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P J Barratt

Publications and source records attributed to P J Barratt.

10 recordsLinked to original sources
PubMed1996

Invasive intestinal spirochetosis: a report of three cases.

We here report on three patients with gastrointestinal symptoms in whom spirochetes were found in colonic biopsies. The patients, heterosexual adults, were not immunocompromised. Electron microscopy was performed on colonic biopsies from each of the three patients. Apart from the basophilic band consisting of spirochetes, the mucosa was normal in two patients on light microscopy and showed mild inflammation in the other one. However on electron microscopy there was invasion of the colonic epithelial cells, macrophages, goblet cells and Schwann cells by spirochetes, and stunting of the microvilli. The spirochetes conformed to the morphology of Brachyspira aalborgi, and no other infective etiology or pathology could be identified in these patients to account for their symptoms. Since the clinical significance of intestinal spirochetosis is uncertain, antibiotics were not administered to any of the three patients and all three improved symptomatically with non-specific treatment. Intestinal spirochetosis, previously thought to be non-invasive and non-pathogenic in humans, may be invasive and may be the cause of gastrointestinal symptoms in some patients.

Adult↗
PubMed1988

Assessment of inflammatory bowel disease activity by technetium 99m phagocyte scanning.

Autologous technetium 99m-labeled phagocyte scanning has been used to assess disease activity in inflammatory bowel disease in 51 consecutive patients. Strong correlations were found between the 24-h fecal excretion of isotope and the histologic score of mucosal biopsy specimens (rS = 0.84, p less than 0.001, where rS is Spearman's rank correlation coefficient), and between the 24-h fecal excretion of isotope and a clinical inflammatory bowel disease activity index based on the Crohn's disease activity index (rS = 0.87, p less than 0.001). To develop a clinically useful and objective measure of inflammatory bowel disease activity that did not require a 24-h stool collection, the intensity of bowel uptake on scanning was graded visually from 0 to 4, a ratio of count rates for the region of interest to the iliac crest reference region was calculated, and the rapidity of labeled phagocyte uptake into inflamed bowel was measured as the peak uptake time. Visual grading of disease activity on the scans was validated by comparing it with the ratio of count rates from inflamed bowel regions of interest and those from the iliac crest reference region. The ratio of count rates showed a significant correlation with the clinical disease activity index (r = 0.75, p less than 0.001). The visual scan grade also correlated well with the clinical activity index (r = 0.87, p less than 0.001). Count rates from hourly scans were also used to calculate the time of peak uptake of counts for a given region of interest. There was a strong negative correlation between this peak uptake time and the fecal excretion of isotope (rS = -0.81, p less than 0.001), a clinical activity index (r = -0.60, p less than 0.001), and the histologic score of the mucosal biopsy specimens (r = -0.84, p less than 0.001). These results indicate that the technetium 99m-labeled phagocyte scan provides an objective assessment of disease activity in inflammatory bowel disease using the visual scan grade, ratio of count rates for the region of inflamed bowel, or by the peak uptake time, thereby avoiding the problems associated with fecal collections. This scanning test may prove to be of significant value in clinical management and in the assessment of treatment response.

Adolescent↗
PubMed1988

Ulcerative colitis--a disease characterised by the abnormal colonic epithelial cell?

The leakiness of the cell membranes of colonic epithelial cells isolated by the collagenase/Dispase technique from normal or diseased colons was assessed in a 4 h 51Cr release assay. Cells from normal, adenoma bearing or cancer bearing colons showed 51Cr release of 8% or less in almost all of 46 cell populations tested. In contrast, cells from mucosa affected by ulcerative colitis [11.9 (4.3%) n = 23] or Crohn's disease [8.4 (2.7%) n = 18] released significantly more 51Cr than the non-inflamed groups. Values are expressed as mean (SD). Overall, release values were greater in ulcerative colitis than Crohn's disease (p less than 0.01). In Crohn's disease, cells obtained from histologically inflamed mucosa released significantly more 51Cr [9.7 (2.5%) n = 11] than those from non-inflamed mucosa [6.4 (1.5%) n = 7, p less than 0.02] whereas, in ulcerative colitis, abnormal release values were found in 8 of 13 cell populations isolated from mucosa showing no histological evidence of active disease. In five patients with distal ulcerative colitis, cells from mucosa not apparently involved demonstrated normal 51Cr release in four of five studies despite abnormal release from cells from involved mucosa suggesting that a diffuse abnormality of the colonic epithelial cell is not usually present. These data indicate that chronic mucosal inflammation per se is associated with abnormalities of the colonic epithelial cell but that, in ulcerative colitis, the abnormality remains in many patients with quiescent disease. Identification of the local factors responsible for such an abnormality may contribute to an understanding of the pathogenesis of ulcerative colitis.

Adolescent↗
PubMed1987

Fetal death associated with a t(1;14) in three generations.

Fetal death is a common phenomenon; parental chromosome study may uncover the cause of the problem and contribute to the management of the couple involved. Discovery of a translocation provides a firm basis for genetic counseling, detection of carriers, and prenatal diagnosis. We have studied a young couple with a history of 4 consecutive spontaneous abortions before cytogenetic study demonstrated the father to carry a t(1;14). The translocation was found in 2 other adults, a liveborn child, and a fetus, in a total of 3 generations.

Abortion, Habitual↗
PubMed1982

Early gastric cancer.

Sixteen patients with early gastric cancer (carcinoma which is confined to mucosa and submucosa) are described. Despite a long duration of symptoms and frequently large tumour surface areas, lymph-node metastasis occurred in only one patient. Findings of endoscopic biopsy were more accurate (100%) than endoscopic (75%), radiological (50%), or clinical features in diagnosing malignancy. However, only an average of 58% of biopsy specimens demonstrated cancer, which emphasises the need for multiple biopsies. After resection, no deaths due to cancer occurred during a mean follow-up period of 28 months. Endoscopy, plus carefully directed biopsy when a lesion is found, should be performed in patients with dyspepsia in whom X-ray examination reveals no abnormality, and in those with persistent symptoms in the upper gastrointestinal tract. Such an approach is a prerequisite to the accurate diagnosis of gastric cancer in its early, curable, stage.

Aged↗
PubMed1976

Review of five cases of early gastric carcinoma.

Five cases of early gastric carcinoma (EGC) were seen in 12 months. The clinical features did not provide guide-lines to diagnosis, which depends on air contrast barium studies, endoscopic recognition of early malignancy, adequate biopsies, and their interpretation. Malignancy was present in an average of 60% of the biopsies taken. The most common type of lesion was IIc. The superficial nature of the malignancy was predicted at endoscopy in four cases but was unsuspected in one case which was considered to be advanced carcinoma until the resected specimen was throughly examined microscopically. The excellent prognosis of EGC was discussed. Only conservative surgery need be performed if the superficial nature of the lesion is recognized before operation.

Adenocarcinoma↗
PubMed1976

LDH isoenzyme pattern of uninvolved gastric mucosa of patients with gastric carcinoma and benign gastric disease.

The LDH isoenzyme pattern of the uninvolved mucosa of gastric cancer patients differs as regards the LDH isoenzyme pattern from that of similar tissue of patients with benign gastric disease; the former tissue is characterised by a high M/H ratio of the LDH isoenzymes (M and H sub-units). A high M/H ratio characterises antral mucosa when the latter is compared with fundic mucosa. Mucosa showing superficial and atrophic gastritis also has a higher M/H ratio, whereas the presence of intestinal metaplasia does not appear to influence the M/H ratio. These observations are consistent with the concept that the tissue from which the cancer arose may possess a pre-malignant biochemical lesion.

Duodenal Ulcer↗
PubMed1968

Death in asthma.

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Aerosols↗