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Biomedical subjects

R M Weaver

Publications and source records attributed to R M Weaver.

At least 19 recordsLinked to original sources
PubMed1988

Indications and outcome of reoperation for ileostomy complications in inflammatory bowel disease.

Indications for ileostomy revision in 49 patients with inflammatory bowel disease operated upon between January 1975 and December 1984 were obstruction (15), retraction (10), parastomal hernia (9), prolapse (8), and fistula (4). Recurrent Crohn's disease was an important factor in the pathogenesis of ileostomy complications particularly obstruction, retraction and fistula. Local revision without laparotomy was successful in seven of eight patients with an ileostomy prolapse, but in only four of eight patients with a retracted stoma. Results of local repair without laparotomy and resiting were successful in five of six patients with a parastomal hernia. Laparotomy was usually necessary in patients with obstruction especially if there was underlying Crohn's disease and in patients with peristomal fistula. Resiting of the stoma after laparotomy was used only if the stoma site was outside the rectus muscle or if the original stoma site was infected.

Colitis, Ulcerative↗
PubMed1987

Manual dilatation of the anus vs. lateral subcutaneous sphincterotomy in the treatment of chronic fissure-in-ano. Results of a prospective, randomized, clinical trial.

The results of a prospective randomized trial in 111 patients were recorded to compare manual dilatation of the anus with lateral subcutaneous sphincterotomy performed under general anesthesia. There was no significant difference in the clinical results nor in the incidence of complications. Persistent or recurrent fissure occurred in three of 59 patients after manual dilatation of the anus and two of 39 patients after lateral subcutaneous sphincterotomy, an incidence of 5.1 percent in each group. Only one patient developed serious impairment of continence, and this occurred following lateral subcutaneous sphincterotomy (5.1 percent).

Adolescent↗
PubMed1986

Measurement of rectal capacity in the assessment of patients for colectomy and ileorectal anastomosis in Crohn's colitis.

A group of 38 patients with Crohn's colitis underwent measurement of rectal capacity prior to colectomy and ileorectal anastomosis. Median values for constant and maximum tolerated volumes were significantly higher in patients who still possessed a satisfactorily functioning ileorectal anastomosis at a mean follow-up of 6.8 years, and measurement of these sensory parameters of rectal capacity was of prognostic value in predicting the likely outcome of ileorectal anastomosis.

Adolescent↗
PubMed1985

Proximal gastric vagotomy in patients resistant to cimetidine.

Fifty-seven patients, with chronic duodenal ulceration resistant to cimetidine therapy, underwent proximal gastric vagotomy during the period August 1979 to May 1984. Thirty-five failed to respond to cimetidine in a dose of 1 g/day, whilst 22 relapsed on reduction of dosage to 400 mg daily or on cessation of therapy. Forty have been followed up for a period of 12-53 months (median duration = 28.5 months), and assessed using the modified Visick system. Thirty-four patients (85 per cent) were graded Visick I or II. Four patients (10 per cent) had non-specific upper gastrointestinal symptoms (Visick III). In these patients endoscopy has shown no evidence of recurrent ulceration. Two patients (5 per cent) were graded Visick IV. One had recurrent ulceration on endoscopy. The other developed symptomatic gastro-oesophageal reflux, necessitating further surgery. These results support the view that cimetidine resistance is not a predictor of poor results following proximal gastric vagotomy.

Adolescent↗
PubMed1985

Localization of plasminogen activators in human colon cancer by immunoperoxidase staining.

The immunoperoxidase technique, using antibodies against human urinary urokinase (Mr 55,000), was used for the localization of this enzyme in histological preparations of human colon tumors and normal colon tissue. The localization of tissue (vascular) activator was also investigated using antibodies against enzyme purified from human malignant melanoma. Both the "indirect method" and the peroxidase-antiperoxidase technique were found to be useful. Urokinase-reactive material was found in all tissues examined (33 primary cancers, 11 metastases, and 8 adenomas). In the normal colon, urokinase was found only in some of the goblet cells of the mucosal epithelium. In colon cancer, diffuse specific staining was observed in the cytoplasm, but the most intense staining was localized at the edge of the cancer cells bordering the lumen of the glands. In some cases, intense supranuclear staining could be observed in a location corresponding to the Golgi apparatus. In a few instances, urokinase could be seen associated with fibroblasts near the advancing front of an invading tumor. Adenoma, a benign tumor but often a precursor of cancer, also showed the presence of urokinase. Most significant were the observations showing that, in regions of the mucosal glands where normal epithelial cells were abruptly replaced by cancer cells, the appearance of cytoplasmic urokinase showed strict and exclusive association with the malignant cells, and the same was the case in transitions from normal epithelium to adenoma. In contrast to urokinase, tissue plasminogen activator was not associated with cancer cells, but was consistently present in the stroma which separates the cancer glands and was localized in the endothelium of the blood vessels. This visual evidence was supported by results of extraction of plasminogen activators from tumors, and from the separated mucosal and submucosal layers of the normal colon of the same patients, which showed that urokinase is most abundant in the tumor tissue and least abundant in the submucosa, while tissue activator is most prevalent in the well-vascularized mucosa and submucosa and scarce in the usually poorly vascularized adenocarcinomas.

Aged↗
PubMed1985

The Angelchik prosthesis for gastro-oesophageal reflux: symptomatic and objective assessment.

Twenty-three patients with intractable gastro-oesophageal reflux were treated by insertion of the Angelchik antireflux prosthesis. Good symptomatic relief was achieved in over 80% of patients reviewed up to 28 months after operation and there was marked resolution of oesophagitis as seen on endoscopy. Oesophageal manometry and pH studies performed preoperatively and at 3 and 12 months after operation, showed a significant increase in lower oesophageal sphincter pressure with decreased acid reflux. Some technical problems were encountered, but the prosthesis is potentially a simple and effective means of controlling gastro-oesophageal reflux.

Adult↗
PubMed1983

Long-term survival in stage I and stage II malignant melanoma of the limbs--a regional review.

A case is reported of survival in excess of 20 years in a patient presenting with Stage II cutaneous malignant melanoma. Long term survival is reviewed of patients with cutaneous malignant melanoma registered during the period 1957-1959. Prognosis is best in women with Stage I disease of the lower limb, but prolonged survival occurs in cases having regional lymph node involvement. Men with stage I disease of the upper limb have a relatively good prognosis.

Adult↗
PubMed1980

Palliation and survival in malignant oesophago-respiratory fistula.

Survival in the presence of malignant oesophago-respiratory fistula is usually limited to a few weeks. In this paper we describe our experience with 3 cases treated by retrosternal oesophagogastric bypass with oesophageal exclusion, and review the experience of previous authors using this and other forms of bypass. The results indicate that both survival and quality of life are considerably better with surgical bypass and exclusion than with any other form of treatment. Indeed, the survival times are frequently better than those achieved after palliative resection of oesophageal carcinoma without fistula. Retrosternal oesophagogastric bypass with oesophageal exclusion is recommended as a simple method of bypass for this condition.

Aged↗
PubMed1979

Abdominal pansonography in the evaluation of renal cancer.

Abdominal pansonography was performed in 34 patients after solid renal tumors were diagnosed. Included were evaluation of the inferior vena cava (IVC), the liver, and the retroperitoneal area. Additional findings including hepatic metastases, IVC extension of tumor, and retroperitoneal nodal masses were discovered in 14 patients. The role of pansonography as a noninvasive adjunctive diagnostic tool for more complete staging and treatment planning of renal cancer is discussed.

Adenocarcinoma↗
PubMed1978

Gray scale ultrasonographic evaluation of hepatic cystic disease.

Eight patients with various forms of hepatic cystic disease studied with gray scale ultrasonography are described. Four had solitary cysts, two had multiple simple liver cysts, and two had congenital polycystic liver and kidney disease. The spectrum of ultrasonographic features in benign cystic disease of the liver is discussed. All eight patients were felt to have malignant disease in the liver prior to ultrasonographic evaluation. The value of gray scale ultrasound as a noninvasive means of differentiating cystic disease from suspected metastatic disease is emphasized.

Adult↗
PubMed1978

Ultrasonic detection of renal tumor extension into the inferior vena cava.

Five cases of extension of renal carcinoma into the inferior vena cava were detected using gray scale ultrasonography. Two different ultrasonographic appearances reflecting the intracaval tumor were observed. Four patients had one or two intraluminal echogenic nodules or thrombi, and the fifth case manifested generalized caval dilatation with innumerable diffuse low amplitude echoes emanating from the lumen. The role of ultrasonography in the complete evaluation of the patient with renal carcinoma is discussed, and the ultrasonographic features of intracaval tumor are demonstrated.

Adolescent↗