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Biomedical subjects

R M Charnley

Publications and source records attributed to R M Charnley.

16 recordsLinked to original sources
PubMed1992

Serum gastrin concentrations in colorectal cancer patients.

Fasting serum gastrin concentrations were shown to be elevated in colorectal cancer patients compared with controls (P = 0.0037), which was mainly accounted for by a subgroup of patients who had significantly elevated levels. In cancer patients there was no difference in gastrin concentrations in blood taken from a tumour-draining mesenteric vein and from a peripheral vein at the time of colonic resection. Serum gastrin concentrations were significantly lower after apparently curative resection for colorectal cancer (P = 0.028), suggesting that the elevated serum gastrin seen in these patients may be due, at least in part, to secretion of gastrin by the tumour.

Adult↗
PubMed1991

Detection of colorectal liver metastases using intraoperative ultrasonography.

Intraoperative ultrasonography of the liver has been carried out in 99 patients undergoing surgery for colorectal cancer. Palpation of the liver, preoperative abdominal ultrasonography and computed tomography scanning were also performed in all patients. Metastases were identified in 26 of the 99 patients (26 per cent). Intraoperative ultrasonography diagnosed more metastases than palpation, abdominal ultrasonography or CT scanning, identifying metastases in 24 of the 26 patients, including six patients in whom the metastases were not detected by any other technique. Identification and localization of impalpable liver metastases is therefore possible using intraoperative ultrasonography.

Colorectal Neoplasms↗
PubMed1991

Effect of hepatic cryotherapy on serum CEA concentration in patients with multiple inoperable hepatic metastases from colorectal cancer.

Eleven patients with multiple hepatic metastases from colorectal cancer, all judged inoperable, were treated by cryotherapy using a probe through which liquid nitrogen was circulated using a single freeze thaw sequence. Localization of metastases, positioning of the probe and monitoring of ice ball size was by intra-operative ultrasound. Serum carcinoembryonic antigen (CEA) was measured in these patients: there was a postoperative fall in all but two. In all but one, there has been a subsequent rise. Speed and degree of rise of CEA varied between patients. Serial CEA may be an effective means of monitoring the effect of hepatic cryotherapy.

Carcinoembryonic Antigen↗
PubMed1990

Rectal endosonography for the visualisation of the anastomosis after anterior resection and its relevance to local recurrence.

Rectal endosonography can be used to detect and localise recurrent rectal carcinoma. Distal and proximal to a rectal anastomosis the separate layers of the bowel wall as seen by rectal endosonography are well defined but at the precise level of the anastomosis separation of the layers is lost and they appear to merge. By studying histological sections of a normal anastomosis we have demonstrated that this loss of definition seen endosonographically correlates with the histological appearances. These appearances of the normal anastomosis provide a baseline image for the identification of recurrences in the region of the anastomosis.

Anastomosis, Surgical↗
PubMed1990

Hepatic perfusion index in the diagnosis of overt metastatic colorectal cancer.

The hepatic perfusion index (HPI) was measured in 180 patients with colorectal cancer: 109 with primary colorectal cancer, 38 with suspected recurrent colorectal cancer and 33 following curative resection of colorectal cancer. In 21 patients with proven metastatic disease serial imaging studies were performed. HPI was determined using the peak of the left kidney time-activity curve to define the division of arterial and portal blood flow. HPI was elevated (greater than 0.37) in 54 of 115 patients (47%) with no evidence of hepatic metastases, 17 of 27 patients (63%) with hepatic metastases at initial presentation and 21 of 25 (84%) with metastatic disease detected during follow-up. Only 4 of 13 patients (31%) with local recurrence but no evidence of liver metastases had an elevated HPI. Serial imaging of patients with metastatic liver disease demonstrated a rising HPI with clinical disease progression in 18 of 21 patients (86%). This study confirms the association of an elevated HPI with hepatic metastases and suggests that a rising HPI in serial studies is associated with progression of disease but highlights the deficiency of one single HPI estimation in the identification of patients with overt hepatic metastases.

Colorectal Neoplasms↗
PubMed1990

Ultrafast magnetic resonance scanning of the liver with echo-planar imaging.

Echo-planar imaging (EPI) is a magnetic resonance imaging (MRI) technique which provides MR images in, typically, 50-100 ms. The potential of EPI as an imaging modality for the liver has been investigated in volunteers and patients with liver disease. Images with improved quality are presented. Obtained at a field strength of 0.52 Tesla, these true unaveraged snap-shot images have larger data arrays, comprising 128 X 128 pixels.

Aged↗
PubMed1990

A pilot randomized control trial of proglumide (a gastrin receptor antagonist) in advanced colorectal cancer.

Forty-one patients with advanced colorectal cancer were entered into a randomized controlled trial of treatment with proglumide--a gastrin receptor antagonist. There was no difference in survival between the treated and the untreated groups of patients, although there was a trend towards increased survival in those treated patients with hepatic metastases alone. Proglumide does not cause regression in advanced colorectal cancer but larger studies would be required to detect an effect on tumour growth.

Adenocarcinoma↗
PubMed1989

Role of dietary restriction in Haemoccult screening for colorectal cancer.

The aim of this study was to investigate the effect of dietary restrictions on the positivity rate and yield of neoplasia during a study based on Haemoccult screening for colorectal neoplasia. Of 18,925 participants who completed Haemoccult tests on a normal diet, 647 (3.4 per cent) were positive. All repeated the test with dietary restrictions: 251 remained positive and underwent further investigations which revealed 35 carcinomas and 169 adenomas in 129 subjects. The remaining 396 were sent a further Haemoccult test at 3 months. Of these, 317 (80.1 per cent) completed the test: 31 (9.8 per cent) were positive. Further investigation of the 31 positive subjects revealed four carcinomas and 20 adenomas. Retesting with dietary restriction will reduce the false positive rate of Haemoccult when used for colonic cancer screening. However, if the retest is negative a further test should be performed. To minimize the adverse effect this may have on compliance, we have allowed an interval of 3 months to elapse before this retest is requested.

Adenoma↗
PubMed1989

Cryotherapy for liver metastases: a new approach.

A new system designed for cryosurgery of liver metastases is described. The cryoprobe, which utilizes circulating liquid nitrogen and produces a spherical iceball around each metastasis, is controlled by operative ultrasound. There was nor mortality and all patients left hospital within 10 days. Cryotherapy produced an area of destruction within the liver substance which decreased in size by 6 weeks as shown on serial computed tomographic scanning.

Cryosurgery↗
PubMed1989

The measurement of osteoporosis in clinical practice. Comparison of histological and radiological methods.

In a prospective study of the measurement of osteoporosis in patients with fracture of the femoral neck, we compared a histological with a radiological method. We found no significant correlation between histological planimetry and the radiological six metacarpal hand index in patients with either cervical or trochanteric fractures. This demonstrates that metacarpal morphometry cannot predict histological osteoporosis of the iliac crest.

Aged↗
PubMed1986

Inhalation of a minitracheotomy tube.

Inhalation of a minitracheotomy tube during sputum aspiration in a patient with sputum retention is reported. Precautionary measures in the insertion and management of a minitracheotomy tube are discussed.

Aged↗