University Hospitals Of Leicester Research Articles

Expression of Thrombospondin-1 in Resected Colorectal Liver Metastases Predicts Poor Prognosis

The aim of this study was to examine the expression and prognostic relevance of thrombospondin-1 (TSP-1) in tumor biopsies taken from a consecutive series of liver resections done at the University Hospitals of Leicester and the Royal Liverpool Hospital. Patients having undergone a liver resection for colorectal liver metastases at our institutions between 1993 and 1999 inclusive were eligible. Inclusion criteria were curative intent, sufficient tumor biopsy, and patient follow-up data. One hundred eighty-two patients were considered in this study. Standard immunohistochemical techniques were used to study the expression of TSP-1 in 5-microm tumor sections from paraffin-embedded tissue blocks. TSP-1 was correlated with survival using the Kaplan-Meier method and log-rank test for univariate analysis and the Cox proportional hazard model for multivariate analysis. One hundred eighty-two patients (male, n = 122 and female, n = 60) ages between 25 and 81 years (mean, 61 years) were included. TSP-1 was expressed around blood vessels (n = 45, 25%) or in the stroma (n = 59, 33%). No expression was detected in the remaining tumors. TSP-1 significantly correlated with poor survival on univariate (P = 0.01 for perivascular expression and P = 0.03 for stromal expression) and multivariate analysis (P = 0.01 for perivascular expression). TSP-1 is a negatively prognostic factor for survival in resected colorectal liver metastases.

Developmental outcome in newborn infants treated for acute respiratory failure with extracorporeal membrane oxygenation: present experience

Objective: To describe the later health status of newborn infants who received extracorporeal membrane oxygenation (ECMO) for acute respiratory failure in the era after the UK ECMO trial. Design: Prospective...

Brachial diplegia as a result of cervical cord injury

To report a case of brachial diplegia with normal lower limb power, after a cervical cord injury. Case report of a 63-year-old man who sustained a neck trauma following a fall. Department of Neurology, University Hospitals of Leicester, Royal Infirmary, Leicester, UK. The mechanism of the injury was probably one of hyperflexion resulting in central cervical cord contusion. Initial neurological examination revealed brachial diplegia, with posterior column sensory involvement of the lower limbs which had normal power. The patient was also in urinary retention but had no respiratory involvement. Magnetic resonance imaging (MRI) of the spinal cord showed a hyperintense signal in the central mid-cervical cord. Pure brachial diplegia represents a rare clinical presentation of cervical cord pathology, including trauma, of which clinicians should be aware.

Diagnosis of abdominal tuberculosis: the importance of laparoscopy.

Abdominal tuberculosis (TB) tends to present with non-specific features and can be hard to diagnose. In the University Hospitals of Leicester, which serve a large immigrant population, 36 patients had this diagnosis between 1995 and 2001. We examined their records to identify features, including history, clinical presentation, investigations and diagnostic procedures, that might help with diagnosis of future cases. 32 of the patients were of Asian origin, predominantly from the Indian subcontinent. The most common presenting complaints were abdominal pain and weight loss. On clinical examination the findings were non-specific. Only 2 patients were found to have concurrent pulmonary TB. The most consistent laboratory finding (>90%) was a low haemoglobin with a raised C-reactive protein. The tuberculin test (Mantoux) was positive in only 7 patients (22%), and Ziehl-Neelsen staining of ascitic fluid was negative in all 11 patients in whom it was examined. An ultrasound scan of the abdomen revealed findings consistent with TB in 9/28 patients and a CT scan was helpful in 6/11. Laparoscopy, although usually performed as a last resort, proved the most effective investigation, yielding the diagnosis in 23 (92%) of the 25 patients in whom it was performed. In patients with the relevant background and clinical history, laparoscopy is the investigation of choice.

Diagnosis of abdominal tuberculosis: the importance of laparoscopy

Abdominal tuberculosis (TB) tends to present with non-specific features and can be hard to diagnose. In the University Hospitals of Leicester, which serve a large immigrant population, 36 patients had this diagnosis between 1995 and 2001. We examined their records to identify features, including history, clinical presentation, investigations and diagnostic procedures, that might help with diagnosis of future cases. 32 of the patients were of Asian origin, predominantly from the Indian subcontinent. The most common presenting complaints were abdominal pain and weight loss. On clinical examination the findings were non-specific. Only 2 patients were found to have concurrent pulmonary TB. The most consistent laboratory finding (>90%) was a low haemoglobin with a raised C-reactive protein. The tuberculin test (Mantoux) was positive in only 7 patients (22%), and Ziehl-Neelsen staining of ascitic fluid was negative in all 11 patients in whom it was examined. An ultrasound scan of the abdomen revealed findings consistent with TB in 9/28 patients and a CT scan was helpful in 6/11. Laparoscopy, although usually performed as a last resort, proved the most effective investigation, yielding the diagnosis in 23 (92%) of the 25 patients in whom it was performed. In patients with the relevant background and clinical history, laparoscopy is the investigation of choice.

Aqueous humor levels of topically applied bupivacaine 0.75% in cataract surgery

Purpose To measure the intraocular levels of bupivacaine 0.75% topically applied before phacoemulsification and to develop standards for topical anesthesia in cataract surgery. Setting Department of Ophthalmology, University Hospitals of Leicester, Leicester, United Kingdom. Methods Forty eyes having phacoemulsification for senile cataract under topical anesthesia without sedation were randomly assigned to 1 of 2 preoperative topical anesthesia regimens. Bupivacaine 0.75% was applied in 0.1 mL drops 3 times in the 30 minutes before surgery in 18 eyes and 6 times in the 60 minutes before surgery in 22 eyes. Aqueous humor and serum samples were taken at the start of surgery and the bupivacaine levels measured. A visual analog pain score scale was used to indicate intraoperative pain. Results The mean aqueous humor level of bupivacaine was 5.9 μg/mL ± 4.3 (SD) after 3 drops and 5.7 ± 4.0 μg /mL after 6 drops. The blood levels were less than 1.0 μg/mL. There was no statistically significant difference in the intraocular level of bupivacaine between the 2 groups. There was no difference in the age or sex distribution between the 2 groups, although there was an increase in the intraocular level of bupivacaine with age (approximately 1.4 μg/mL per decade; P = .048). There was no clear pattern associating the pain score with age, sex, or intraocular level of bupivacaine. Conclusions A 3-drop regimen of bupivacaine 0.75% in the half hour before cataract surgery penetrated the eye as effectively as 6 drops in the 1 hour before surgery and provided good analgesia for phacoemulsification. Bupivacaine 0.75% penetrated the eye increasingly effectively with increasing age.

The Cancer Collaborative Services Project.

Colorectal DiseaseVolume 4, Issue 5 p. 365-366 The Cancer Collaborative Services Project M. J. Kelly, M. J. Kelly CSC National Lead Clinician in Colorectal Cancer, University Hospitals of Leicester, Leicester UKSearch for more papers by this author M. J. Kelly, M. J. Kelly CSC National Lead Clinician in Colorectal Cancer, University Hospitals of Leicester, Leicester UKSearch for more papers by this author First published: 30 August 2002 https://doi.org/10.1046/j.1463-1318.2002.00393.xCitations: 1 M. J. Kelly, CSC National Lead Clinician in Colorectal Cancer, University Hospitals of Leicester, Leicester LE5 4PW, UK. E-mail: michaeljkelly@compuserve.com Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume4, Issue5September 2002Pages 365-366 RelatedInformation