumatoid disease, whereas 3 of the 4 patients with normal biopsies had no evidence of active synovitis.

Arthritis↗

Direct vision brush cytology with colonoscopy: an aid to the accurate diagnosis of colonic strictures.

The accuracy of direct vision brush cytology at colonoscopy was compared with colonoscopic biopsies, colonoscopy alone and radiology in the diagnosis of colonic strictures. There were 82 brushings in 79 patients; 55 had malignant and 24 had benign lesions. Cytology was correct in 66 (81 per cent), and biopsy was less accurate with 53 (68 per cent) correct reports. The combined accuracy of cytology and biopsy was 88 per cent. Whilst an endoscopic diagnosis was usually correct (96 per cent), direct vision brush cytology had an important place in the accurate tissue diagnosis of colonic strictures, particularly those in the rectosigmoid.

Barium Sulfate↗

Complete heart block in rheumatoid arthritis.

We report 8 cases of complete heart block (CHB) occurring in patients with rheumatoid arthritis and review 20 similar patients previously reported. Complete heart block occurs generally in patients with established erosive nodular rheumatoid disease. It usually appears to be sudden and permanent, but progression from minor conduction delays is not uncommon. The characteristic histopathological finding is a rheumatoid granuloma in or near the AV node or bundle of His. If syncope or Stokes-Adams attacks occur, the treatment of choice is the insertion of a permanent pacemaker. The prognosis is good provided no other cardiac lesions occur, whether pericardial, valvular, or myocardial.

Adult↗

Total body irradiation as a secondary therapy in non-Hodgkin's lymphoma.

Twenty-six patients with non-Hodgkin's lymphoma have received total body irradiation (TBI) as a secondary therapy. A response was achieved with 17 patients, in six of whom it was complete. The actuarial survival rates were 50% at one year and 42% at 30 months. Best results were achieved in those with low grade histology and in those under 60 years of age. Transient marrow toxicity was the only detected significant side-effect of treatment and although it was usually severe there were no serious sequelae. TBI should be considered as a secondary therapy in non-Hodgkin's lymphoma, regardless of previous treatment.

Adult↗

Primary malignant lymphoma of the heart. Antemortem cytologic diagnosis.

A case of primary malignant lymphoma of the heart diagnosed cytologically is reported. The patient presented with pericardial tamponade and ventricular arrhythmias and developed rapidly progressive and intractable cardiac failure. Two-dimensional echo-cardiography, which demonstrated the pericardial effusion, showed progressive impairment of the left ventricular contraction. The pericardial fluid contained malignant lymphoid cells. Despite vigorous treatment and chemotherapy, the patient died within 15 days; postmortem examination showed malignant lymphoma confined to the myocardium.

Cytodiagnosis↗

Needle aspiration in pathology.

Fine needle aspiration biopsy cytology is a simple technique for the outpatient diagnosis of subcutaneous malignancies. It is most useful for breast tumours but is also an aid in the clinical assessment of thyroid, salivary glands and lymph nodes and with the use of a special needle, the prostate. This paper describes the technique, briefly reviews the criteria for malignancy, the dangers of false positive and the inevitability of false negative results. Nevertheless in a clinical context, it is a useful technique that helps clinicians and their patients.

Biopsy, Needle↗