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Biomedical subjects

M Stuart

Publications and source records attributed to M Stuart.

At least 19 recordsLinked to original sources
PubMed1992

Colonoscopy in patients with a family history of colorectal cancer.

Since 1982 it has been the second author's policy to advise all patients who have presented with a positive family history of bowel cancer and who are over the age of 30 years to undergo colonoscopy. In the period to August 1990, 600 such patients had at least one colonoscopy. Colorectal polyps or cancer were detected in 270 patients (45 percent). The incidence was essentially the same for the 171 patients with only second-degree relatives affected (43 percent), for the 194 patients with more than one affected relative (45 percent), and for the 429 patients with an affected first-degree relative (46 percent). Only the 55 patients with more than one affected first-degree relative had a higher incidence (67 percent). The incidence in the 136 totally asymptomatic patients was 36 percent but was 48 percent in the 464 with symptoms. In 37 patients carcinoma was diagnosed. Even in the 30- to 39-year age group there was a 29 percent incidence of polyps or carcinoma. Colonoscopic screening of patients with a family history of bowel cancer compares favorably with mass screening for breast cancer. It is currently advised that all patients over 30 years of age with a family history of colorectal cancer undergo colonoscopy on presentation and, if clear, every four years thereafter unless two first-degree relatives are affected, when it should be every two years.

Adult↗
PubMed1992

Beginning reading with phonology.

Seymour & Elder (1986) investigated the reading of children in the first year of school and suggested that the first stage of learning to read shows little involvement of assembled phonology. The present study examines processes involved in the reading-aloud and printed-word comprehension of children in the second year of school. Use of assembled phonology was evident in the children's reading-aloud responses, and proficiency in its use was related to reading ability. Printed-word comprehension appeared to involve prior retrieval of a phonological code for less frequent words. Similarities between the processing systems for reading used by these children and by skilled readers were discussed, and related to the computational model of reading development proposed by Seidenberg & McClelland (1989).

Child↗
PubMed1979

Fibreoptic colonoscopy. Indications, results and complications.

Fibreoptic colonoscopy was commenced in the Edward Wilson Colon and Rectum Unit at Sydney Hospital in June, 1973. The experience of the first five years of its use is reported. Six hundred and twenty-six examinations have been performed in 568 patients. Fibreoptic colonoscopy has been of particular value in the diagnosis and treatment of colonic polyps. A total of 318 polyps were removed from 184 patients. Their distribution, size and histological features are recorded. Eight complications occurred in the 628 examinations (1.6%). There were six colonic perforations (1.2%) with one death, and two significant haemorrhages (0.4%). This incidence of complications is acceptably low, especially in view of the great benefits obtained by the patient from fibreoptic colonoscopy. The newer instruments, especially the medium length Olympus MB3 colonoscope, have greatly facilitated the examination and, combined with increasing experience, may significantly lower the incidence of complications in the future.

Adolescent↗
PubMed1979

Peritoneal nocardiosis: report of a case.

A case of primary peritoneal nocardiosis is presented. The patient died, despite prompt, aggressive and appropriate antibiotic therapy. Decreased patient resistance is suggested as the cause of the overwhelming nature of the infection in this case. The importance of administering prophylactic antibiotics on a long-term basis to prevent recurrence after successful treatment is stressed. Although nocardial infections are rare, they may become more common because of the current widespread use of immunosuppressive therapy.

Anti-Bacterial Agents↗
PubMed1979

Elective resection for diverticular disease.

A series of 119 patients undergoing elective resection for diverticular disease has been reviewed. The indications for resection were classified into two major groups--those with severe infections ("complicated" diverticulitis), comprising 58 patients, and those with minimal infections, comprising 61 patients. The majority of the resections were limited to the sigmoid colon (101 patients). Fifteen patients underwent left hemicolectomy, whilst three had total colectomy. Thirty-six patients (30%) had a proximal defunctioning stoma--18 prior to resection and 19 at the time of resection. Anastomotic defects were noted in 15 patients (12.6%), but these were of clinical significance only in eight (6.7%). There were two deaths (1.7%) and 17 wound infections (14.3%). The group classified as "complicated" diverticulitis included the great majority of the patients requiring colostomy (32 out of 37), almost all those with anastomotic defects (14 out of 15), and most of the patients who had postoperative complications.

Acute Disease↗
PubMed1979

Rectal prolapse.

One hundred and twenty-seven patients with complete rectal prolapse have been reviewed. The condition occurred more commonly in females than males (105 to 22), and at an older age in females (mean age 55 years compared with 40 years for males). Although the diagnosis is usually obvious, the importance of recognizing occult prolapse is stressed, especially in association with benign rectal ulcer, localized proctitis and colitis cystica profunda. Examination of the patient in the squatting position may assit in showing occult prolapse. Associated incontinence occurred in 33 patients (26%). Since 1971 the policy of this Unit has been to perform a Ripstein repair for complete rectal prolapse wherever possible. One hundred and two Ripstein repairs have not been performed. A minimum follow-up period of two years is available for 53 patients, of whom 50 (94%) have had their prolapse cured. Control of prolapse usually improves continence; however, seven (13%) remained incontinent despite surgery. The Ripstein repair is strongly advocated as the most effective operation for cure of complete rectal prolapse.

Adolescent↗
PubMed1979

Ileostomy reconstruction.

A study of 47 patients undergoing ileostomy reconstruction is presented. The most common indications were recession (15 patients) and a desire for a continent type of ileostomy (12 patients). Less frequent indications were stenosis (6 patients), parastomal ulceration (6 patients), prolapse (4 patients), unsatisfactory siting (3 patients), and parastomal hernia (1 patient). Refashioning of the ileostomy at the same site was possible in 17 patients, whilst repositioning at a new site was required in 30 cases. In 28 of these laparotomy was carried out to enable repositioning, but in two cases resiting was performed without laparotomy. After the original operation, reconstruction may become necessary at any time from a few months to over 20 years.

Adolescent↗
PubMed1979

The surgical treatment of anal incontinence.

This study is review of 31 patients undergoing surgery for anal incontinence. Three groups of patients are defined--those with incontinence due to trauma (nine patients), to a combination of trauma and degeneration (five patients), and to degeneration alone (17 patients). Two surgical techniques were used--either a direct repair of the anal sphincter or a postanal repair of the levator ani muscles and external sphincter (Parks operation). In the trauma group and the combined group the more common method used was a direct repair (ten patients)--five underwent a Parks operation. In the degeneration group all but one patient underwent a Parks operation. A defunctioning proximal colostomy was carried out in only four patients--all with incontinence due to trauma. Satisfactory continence was restored in 80% of these patients. Although this is a small series, the results are considered worthwhile and greater awareness and use of the above technique is recommended.

Adult↗
PubMed1978

The value of delayed primary wound closure in colonic and rectal surgery.

The technique of delayed primary wound closure was employed in 82 out of 100 consecutive colorectal operations. Problems with wound healing occurred in seven patients, but in only three of them was it a wound infection. The value of delayed primary wound closure has been demonstrated by this low rate of wound infection (3.7%).

Colonic Diseases↗
PubMed1978

Activation of the carcinogen N-hydroxy-2-acetylaminofluorene by rat mammary peroxidase.

A peroxidase preparation from rat mammary gland parenchymal cells, a target tissue of arylamine carcinogens, was shown to activate the carcinogen N-hydroxy-2-acetylaminofluorene via a nitroxyl free radical intermediate to the more active carcinogens nitrosofluorene and N-acetoxy-2-acetylaminofluorene. Hydrogen peroxide, cumene hydroperoxide, and linoleic acid hydroperoxide were effective as substrates. The antioxidants ascorbate, propyl gallate and reduced glutathione prevented the free radical activation route.

Animals↗
PubMed1978

Prophylactic administration of low-dose heparin in colorectal surgery.

A retrospective study of 192 patients operated on by three members of the Edward Wilson Colon and Rectum Unit, Sydney Hospital, was carried out. All operations performed involved dissection within the pelvis. Prophylactic administration of low-dose heparin was used for 71 of these patients. The incidences of clinical thromboembolic disease were 7 per cent in both the group receiving heparin and the other group. In slightly more than half of the patients, pulmonary emboli occurred in the absence of peripheral deep venous thrombosis. It is suggested that the source of these emboli was thrombosis arising in the pelvic veins.

Colon↗
PubMed1976

Colostomy irrigation: its role in improving the colostomate's quality of life.

The wider use of the irrigation technique for the management of the permanent colostomy has previously been advocated. The results of its use in a group of 10 colostomates followed more than two years is discussed. As more than half of these colostomates have been able to resume a normal life after beginning colostomy irrigation, a further plea is made for a better understanding of the technique and the advantages that it offers.

Colostomy↗
PubMed1976

Biogenic amine control of growth hormone secretion in the fetal and neonatal rat.

The development of the hypothalamic-pituitary axis for growth hormone (GH) secretion has been studied in the rat fetus and in the neonate 4, 24, 48 and 72 h after birth. Injections of the serotonin blocker cyproheptadine (Cypro) and a catecholamine, dopamine (DA), each led to reductions in the level of serum GH in 21 to 22 day fetuses and in neonates up to 3 days after birth. The O-methylated derivative of dopamine, dimethoxyphenylethylamine (DMPEA), did not alter serum GH levels from those seen in saline-treated control animals. These results indicate that biogenic amines exert control over GH secretion in the fetus, close to term, and in early neonatal period. They suggest that this control is similar to that seen in the adult rat and in man and that such control may operate through serotonin receptors.

Animals↗
PubMed1976

Lipid hydroperoxide activation of N-hydroxy-N-acetylaminofluorene via a free radical route.

The data presented here demonstrate that linoleic acid hydroperoxide in the presence of methemoglobin or hematin activated the carcinogen N-hydroxy-N-acetyl-2-amino-fluorene via the nitroxyl free radical intermediate into 2-nitrosofluorene and N-acetoxy-N-acetyl-2-aminofluorene. Ascorbate inhibited the activation, in which case the free radical intermediate was replaced by the ascorbate free radical. On the basis of optical kinetics, we have established that the rate of linoleic acid hydroperoxide decrease paraleled the rate of N-hydroxy-N-acetyl-2-aminofluorene decrease and also the rate of 2-nitrosofluorene increase. The stoichiometry of the reaction was such that, for every 2 linoleic acid hydroperoxide molecules consumed, 2 N-hydroxy-N-acetyl-2-aminofluorene molecules were oxidized and 1 2-nitrosofluorene and 1 N-acetoxy-N-acetyl-2 aminofluorene molecule was formed.

Ascorbic Acid↗