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Biomedical subjects

R C Haggitt

Publications and source records attributed to R C Haggitt.

10 recordsLinked to original sources
PubMed1978

Esophageal epithelial response to gastroesophageal reflux. A quantitative study.

Exposure of the distal esophageal mucosa to acid gastric juice was quantitated by 24-hr pH monitoring in 100 individuals and was correlated with morphologic data derived from esophageal biopsies. The degree of acid exposure to the distal esophagus correlated directly with increases in both relative and absolute length of the subepithelial papillae and to relative basal zone hyperplasia. Both papillary length and basal zone hyperplasia decreased after antireflux surgery had reduced acid exposure to normal. Reflux in the recumbent position resulted in prolonged exposure of the mucosa to acid because of poor acid clearing from the esophagus. This caused longer papillae than did upright reflux, where there were more frequent reflux episodes, but with rapid acid clearance. The presence of a hiatal hernia was associated with longer papillae, lower DES pressure, increased reflux frequency, and prolonged recumbent acid clearance. Twenty-four hour pH monitoring correlated better with papillary length than did symptoms or other clinical measures of gastroesophageal reflux.

Esophagus↗
PubMed1978

Adenocarcinoma complicating columnar epithelium-lined (Barrett's) esophagus.

Prolonged reflux esophagitis leads to replacement of the esophageal squamous epithelium by columnar epithelium in some patients. This columnar epithelium resembles gastric or intestinal mucosa and has been implicated as a precursor of esophageal adenocarcinoma. A review of 14 cases of primary esophageal adenocarcinoma disclosed that 12 (86%) arose in a columnar epithelium-lined (Barrett's) esophagus. Ten of the 12 patients had a hiatal hernia or symptoms of reflux esophagitis or both. In ten patients the columnar epithelium adjacent to and remote from the invasive adenocarcinoma showed a spectrum of abnormalities ranging from mild dysplasia to carcinoma in situ. These data support the concept that esophageal adenocarcinoma is one complication of a columnar epithelium-lined esophagus, and suggest that the invasive carcinoma evolves through a sequence of epithelial dysplasia and carcinoma in situ in most cases. Esophageal biopsy and cytology can detect this dysplasia, and should provide an effective means for monitoring patients with Barrett's esophagus for impending malignancy.

Adenocarcinoma↗
PubMed1978

Intranuclear inclusions of the human vas deferens.

Intranuclear inclusions in epithelial cells of the human vas deferens have not been well characterized or widely recognized. We studied their prevalence in an adult male population by light microscopy and characterized them using the techniques of histochemistry, electron microscopy, and electron microprobe analysis. They occurred in all cases studied, consisted of electron dense globules, contained neutral mucosubstances, and occasionally were single membrane bound. Epithelial intranuclear inclusions routinely occur in the vas deferens of sexually mature males, do not disappear with advancing age, and should not be interpreted as a pathologic finding.

Aged↗
PubMed1977

Ileostomy complications requiring revision: Lahey clinic experience, 1964-1973.

From 1964 to 1973, 50 patients who initially underwent ileostomy for inflammatory bowel disease at the Lahey Clinic required 84 revisions. The commonest reason for revision was stenosis. Fistula, prolapse, and retraction followed in order of frequency. Patients with Crohn's disease seemed to have a higher incidence of revision, but this was not statistically significant. Other reasons for revision were analyzed, and recommendations for treatment were discussed. Retrospective study revealed that 50% of ileostomy revisions were performed for probably preventable complications.

Adolescent↗
PubMed1977

Gastric cancer. Contemporary aspects.

Records of 403 patients with gastric cancer seen between 1957 and 1966 at the Lahey Clinic Foundation have been analyzed. While the operability rate was 94 per cent and the resectability rate was 58 per cent, the cure rate was only 11 per cent and was unchanged from the previous decade. Significant correlation occurs with location, clinical type, histologic type, size of tumor, and number of lymph node metastases. The surgical approach is aggressive in exploration and in treating extensive but resectable cancers but is conservative for the average cancers and does not include resection of spleen, omentum, pancreas, and total stomach if possible. The histologic differentiation into diffuse and intestinal varieties provides additional prognostic information as well as clues to the etiology of varieties of gastric cancer.

Aged↗
PubMed1975

Myoepithelioma of minor salivary gland origin. Light and electron microscopical study.

A gingival tumor that invaded the anterior maxilla was removed from a 14-year-old boy and studied by light and electron microscopy. The tumor was composed exclusively of myoepithelial cells and appeared to be malignant. By light microscopy, the tumor appeared to be a poorly differentiated epithelial neoplasm of undetermined origin; however, electron microscopical examination showed myoepithelial differentiation, indicative of a salivary gland origin. To our knowledge, the present case represents the only confirmed myoepithelioma that shows features indicative of malignant potential. Myoepitheliomas may be related to mixed tumors of salivary glands.

Adolescent↗