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Biomedical subjects

R H Grace

Publications and source records attributed to R H Grace.

At least 37 records · Page 2Linked to original sources
PubMed1991

Developmental regulation of heat shock protein synthesis and HSP 70 RNA accumulation during postimplantation rat embryogenesis.

Exposure of postimplantation rat embryos on days 9, 10, 11, and 12 of gestation to an in vitro heat shock of 43 degrees C for 30 min results in the induction of heat shock proteins (HSPs) in day 9 and 10 embryos, a severely attenuated response in day 11 embryos, and no detectable response in day 12 embryos. The heat shock response in day 9 embryos (presomite stage) is characterized by the synthesis of HSPs with molecular weights of 28-78 kDa. In heat shocked day 10 embryos, two additional HSPs are induced (34 and 82 kDa). In addition, two HSPs present on day 9 are absent on day 10. In day 11 heat shocked embryos, only three HSPs (31, 39, and 69 kDa) are induced, while in day 12 embryos no detectable HSPs are induced. Northern blot analysis of HSP 70 RNA levels indicates that the accumulation of this RNA, but not actin RNA, varies depending on developmental stage at the time of exposure to heat as well as the duration of the heat shock. Day 9 embryos exhibit the most pronounced accumulation of HSP 70 RNA while embryos on days 10-12 exhibit an increasingly attenuated accumulation of HSP 70 RNA, particularly after the more acute exposures (43 degrees C for 30 or 60 min). Thus, the ability to synthesize HSP 70 and to accumulate HSP 70 RNA changes dramatically as rat embryos develop from day 9 to day 12 (presomite to 31-35 somite stages).

Animals↗
PubMed1989

Detection of lymph node metastases in colorectal carcinoma before and after fat clearance.

One hundred and three colorectal carcinoma specimens were examined to determine the value of the xylene and alcohol fat clearance technique in detecting lymph node metastases. The mesocolon or mesorectum was dissected initially by the traditional method and all the lymph nodes identified were examined histologically. After fat clearance the specimen was dissected again and further lymph nodes were examined. Forty-one specimens were obtained from the rectum and 62 from the colon. Traditional dissection produced a mean of 6.2 lymph nodes per specimen, but following fat clearance a further mean of 12.4 nodes per specimen were found. The total number of lymph nodes recovered varied from two to 69 with a mean of 18.5 per specimen. Traditional dissection showed 45 specimens (43.7 per cent) to have lymph node metastases but after fat clearance a further five specimens (4.8 per cent) were found to be lymph node positive. Therefore, of the 58 specimens graded initially as Dukes' B, five (8.6 per cent) were shown after fat clearance to be Dukes' C tumours. In the Dukes' C cases the mean (s.d.) number of involved lymph nodes per specimen was 2.7 (2.1) by traditional dissection and 4.2 (3.9) after fat clearance. Forty-seven (94.0 per cent) of the Dukes' C tumours were correctly identified after examination of specimens containing up to 13 lymph nodes. Fat clearance of the mesocolon or mesorectum should be used when traditional dissection has failed to identify at least 13 nodes and the tumour has been classified as Dukes' B.

Adipose Tissue↗
PubMed1988

The role of Picolax before whole gut irrigation in the preparation of the colon for large bowel surgery.

Whole gut irrigation is easier for the patient and more likely to be successful if the colon is prepared before irrigation. This study compared Picolax, given the day before irrigation, with an enema regimen and showed that there was no difference in the volume of fluid required and the time taken for whole gut irrigation to produce a clear effluent between the two groups.

Cathartics↗
PubMed1987

Comparative trial of sodium cromoglycate enemas with prednisolone enemas in the treatment of ulcerative colitis.

A double blind multicentre study comparing sodium cromoglycate (600 mg/100 ml) by enema with prednisolone (20 mg/100 ml) by enema is reported. The study was conducted over a nine week period in the treatment of 70 patients with ulcerative colitis. Analysis of symptoms showed significant decreases in scores for patients in both groups, both at four and eight weeks; the only difference between the two groups was a significantly greater improvement in the reduction of rectal bleeding after four weeks in the prednisolone group. On sigmoidoscopy, both treatment groups showed a highly significant improvement after four and eight weeks with no significant differences being seen between the groups. Histology of the rectal biopsies showed a significant improvement in the inflammation of the mucosa for both treatment groups after four and eight weeks with no differences being observed between the groups. There were no significant changes in eosinophils from baseline and no difference between the groups at four and eight weeks.

Adolescent↗
PubMed1986

The relevance of microbiology in the management of anorectal sepsis.

Eighty patients with anorectal sepsis were studied over three years. All abscesses were drained and pus was submitted for culture. If a fistula was found when the abscess was drained it was laid open otherwise a second examination under anaesthetic was performed within 7-10 days. In no case was sterile pus obtained. Gut aerobes, predominantly Escherichia coli, were isolated from 49 of 53 (92.5%) of patients with a fistula and 8 of 27 (29.6%) of those without. 'Gut-specific bacteroides' predominantly Bacteroides fragilis were isolated from 47 of 53 (88.7%) patients with a fistula and 5 of 27 (18.5%) of those without. Anaerobes not specific to the gut, predominantly B. asaccharolyticus, B. ureolyticus, peptococci and peptostreptococci, in the absence of those specific to the gut, were isolated from 2 of 53 patients with a fistula (3.8%) and 17 of 27 (63%) of those without. Staphylococcus aureus was isolated from only 1 of 53 (1.9%) patients with a fistula but from 8 of 27 (29.6%) of those without. It is concluded that only patients with gut-specific organisms should be submitted to a second examination under anaesthetic and that culture of pus in anorectal sepsis is an essential part of its management.

Abscess↗
PubMed1983

Sampling variability of liver biopsy in inflammatory bowel disease.

Sampling errors may occur when hepatic needle biopsy specimens are obtained for histologic examination. We obtained biopsy specimens from the right and left lobes of the livers of 29 patients who were to undergo surgery for inflammatory bowel disease. The histologic appearances of Kupffer's cell hyperplasia, fatty change, portal tract inflammation, and focal necrosis, but not giant cell granulomas, were well represented by a single specimen. The incidence of minor hepatic abnormalities was high and is likely to reflect the severity of the disease leading to surgery, but serious lesions were uncommon.

Biopsy, Needle↗
PubMed1982

Anorectal sepsis: microbiology in relation to fistula-in-ano.

One hundred and sixty-five patients presented in a 4-year period: 68 (41.2 per cent) had had previous anorectal sepsis and in 56 of these patients (82.3 per cent) the presenting sepsis was at the site of the previous abscess. The abscesses were drained and pus was sent for culture; any fistula, if found, was laid open. A second examination under anaesthesia was performed within 7--10 days if no fistula had been found. The pus from 114 patients grew bowel-derived organisms; 62 (54.4 per cent) fistulas were found. The pus from 34 patients grew skin-derived organisms but no fistula was demonstrated in this group. It is suggested that a second examination need only be performed if culture of the pus grows bowel-derived organisms: anorectal abscesses which grow skin-derived organisms are not associated with a fistula.

Abscess↗
PubMed1980

The value of routine preoperative urological assessment in patients undergoing elective surgery for diverticular disease or carcinoma of the large bowel.

A consecutive series of 176 patients was studied prospectively in order to assess the value of full urological assessment prior to elective colorectal surgery for carcinoma or diverticular disease. Fifty-one patients had urological symptoms and 29 of these had an abnormal intravenous urogram (IVU); when compared with the 125 asymptomatic patients, they were twice as likely to develop acute retention of urine and four times more likely to require prostatectomy. Twenty of the 31 patients with an abdominal mass had an abnormal intravenous urogram, and the presence of this physical sign may be regarded as an absolute indication for IVU. Forty-five patients had a urological abnormality on the preoperative IVU; of these, 1 in 6 required treatment prior to elective large bowel surgery and 1 in 3 developed acute retention of urine postoperatively (half required prostatectomy). Twenty-two patients had a disease-related abnormality on preoperative IVU and in 12 planned urological surgery was undertaken at the time of the colorectal resection. In the 91 patients with no urological symptoms, no abnormal mass and normal blood urea and mid-stream urine sample, the incidence of IVU abnormalities and of postoperative complications was low and surgical management was not altered in these patients.

Bacteriuria↗
PubMed1978

The treatment of perianal and anal condylomata acuminata: a new operative technique.

Seventy-five patients have been treated for condylomata acuminata by means of a new operative approach which results in the preservation of the maximum amount of normal tissue. The technique has proved to be simple to perform, it has minimal complications and causes the patient little in the way of discomfort. Three out of 4 patients treated have no significant recurrent wart formation.

Adult↗
PubMed1977

Organic constipation in adults.

Four cases of non-Hirschsprung megacolon in adults are presented. The histology of the myenteric plexus suggests that this may be an anomaly of development.

Adolescent↗
PubMed1976

Incidence of incisional hernai after dehiscence of the abdominal wound.

The records of 103 patients whose abdominal wounds burst were studied in an attempt to assess the subsequent incidence of incidence of incisional hernia. Sufficient information about seventy patients was obtained. Forty-nine patients (47.6 per cent) had a hernia whereas twenty-one patients (20.4 per cent) definitely did not have a hernia. The incidence of hernia was associated wit- the age of the patient, the site of the wound, the day of resuture, an original diagnosis of malignancy, and the postoperative blood urea level but not with the technic employed in the resuture nor with infection. It is suggested that a blood-stained serous discharge and the "dip sign" should enable an early diagnosis of dehiscence to be made before the small bowel appears in the wound; after diagnosis, the wound should either be explored electively or the skin sutures left for at least three weeks until the skin heals.

Abdomen↗