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W T Cooke

Publications and source records attributed to W T Cooke.

At least 91 records · Page 5Linked to original sources
PubMed1974

Cellular infiltrate of jejunal biopsies in adult coeliac disease in relation to gluten withdrawal.

A comparison has been made of inflammatory cell counts in the lamina propria and epithelium of jejunal biopsies in 11 patients with adult coeliac disease with those found in 12 control subjects. In the coeliac patients, there were significant increases in the numbers of total cells, plasma cells, and intraepithelial lymphocytes, but a significant reduction in lamina propria lymphocytes. Following clinical improvement on a strict gluten-free diet, significant changes in cell counts occurred, but with the exception of lymphocytes in the lamina propria, the counts were still abnormal. Analysis of five patients in whom the biopsy improved to near normal morphology and of six in whom there was no such improvement showed that significant falls in plasma cells and rises in lymphocytes in the lamina propria could occur without improvement in other morphological appearances. These results seem relevant to the problem of diagnosing coeliac disease in patients who, on gluten withdrawal, show an unequivocal clinical response, but no gross morphological improvement in the jejunal biopsy. On the basis of the observed changes in cell counts, there seems little justification in questioning the diagnosis of coeliac disease in such patients.

Adult↗
PubMed1973

Serum alkaline phosphatase and rickets in urban schoolchildren.

Among 569 schoolchildren (386 boys and 183 girls) aged 14-17 years, 233 had serum alkaline phosphatase values of 30 K.A. units or greater. There was no significant difference in the results in Asian, white, or West Indian children. The mean values were significantly greater in boys than girls and both showed a fall in mean values with increasing age. Radiological rickets occurred in at least 4% of the survey, and was more common in Asians. Low calcium and high hydroxyproline excretion in most of those investigated and the response to vitamin D therapy suggests that most children with alkaline phosphatase levels above 30 K.A. units have rickets.Since the decline of the widespread supplementation of the diet with vitamin D, the demands of the physiological growth spurt for extra vitamin D in adolescents already on a borderline intake may be responsible for the great increase in "biochemical" rickets. Once the growth spurt is over the condition subsides but the results of impaired growth or permanent pelvic deformity will not necessarily be eradicated.

Adolescent↗
PubMed1973

Abscess and fistulae in Crohn's disease.

In a series of 360 patients with Crohn's disease 18% have developed a complication of abscess and/or fistula. Both complications can be spontaneous but more commonly occur in patients who have had a previous operation. There is a high incidence of fistula after laparotomy without resection of diseased bowel. Simple drainage of an abscess is usually followed by a fistula and fistulae do not close spontaneously. The optimal surgical treatment for fistula and for deep abscess is excision in continuity with the diseased segment of intestine.

Abscess↗
PubMed1973

Free perforation in Crohn's disease.

Free perforation is a rare complication of Crohn's disease. Seven cases were found in a total series of 360 in Birmingham. It occurs during an acute exacerbation of chronic disease, particularly in the presence of distal obstruction. The incidence of this complication may becoming less common and steroid therapy was not a precipitating factor. Primary resection of the perforated and distal obstructed bowel is likely to give the best results.

Adolescent↗
PubMed1973

Inheritance and influence of histocompatibility (HL-A) antigens in adult coeliac disease.

In a study of histocompatibility antigens in adult coeliac disease the HL-A phenotypes have been determined in 117 patients and 149 of their first-degree relatives, of whom 94 had had a jejunal biopsy performed. There was an increased frequency of the HL-A 8 antigen in the patients and their relatives. Family studies showed no irregularity in the inheritance of both this antigen and the HL-A 1 and 8 haplotype.

Biopsy↗
PubMed1972

Growing pains.

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Adolescent↗
PubMed1972

A comparison of results of excision and bypass for ileal Crohn's disease.

One hundred and ten patients presented with Crohn's disease confined to the terminal ileum, and indications for their surgical treatment are reviewed. Treatment was either by ileo-transverse side-to-side bypass (21 patients) or primary excision and end-to-end ileo-colic anastomosis (89 patients). In a long follow up (mean 13.8 years) the date and indications for the second major operative intervention are recorded. The cumulative risk of recurrence recorded each year after the primary operation shows that after bypass compared with excision there is approximately twice the risk of requiring a further major operation. After bypass the indication for the second operation is usually a local complication of the still active disease and after excision it is usually a juxta-anastomotic recurrence with stenosis.

Crohn Disease↗
PubMed1972

Impaired lymphocyte reactivity against tumour cells in patients with Crohn's disease.

Evidence is presented which indicates a possible reduction in recognition capacity for tumour cell antigens (EB(2) Burkitt lymphoma cell line) by lymphocytes from some patients with longstanding but inactive Crohn's disease. Three out of seven patients tested also showed diminished or absent lymphocytotoxicity when their cells were grown in mixed culture with chromium-labelled lymphoma cells and absent response has never been observed in a large series of controls similarly tested. In both test systems impaired reactivity appeared to be partly caused by a factor present in Crohn's disease serum. Increased tumour incidence in Crohn's disease may in part be attributable to defective immune surveillance and the histology of Crohn's disease could reflect an imbalance between the proliferative and the cytotoxic responses of lymphocytes to various antigens in the bowel lumen in this disease.

Adolescent↗