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Biomedical subjects

K C Simpkins

Publications and source records attributed to K C Simpkins.

30 records · Page 2Linked to original sources
PubMed1977

A controlled comparison one- and two-layer techniques of suture for high and low colorectal anastomoses.

A controlled trial of one- and two-layer inverting techniques of sutures for the contruction of high and low colorectal anastomoses was conducted on 137 patients, the integrity of the suture lines being assessed clinically and by routine radiological examination after a small Gastrografin enema. A clinical diagnosis of anastomotic leakage was made in 9 patients (or perhaps more accurately in 5 only), but subclinical dehiscence was demonstrated radiologically in a further 39 patients (or perhaps 43). There was a slightly greater incidence of dehiscence after the one-layer technique of suture for both high and low anterior resection.

Clinical Trials as Topic↗
PubMed1977

Aphthoid ulcers in Crohn's colitis.

Aphthoid ulceration is a strong indication and the earliest radiographic sign of Crohn's colitis. These small discrete ulcers were found by double contrast barium enema examination in 40 out of 91 patients with Crohn's colitis. Seen en face each ulcer appears as a central fleck of barium surrounded by a translucent halo set amidst a patch of normal mucosa. Their detection gives a more accurate assessment of the extent of disease. This information is required in order to plan medical or surgical treatment and can only be provided by meticulous double contrast examination or colonoscopy. Aphthoid ulceration has been demonstrated prior to the onset of bowel symptoms, and several years before the advent of severe colonic disease. The appearance of aphthoid ulcers in established quiescent disease has been observed to herald a relapse. The radiographic demonstration of the evolution of ulceration, which is illustrated, closely reflects what is seen on macroscopic examination of excised specimens and explains the characteristic patchiness and discontinuity of disease.

Barium Sulfate↗
PubMed1975

The definition of radiological signs in gastric ulcer and assessment of their validity by inter-observer variation study.

The initial aim was to program a computer with information on the frequency of radiological signs in benign and malignant gastric ulcers in order to obtain a percentage probability of benignancy or malignancy in succeeding ulcers in clinical practice. However, only four of the many signs described in gastric ulcer were confirmed to be of validity (i.e. reliable existence) by an inter-observer variation study using two observers and the films from 69 barium meal examinations. These were projection or non-projection of the in-profile ulcer, presence or absence of adjacent mucosal folds, good or poor definition of the in-face ulcer's edge, and extension of radiating folds to the in-face ulcer's edge. A few more remained unassessed due to insufficient numbers of relevant cases. It is condluced that: as defined in the literature the majority of radiological signs in this field are of uncertain existence; and the four that were found to be valid do not fully describe the important appearances that may be seen in benign and malignant ulcers and would be inadequate to differentiate them to a sufficiently high degree of probability.

Diagnosis, Computer-Assisted↗
PubMed1975

The accuracy of radiological diagnosis of benign, primarily and secondarily malignant gastric ulcers and their correlation with three simplified radiological types.

Two radiologists individually gave 'blind' diagnoses of benignancy or malignancy to 145 radiographic representations of gastric ulcers, all with gastrectomy histological proof of benignancy or malignancy. A radiological diagnosis of malignancy was shown to be 98-6% reliable. A diagnosis of benignancy was less reliable (85-4% true positives) but this was a surgical series containing thereby an abnormally high proportion (over a third) of malignant ulcers. A correct diagnosis was mde in 99-5% of the proven benign ulcers, but in only 68-6% of the proven malignant ulcers. Analysis of the pathology reports on the malignant ulcers has shown that it was mainly those arising on the basis of pre-existing benign ulcers (i.e. secondarily malignant ulcers) that were wrongly diagnosed radiologically, thus suggesting that they have fundamentally different radiographic appearance from that of primarily malignant ulcers. It was then found that the ulcers could be divided into three simplified radiological types based on their in-profile appearances: type 1 (projecting), type 2 (intraluminal) and type 3 (so shallow as to be neither projecting nor intraluminal). Statistical association with the histological types led to the following conclusions: (a) radiological type 2 or 3 ulcers should be diagnosed as almost certainly malignant (usually primarily malignant) and (b) radiological type 1 ulcers are almost always benign but should be followed up until healed because the rare secondarily malignant ulcers are also usually of this type.

Diagnosis, Differential↗