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R Rowland

Publications and source records attributed to R Rowland.

At least 19 recordsLinked to original sources
PubMed1998

Evaluation of the CytoRich technique for cervical smears.

The aim of the study was to assess the ability of the CytoRich System to prepare optimal gynaecological smears for diagnosis. The diagnostic results obtained from evaluating 1,325 matched slide-pairs, prepared using conventional methods and thin-layer technology, were compared. Cytological material for study was obtained using the combined spatula-cytobrush sampling technique. An assessment of the pitfalls associated with the interpretation of these smears was also undertaken. Diagnostic agreement was achieved in 1,272 of the 1,325 matched slide-pairs (96.0%), and these included 1,172 negative, 50 atypical, 24 low-grade squamous intraepithelial lesion (LSIL), 24 high-grade SIL (HSIL), and two malignancies. A total of 1,309 cases showed the same diagnosis within one diagnostic grade for an agreement of 98.8%. Evaluation of the 53 discordant diagnoses revealed that the conventional smear identified a significantly greater number of abnormal smears than the CytoRich technique (P < .001). It is suspected that the use of the combined spatula-cytobrush sampling technique did not provide adequate residual specimen for CytoRich after conventional smear preparation. This limitation is evidenced by the fact that the CytoRich preparations showed a lower yield of endocervical cells (P < .001) and infectious organisms (P < .001) than was demonstrated on conventional smears. Despite a number of diagnostic pitfalls associated with the interpretation of thin-layer smears, these preparations were easier and faster to screen and showed well-preserved and evenly distributed cells. Thin-layer smears were also characterised by a marked reduction in thick cell groups, air drying artifact, and obscuring inflammation and blood. The results confirm the limitation of the combined spatula-cytobrush technique in these types of comparative studies.

Carcinoma in Situ↗
PubMed1998

Wound metastasis after laparoscopy with different insufflation gases.

BACKGROUND: There is growing evidence that laparoscopy for malignancy is associated with an increased incidence of metastasis to port sites. This study investigated the effect of different insufflation gases on port-site metastasis after laparoscopy in an established animal model. METHODS: Forty-eight Dark Agouti rats with an established adenocarcinoma in the left flank underwent laparoscopic intraperitoneal tumor laceration. The gas used for insufflation was one of the following (12 rats in each group): (1) CO2, (2) N2O, (3) helium, or (4) air. Rats were killed 7 days after the procedure, and the port sites were examined for the presence of tumor metastasis. RESULTS: Tumor involvement of port sites was significantly less likely after helium insufflation than in the other groups (p < 0.0001). There was no significant difference between the air, CO2, and N2O groups. CONCLUSIONS: This study suggests that the development of metastases in port sites after laparoscopy may be influenced in part by the choice of insufflation gas used to create the pneumoperitoneum. In particular, helium was associated with a reduced rate of metastases.

Adenocarcinoma↗
PubMed1997

Hydrogen sulphide produces diminished fatty acid oxidation in the rat colon in vivo: implications for ulcerative colitis.

BACKGROUND: Several lines of evidence suggest a possible role for reduced forms of sulphur (including sulphide) in ulcerative colitis. The aims of this study were to assess the metabolic profile of colonic epithelial cells after treatment in vivo with hydrogen sulphide and correlate this with mucosal histological appearances. METHODS: Adult Sprague-Dawley rats had antegrade Roux-en-Y colostomies fashioned to allow access to the 'in-flow' bowel. Animals were treated with 2 mL sodium hydrosulphide (10, 20, 30 mmol/L) or saline control twice daily via the stoma for four (acute experiments) and 90 (chronic experiments) days. Isolated colonic epithelial cell suspensions prepared from such animals were incubated in the presence of [1-14C]-labelled n-butyrate (5 mmol/L) or [6-14C]glucose (5 mmol/L). Metabolic performance was measured radiometrically (14CO2 production) and enzymatically (ketone body production and lactogenesis). The histological appearances of treated mucosa were scored for acute inflammatory changes. RESULTS: There was a highly significant reduction in 14CO2 production from both n-butyrate and glucose in all groups compared to the control in both acute and chronic experiments. There was no difference between groups with respect to histological appearance and no evidence of acute inflammation in any specimen. CONCLUSIONS: Sodium hydrosulphide impairs rat colonic epithelial metabolic performance in vivo, but does not produce mucosal inflammation.

Animals↗
PubMed1997

Effects of fractionated abdominal irradiation on small intestinal motility--studies in a novel in vitro animal model.

Disordered small intestinal motility occurs frequently during acute radiation enteritis. However, the characteristics and time course of the motor dysfunction are poorly defined. These parameters were assessed in a novel animal model of radiation enteritis. Ileal pressures were recorded in vitro with perfused micromanometric catheter using an arterially perfused ileal loop in 22 ferrets following fractionated abdominal irradiation (9 doses 2.50 Gy thrice weekly for 3 weeks). Tissue damage was graded histologically. Studies were performed 3 to 29 days after irradiation. Tissue from 7 control animals was also studied. All treated animals developed diarrhoea. Histology showed changes consistent with mild to moderate radiation enteritis. Following irradiation, there was an initial increase in frequency followed by a non-significant reduction in the frequency, but not the amplitude of ileal pressure waves. The frequency of pressure waves showed an inverse relationship with time after radiation (r = -0.634, p < 0.002). There was no relationship between motility and histology. We conclude that abdominal irradiation is associated with a time-dependent reduction in ileal motility which does not correlate with light microscopic changes.

Animals↗
PubMed1996

Teratoma in the orchiectomy specimen and volume of metastasis are predictors of retroperitoneal teratoma in low stage nonseminomatous testis cancer.

PURPOSE: We determined whether teratomatous elements in the orchiectomy specimen predict for teratoma in the retroperitoneum in patients who have not received chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the records of patients with clinical stages A, B and B2 nonseminoma who underwent retroperitoneal lymph node dissection. RESULTS: Teratomatous elements in the orchiectomy specimen predict for retroperitoneal teratoma. CONCLUSIONS: When deciding on treatment for low stage nonseminoma, the presence or absence of teratoma in the orchiectomy specimen should be considered to minimize double therapy.

Humans↗
PubMed1994

Management of the malignant colorectal polyp: the importance of clinicopathological correlation.

The results of management of colorectal adenomas removed endoscopically and found to contain invasive cancer seen in a single institution over a 10 year period are presented. Clinical data were obtained retrospectively from patient case notes and all specimens were reviewed by one pathologist. Fifty-four patients with malignant polyps were studied after exclusion of others with polypoid carcinomas, epithelial misplacement and cases managed by primary segmental resection. Of the various considered predictors of adverse outcome, only histologically incomplete excision proved significant. However, when excision was considered macroscopically complete there was no significant association between incomplete histological excision and adverse outcome. Consideration should be given to conservative management of such cases.

Adenocarcinoma↗
PubMed1993

Chronic liver disease in asymptomatic hepatitis C antibody positive blood donors.

The risks of acquisition of hepatitis C infection, the histological spectrum of liver disease, and the presence of viraemia were investigated in anti-hepatitis C virus (HCV) antibody positive blood donors. All 357 (0.64%) blood donors to the South Australian Red Cross Transfusion Service found to have anti-HCV antibody during the first seven months of testing in 1990 were assessed, and 70 (19.6%) were found to have elevated alanine transaminase levels. These subjects were referred for participation in the study; 31 presented for enrollment. Sixteen (52%) of the 31 patients had previously used intravenous drugs, four (13%) had been transfused, two (6%) had a history of occupational exposure to blood, and three (10%) had tattoos and ear-piercing as possible risk factors for acquisition of hepatitis C. There was no history of parenteral exposure in six (16%). None of these donors had clinical evidence of liver disease, but in all 24 of the 31 who had a liver biopsy there was histological evidence of significant liver damage. Twelve had evidence of chronic active hepatitis. All 24 subjects biopsied were viraemic as judged by the presence of HCV RNA in serum.

Adult↗
PubMed1993

Immunohistochemical detection of the NS4 antigen of hepatitis C virus and its relation to histopathology.

The immunohistochemical localization of the hepatitis C virus (HCV) nonstructural antigen 4 (NS4) was investigated in formalin-fixed human liver biopsy samples taken from 10 patients who were anti-HCV positive. NS4 was detected within the cytoplasm of hepatocytes in all HCV-positive patients studied, but not in the mononuclear cell infiltrates, bile duct epithelium, or endothelial cells. A high proportion of hepatocytes appeared positive, but the staining intensity was variable. After a coded histological evaluation of the liver tissue, the pattern of liver injury was shown to have no significant correlation with antigen-positive hepatocytes, and no direct relationship was observed between the distribution of antigen-positive hepatocytes and areas of hepatocyte necrosis. The staining pattern was considered to be specific because liver samples from patients chronically infected with hepatitis B virus or from uninfected individuals were negative. Furthermore, no staining was noted when either preimmune rabbit serum or anti-NS4 adsorbed against the specific synthetic peptide was substituted for the primary antibody.

Adult↗
PubMed1993

Jejunal diverticulosis.

Jejunal diverticulosis is considered to be a generally asymptomatic condition in which the diverticula are pulsion mucosal herniations with walls lacking a muscle layer. These opinions in particular are examined in this review of 20 cases of jejunal diverticulosis treated during an 8 year period. The predominant complication in each case was inflammation or perforation (nine), diarrhoea or malabsorption (five), haemorrhage (three), chronic abdominal pain (two) and pseudo-obstruction (one). At least 10 patients had more than one complication, although this was often unrecognized. Ten patients complained of chronic abdominal pain, in eight of whom the cause was not diagnosed until other complications supervened. Unrecognized malabsorption may be common, as the mean serum albumin in 12 patients presenting acutely with inflammation, perforation or haemorrhage, was low (mean 32 g/L, normal 39-48 g/L). Histology sections were reviewed in the 12 cases that underwent resection, of whom 11 were suitable for classification. Four cases had narrow-mouthed pulsion diverticula with a thin or absent muscle coat, and had developed at the point of blood vessel penetration. Four cases had wide-mouthed diverticula in which the muscle layer was present, suggesting an abnormality of the intestinal wall. Two had features of both. In one case a Meckel's type diverticulum was located 10 cm from the duodenal-jejunal flexure. Seven had mucosal villous atrophy consistent with bacterial overgrowth. In conclusion, jejunal diverticulosis may be associated with complications more frequently than has been recognized and pathologically is a diverse condition.

Aged↗
PubMed1992

Density of lymphoid follicles in the rectum and at the anorectal junction.

To determine the density of mucosal lymphoid follicles in 10 histologically normal rectums, including the anorectal junction, we counted the follicles macroscopically after the specimens were fixed in 10% acetic acid. The mean density in the rectum was 25.6/cm2. The mean density at the anorectal junction was slightly but not significantly higher, at 29.2/cm2. We found no significant change in follicle density with increasing age in specimens from people between the ages of 17 and 90 years.

Aged↗
PubMed1992

Prolonged hepatic ischaemia due to liver injury: a case report.

A case is reported in which a young male who underwent right hepatectomy necessitated by gunshot wound to the liver, survived 2 h 20 min of normothermic hepatic ischaemia. This case extends the documented duration of hepatic ischaemia compatible with survival and documents the histopathology of the post-ischaemic liver.

Adult↗
PubMed1992

Detection of hepatitis C virus RNA by in situ hybridization.

Persistent infection with hepatitis C virus (HCV) is associated with chronic hepatitis and cirrhosis which may eventually develop into primary hepatocellular carcinoma. The mechanism of pathogenesis is ill-defined and nothing is known of the distribution, frequency or type of infected cell in the liver of HCV-infected individuals. In this study we have examined liver tissue taken at autopsy from 2 anti-HCV-positive patients by in situ hybridization for the presence of HCV RNA. Viral RNA was detected by autoradiography after hybridization with 125I-labelled riboprobes, representing approximately 35% of the HCV genome. Only a few positive cells were identified in the HCV-infected liver samples, but not in a normal liver sample. Hybridization with an unrelated probe was negative in all samples. The HCV RNA-positive cells were detected with anti-sense but not sense RNA probes, suggesting that they contained a high ratio of genomic:antigenomic RNA. The appearance and distribution of the HCV RNA-positive cells suggested that they were not hepatocytes and were more likely to be lymphocytes or macrophages.

Autoradiography↗
PubMed1990

Diffuse ileal conduit stenosis from Crohn's disease.

A case of Crohn's disease affecting an ileal loop urinary conduit presented as a diffuse loop stenosis and bilateral hydronephrosis. Radiologic appearance and histology are analyzed to differentiate this unusual complication from other causes of conduit stricture.

Adult↗
PubMed1990

Quantitative histological study of enteropathy associated with HIV infection.

A quantitative histological study was performed on small intestinal biopsies from eight ambulatory patients with HIV infection (AIDS/AIDS-related complex, ARC) and compared with those from 16 normal subjects. Enteropathy was assessed by measurement of villus area, crypt length and mitotic count, as well as duodenal counts of intraepithelial lymphocytes, mucosal mast cells and goblet cells. Enteropathy in subjects with AIDS/ARC was shown by reduced mean villus area of 0.363 (SD 0.081) compared with 0.500 (SD 0.064) mm2 in control subjects (p less than 0.0001), while intestinal crypts were of similar length with 239 (SD 36) compared with 225 (SD 28 microns, but mitotic count was increased to 3.8 (SD 1.2) compared with 2.4 (SD 0.8) (p = 0.01) in the same control subjects. These results indicate villous atrophy with impaired crypt hyperplasia. Duodenal cell counts showed similar numbers of mucosal mast cells, intraepithelial lymphocytes and goblet cells in AIDS/ARC patients and fifteen control subjects.

AIDS-Related Complex↗
PubMed1990

Activity of duodenal disaccharidases in relation to normal and abnormal mucosal morphology.

Endoscopic duodenal biopsy specimens from 100 predominantly adult Caucasian patients under investigation for gastrointestinal symptoms were used to establish reference ranges for lactase, sucrase, and maltase in the duodenum. Duodenal and jejunal disaccharidase values were compared and the association between disaccharidase activity and morphology in the duodenum was examined. Mean lactase activities were about 40% lower in the duodenum compared with the jejunum; maltase was reduced to a lesser extent; and sucrase activities were much the same in the two sites. Lactase deficiency was found in 24 patients of whom 14 (58%) had duodenal disease. The presence of moderate to severe duodenal lesions was associated with a significant decrease in all disaccharidase activities, while only lactase was reduced in mild lesions. Twelve patients had normal lactase activity, despite the presence of duodenal disease. It is concluded that specific reference ranges for duodenal mucosal disaccharidase activity are required as this is less than that of jejunum. Reduced duodenal disaccharidase activity is usually but not invariably associated with morphological abnormality.

Adolescent↗
PubMed1989

Clomiphene citrate.

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Abnormalities, Drug-Induced↗
PubMed1989

Endometriosis of the large bowel: a report of 11 cases.

The clinical and pathological features of 11 cases of large bowel endometriosis are reported, one of which also had lesions in the small intestine. All of the cases had rectal or rectosigmoid involvement. Altered bowel habit and pain were common symptoms but were rarely associated with the menstrual cycle. Sigmoidoscopy was generally unhelpful. Rectal or vaginal examination and barium enema often revealed a mass which was usually diagnosed preoperatively as a malignancy. A correct diagnosis was made preoperatively in only two cases; carcinoma was suspected in four and carcinoid in one case. Histological evidence of recent hemorrhage was confined to those cases where endometriosis seemed to be the major cause of intestinal symptoms. The colonic mucosa overlying the endometriotic deposits was commonly histologically abnormal. It showed a range of changes resembling colitis, solitary ulcer, prolapse or even neoplasm. An appreciation of these mucosal alterations is important to those reporting colonic and rectal biopsies; when observed to be focal in a female patient they should arouse a suspicion of endometriosis.

Adult↗