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Biomedical subjects

M Hobsley

Publications and source records attributed to M Hobsley.

At least 19 recordsLinked to original sources
PubMed1992

Smoking predisposes to parotid adenolymphoma.

Of 574 patients with previously untreated, unremarkable parotid lumps, 194 proved to have pleomorphic adenomas and 73 adenolymphomas. ABO blood group details were available in 59 and 85 per cent of patients respectively. Smoking details were available in 84 per cent of a randomly chosen 46 per cent subgroup of patients with pleomorphic adenomas and in 86 per cent of all those with adenolymphomas. The incidences of smoking and of the ABO blood groups in these two diagnoses were compared with standard sources. There was no evidence that either histological diagnosis of parotid tumours was linked to an abnormal pattern of ABO blood groups. However, there was a much greater incidence of smoking among the adenolymphoma than in the pleomorphic adenoma group: only one of 63 patients with adenolymphoma as opposed to 31 of 75 with pleomorphic adenoma had never smoked, while the mean number of cigarettes smoked by each patient with an adenolymphoma was estimated to be 300,000 as opposed to 80,000 for those with pleomorphic adenoma.

ABO Blood-Group System↗
PubMed1992

Eicosanoid synthesis in duodenal ulcer disease: decrease in leukotriene C4 by colloidal bismuth subcitrate.

The release of immunoreactive prostaglandin E2 (PGE2) and leukotriene C4 (LTC4) from antral and duodenal mucosal biopsy specimens taken from 20 patients with duodenal ulcer disease was measured by radioimmunoassay before and four weeks after treatment with colloidal bismuth subcitrate. Gastroscopic and histological examination showed complete ulcer healing in 15/18 patients and duodenal histology looked normal (n = 15) or improved (n = 3): two patients failed to attend for a second endoscopy. Analysis of the supernatant from incubations of biopsy tissue in vitro showed that unstimulated antral release of PGE2 was significantly more than that from the duodenal mucosa (p less than 0.05), whereas basal release of LTC4 was significantly lower from antral biopsy specimens (p less than 0.05). Subsequent incubation of specimens with calcium ionophore A23187 caused an increase in LTC4 but not in PGE2 generation. The ability of antral and duodenal mucosa to form ionophore mediated LTC4 in patients with duodenal ulcer disease was significantly greater (p less than 0.05; p less than 0.01 respectively) than that of normal gastroduodenal mucosa. After colloidal bismuth subcitrate treatment, basal synthesis of PGE2 was unchanged in duodenal and antral specimens. In contrast, basal duodenal LTC4 was reduced (p less than 0.05), and the capacity for ionophore mediated duodenal LTC4 formation was substantially and significantly reduced after treatment (p less than 0.001). These results indicate that after therapeutic healing of duodenal ulcer (accompanied by clearance of inflammatory cell infiltrate), there is a reduced ability of duodenal mucosa to generate proinflammatory peptidoleukotrienes.

Adult↗
PubMed1992

Effect of acute cigarette smoking on gastric secretion.

The effects of smoking one cigarette on a plateau of submaximal gastric secretion induced by histamine acid phosphate (16 nmol kg-1 h-1 (0.005 mg kg-1 h-1)) were measured in eight normal volunteers and in eight duodenal ulcer subjects. The rate of secretion in both groups fell by 25% without any statistically significant change in pyloric loss or duodenogastric reflux. It is concluded that smoking reduces gastric secretion. The possibility that relative antral hypoacidity induced by regular smoking produces an increase in parietal cell mass via a feedback mechanism mediated by gastrin is discussed: such a mechanism would explain the previously reported positive correlation between maximal gastric secretion of acid and the total dose of cigarettes.

Adult↗
PubMed1991

Further evaluation of radical surgery following radiotherapy for advanced parotid carcinoma.

A series of 30 patients who have been treated for advanced carcinoma of the parotid gland using radiotherapy followed by radical surgery is presented. Three patients deteriorated during preoperative radiotherapy and remained unfit for surgery; the remaining 27 underwent radical parotidectomy with block dissection of the neck. Twelve patients received additional radiotherapy after operation. Of those patients undergoing surgery, three have been lost to follow-up, 17 have died and seven remain alive; the period of follow-up ranges from 3 to 133 months. Fourteen patients remained free of recurrent disease at death or when last seen, and six patients developed a local recurrence at a medium period of 10.5 (range 3-36) months after surgery. For all 30 patients, the cumulative proportion surviving for 5 years was 30 per cent.

Adult↗
PubMed1991

Risk of strangulation in groin hernias.

Although the elective repair of groin hernias is advised to prevent strangulation, the likelihood of this complication occurring is unknown. To quantify this risk, the cumulative probability of strangulation in relation to the length of history has been calculated for inguinal and femoral hernias presenting to this hospital between 1987 and 1989. Of 476 hernias (439 inguinal, 37 femoral), there were 34 strangulations (22 inguinal, 12 femoral). After 3 months the cumulative probability of strangulation for inguinal hernias was 2.8 per cent, rising to 4.5 per cent after 2 years. For femoral hernias the cumulative probability of strangulation was 22 per cent at 3 months and 45 per cent at 21 months. The rate at which the cumulative probability of strangulation increased was in both cases greatest in the first 3 months, suggesting that patients with a short history of herniation should be referred urgently to hospital and given priority on the waiting list.

Adolescent↗
PubMed1991

Postgastrectomy osteoporosis.

Osteoporosis is a recognized complication following partial gastrectomy and is more common than osteomalacia. Recent improvements in the measurement of bone mineral status (dual energy X-ray absorptiometry, DEXA) have assisted in measuring osteoporosis. Sixteen men who had undergone gastrectomy more than 30 years previously were examined. This study reports the effect of calcium supplementation in six patients in whom osteomalacia had been excluded and who showed abnormally low bone mineral densities on DEXA scanning. Calcium supplementation for 6 months (microcrystalline hydroxyapatite, Ossopan 8-32 g per day) produced no significant advantage for the treatment group at any site measured.

Absorptiometry, Photon↗
PubMed1990

Unremarkable parotid tumours that prove to be malignant.

Of 539 patients with clinically unremarkable lumps treated by formal parotidectomy, subsequent histological examination indicated that 20 of these lesions were malignant. After a follow-up of 1-18 years, only one patient has suffered a recurrent tumour and none has died from disease related causes. The results indicate that formal parotidectomy is an acceptable means of treating the small number of malignant tumours presenting in this way, and strengthen the argument that attempts to obtain a histological diagnosis before treatment are contraindicated.

Humans↗
PubMed1990

Abdominal wall pain: an alternative diagnosis.

The cause of abdominal pain need not necessarily reside in the viscera; the abdominal wall is another source of symptoms. Some causes of abdominal wall pain are obvious, e.g. hernias, but not so others such as nerve entrapment syndromes. This review is concerned with causes of abdominal wall pain which, although common, may be easily overlooked.

Abdominal Muscles↗
PubMed1989

Recognition and treatment of abdominal wall pain.

In some patients with abdominal pain, the source of the pain may be the abdominal wall. A simple test is described which allows these patients to be identified and treated with injections of local anaesthetic and steroid. Twenty-six patients were studied, 20 of whom were available for follow-up. Sixteen of these 20 were symptom free or improved at a median follow-up period of 29 months. Failure to recognize abdominal wall pain may lead to unnecessary investigation.

Abdominal Muscles↗
PubMed1979

Dysphagia following selective vagotomy.

Progression of dysphagia after vagotomy to the stage of complete obstruction due to a peri-oesophageal fibrotic collar needing operation is a rare event. Review of the 4 such cases previously described, all needing further operation and all after truncal vagotomy, indicates that the oesophageal mucosa was normal on oesophagoscopy and that bouginage appeared to make the condition worse. This paper describes the first patient in whom (a) the vagotomy was selective and (b) no bouginage was carried out before the condition was relieved by a further surgical operation.

Deglutition Disorders↗
PubMed1979

Recurrent unilateral swelling of the parotid gland.

The clinical features of 109 patients with recurrent unilateral parotid swelling (24 patients with Sjögren's disease were excluded) have been analysed to explore the best system of management. The cause was definitely a parotid duct calculus in 36 patients, and evidence is presented that the same diagnosis probably applied to another 59 patients. Features suggesting a diagnosis of calculus included age (greater than 29 years); duration of the attacks of pain (less than 24 hours); cessation of salivation on the affected side; and a spurt of saliva heralding the relief of symptoms. Only three patients in the definite calculus group (8.3%) had no physical signs. However, had physical examination not included inspection and palpation of the parotid duct and its orifice from within the mouth 75% of the proven calculi would have been missed. The intraoral and anteroposterior plain radiographs are likely to be helpful, and sialography even more so. A sialographic appearance of a stricture in the main duct with proximal dilatation is usually due to a claculus. It would appear that calculi are the cause of recurrent unilateral parotid swelling (after exclusion of Sjögren's disease) in an overwhelming proportion of patients with this symptom.

Adult↗