Faecal toxin and severity of antibiotic-associated pseudomembranous colitis.
Burdon, D W, George, R H, Mogg, G A, Arabi, Y, Thompson, H, Johnson, M, ...
The relationship between faecal toxin titre, histological evidence of pseudomembrane in the rectum, and severity of antibiotic-associated colitis has been analysed from data on 62 patients whose...
Anal sphincter defects. Correlation between endoanal ultrasound and surgery.
Deen, K I, Kumar, D, Williams, J G, Olliff, J, Keighley, M R
OBJECTIVE: This study was performed to (1) correlate and sphincter defects, identified by endoanal ultrasound with operative findings, and (2) define the appearance of such sphincter defects as seen...
Lateral subcutaneous sphincterotomy: local or general anaesthetic?
Gatehouse, D, Arabi, Y, Alexander-Williams, J, Keighley, M R
Arthritis in pseudomembranous colitis associated with an antibody to Clostridium difficile toxin.
Fairweather, S D, Youngs, D, George, R H, Burdon, D W, Keighley, M R
Value of an anal dilator after anal stretch for haemorrhoids.
Greca, F, Nevah, E, Hares, M, Keighley, M R
A prospective randomized trial compared anal stretch with or without continued dilatation for three months in 89 consecutive patients with haemorrhoids. Complications of therapy occurred in only 4...
Postanal repair for faecal incontinence.
Between 1977 and 1983, 105 patients had a postanal repair for the treatment of faecal incontinence. All except 8 patients were women. The principal reasons for operation were: persistent incontinence...
Outlet syndrome: is there a surgical option?
Of 46 patients investigated for constipation, 21 were found to have some other primary abnormality, leaving 25 patients for study: 6 had evidence of the outlet syndrome alone, 5 had slow transit...
Optimal timing of operation for bleeding peptic ulcer: prospective randomised trial.
Morris, D L, Hawker, P C, Brearley, S, Simms, M, Dykes, P W, Keighley, M R
From October 1980 to September 1983 all patients with upper gastrointestinal bleeding were admitted to a centralised unit and investigated by early endoscopy. A total of 142 patients with a proved...
Obscure bleeding from the small bowel.
Brearley, S, Ambrose, N S, Silverman, S, Hawker, P C, Dorricott, N J, Keighley, M R
Fatal pseudomembranous colitis despite eradication of Clostridium difficile.
Hawker, P C, Hine, K R, Burdon, D W, Thompson, H, Keighley, M R
Ambrose, N S, Hares, M M, Alexander-Williams, J, Keighley, M R
Two hundred and sixty eight patients with haemorrhoids were allocated at random to treatment by either photocoagulation (group 1, n=141) or rubber band ligation (group 2, n=127) and followed up for...
Prospective trials of minor surgical procedures and high-fibre diet for haemorrhoids.
Keighley, M R, Buchmann, P, Minervini, S, Arabi, Y, Alexander-Williams, J
Two hundred and sixteen consecutive patients seen for the first time with symptomatic haemorrhoids entered trials of conservative and minor surgical treatment. They were divided into two groups...
Diagnosis of pseudomembranous colitis.
Kappas, A, Shinagawa, N, Arabi, Y, Thompson, H, Burdon, D, Dimock, F, ...
Twenty-eight patients with histologically proved pseudomembranous colitis have been seen in one hospital since July 1975. All patients with the disease had received antibiotics, six for infections...
Identification of Clostridium difficile as a cause of pseudomembranous colitis.
George, R H, Symonds, J M, Dimock, F, Brown, J D, Arabi, Y, Shinagawa, N, ...
Randomised controlled trial of vancomycin for pseudomembranous colitis and postoperative diarrhoea.
Keighley, M R, Burdon, D W, Arabi, Y, Williams, J A, Thompson, H, Youngs, D, ...
The efficacy of vancomycin in pseudomembranous colitis was assessed in a prospective randomised controlled trial. Forty-four patients with postoperative diarrhoea were allocated to five days'...
Mortality in patients with bleeding peptic ulcer when those aged 60 or over are operated on early.
Wheatley, K E, Snyman, J H, Brearley, S, Keighley, M R, Dykes, P W
Letter: Postoperative pseudomembranous colitis.
Crapp, A R, Powis, J, Clark, C, Keighley, M R, Alexander-Williams, J
Faecal toxin and severity of antibiotic-associated pseudomembranous colitis.
Burdon, D W, George, R H, Mogg, G A, Arabi, Y, Thompson, H, Johnson, M, ...
The relationship between faecal toxin titre, histological evidence of pseudomembrane in the rectum, and severity of antibiotic-associated colitis has been analysed from data on 62 patients whose...
Anal sphincter defects. Correlation between endoanal ultrasound and surgery.
Deen, K I, Kumar, D, Williams, J G, Olliff, J, Keighley, M R
OBJECTIVE: This study was performed to (1) correlate and sphincter defects, identified by endoanal ultrasound with operative findings, and (2) define the appearance of such sphincter defects as seen...
Lateral subcutaneous sphincterotomy: local or general anaesthetic?
Gatehouse, D, Arabi, Y, Alexander-Williams, J, Keighley, M R
Arthritis in pseudomembranous colitis associated with an antibody to Clostridium difficile toxin.
Fairweather, S D, Youngs, D, George, R H, Burdon, D W, Keighley, M R
Value of an anal dilator after anal stretch for haemorrhoids.
Greca, F, Nevah, E, Hares, M, Keighley, M R
A prospective randomized trial compared anal stretch with or without continued dilatation for three months in 89 consecutive patients with haemorrhoids. Complications of therapy occurred in only 4...
Postanal repair for faecal incontinence.
Between 1977 and 1983, 105 patients had a postanal repair for the treatment of faecal incontinence. All except 8 patients were women. The principal reasons for operation were: persistent incontinence...
Outlet syndrome: is there a surgical option?
Of 46 patients investigated for constipation, 21 were found to have some other primary abnormality, leaving 25 patients for study: 6 had evidence of the outlet syndrome alone, 5 had slow transit...
Optimal timing of operation for bleeding peptic ulcer: prospective randomised trial.
Morris, D L, Hawker, P C, Brearley, S, Simms, M, Dykes, P W, Keighley, M R
From October 1980 to September 1983 all patients with upper gastrointestinal bleeding were admitted to a centralised unit and investigated by early endoscopy. A total of 142 patients with a proved...
Obscure bleeding from the small bowel.
Brearley, S, Ambrose, N S, Silverman, S, Hawker, P C, Dorricott, N J, Keighley, M R
Fatal pseudomembranous colitis despite eradication of Clostridium difficile.
Hawker, P C, Hine, K R, Burdon, D W, Thompson, H, Keighley, M R
Ambrose, N S, Hares, M M, Alexander-Williams, J, Keighley, M R
Two hundred and sixty eight patients with haemorrhoids were allocated at random to treatment by either photocoagulation (group 1, n=141) or rubber band ligation (group 2, n=127) and followed up for...
Prospective trials of minor surgical procedures and high-fibre diet for haemorrhoids.
Keighley, M R, Buchmann, P, Minervini, S, Arabi, Y, Alexander-Williams, J
Two hundred and sixteen consecutive patients seen for the first time with symptomatic haemorrhoids entered trials of conservative and minor surgical treatment. They were divided into two groups...
Diagnosis of pseudomembranous colitis.
Kappas, A, Shinagawa, N, Arabi, Y, Thompson, H, Burdon, D, Dimock, F, ...
Twenty-eight patients with histologically proved pseudomembranous colitis have been seen in one hospital since July 1975. All patients with the disease had received antibiotics, six for infections...
Identification of Clostridium difficile as a cause of pseudomembranous colitis.
George, R H, Symonds, J M, Dimock, F, Brown, J D, Arabi, Y, Shinagawa, N, ...
Randomised controlled trial of vancomycin for pseudomembranous colitis and postoperative diarrhoea.
Keighley, M R, Burdon, D W, Arabi, Y, Williams, J A, Thompson, H, Youngs, D, ...
The efficacy of vancomycin in pseudomembranous colitis was assessed in a prospective randomised controlled trial. Forty-four patients with postoperative diarrhoea were allocated to five days'...
Mortality in patients with bleeding peptic ulcer when those aged 60 or over are operated on early.
Wheatley, K E, Snyman, J H, Brearley, S, Keighley, M R, Dykes, P W
Letter: Postoperative pseudomembranous colitis.
Crapp, A R, Powis, J, Clark, C, Keighley, M R, Alexander-Williams, J
Evaluation of single-dose hypnotic treatment before elective operation.
Keighley, M R, Gannon, M, Warlow, J, Jenkins, C R, Gammon, R J
A prospective randomised double-blind controlled trial was carried out to evaluate the place of a single dose of triazolam, flurazepam, and placebo on the evening before an elective operation in 96...
Influence of prophylaxis against bacteroides on incidence of sepsis after large-bowel surgery.
Keighley, M. R., Burdon, D. W., Cooke, W. T., Alexander-Williams, J.
Hall, C, Griffin, J, Dykes, P W, Williams, J A, Keighley, M R
Patients who had undergone curative resection for colorectal cancer were studied to compare the efficacy of faecal occult blood detection (Haemoccult test) with colonoscopy in the detection of...
Ileal mucosal absorption of bile acid in man: validation of a miniature flux chamber technique.
Hosie, K B, Davie, R J, Panagamuwa, B, Grobler, S, Keighley, M R, Birch, N J
A method that allows the quantitative assessment of ileal mucosal cell uptake and transport of bile acids in mucosal biopsy specimens has been validated. Viability of the tissue was confirmed by...
An audit of restorative proctocolectomy.
Keighley, M R, Grobler, S, Bain, I
A total of 168 restorative proctocolectomies have been performed without mortality during the past nine years. Morbidity from pelvic sepsis (12%), ileoanal stricture (15%), and pouch related fistulas...
The prevalence of anal sphincter defects in faecal incontinence: a prospective endosonic study.
Deen, K I, Kumar, D, Williams, J G, Olliff, J, Keighley, M R
Forty six patients (median age 61 years; 42 women) with faecal incontinence and 16 age and sex matched controls undergoing a restorative proctocolectomy were assessed by clinical examination,...
Winslet, M C, Allan, A, Poxon, V, Youngs, D, Keighley, M R
The high incidence of clinical remission after faecal diversion for Crohn's colitis suggests the faecal stream may play a part in the inflammatory mechanism. The effect of faecal diversion (n = 22)...
Outcome of restorative proctocolectomy when the diagnosis is suggestive of Crohn's disease.
Grobler, S P, Hosie, K B, Affie, E, Thompson, H, Keighley, M R
Twenty of 81 patients treated by restorative proctocolectomy for presumed ulcerative colitis had some features of Crohn's disease: 10 were classified as definite Crohn's disease and 10 as...
Fistulas in ano: endoanal ultrasonographic assessment assists decision making for surgery.
Deen, K I, Williams, J G, Hutchinson, R, Keighley, M R, Kumar, D
Eighteen patients with a clinical impression of a complex fistula in ano, had anal endosonography to delineate the anatomy of the fistula track and identify associated areas of sepsis. The clinical...
Superoxide production by Crohn's disease neutrophils.
Curran, F T, Allan, R N, Keighley, M R
Neutrophil superoxide anion production was measured in healthy subjects and in patients with quiescent and active Crohn's disease using superoxide dismutase inhibitable cytochrome C reduction. Three...
Candidacidal activity of Crohn's disease neutrophils.
Curran, F T, Youngs, D J, Allan, R N, Keighley, M R
The ability of normal and Crohn's disease neutrophils to kill Candida albicans has been studied using neutrophils isolated from peripheral blood and suspended in phosphate buffered saline at 5 x...
Barsoum, G H, Thompson, H, Neoptolemos, J P, Keighley, M R
It has been proposed that colorectal carcinogenesis is accompanied by increased mucosal cell proliferation and that the converse may also apply. To examine this thesis, the crypt cell production rate...
Crypt cell production rates at various sites around the colon in Wistar rats and humans.
Hall, C, Youngs, D, Keighley, M R
The crypt cell production rate (CCPR) is considered the most robust estimate of cell turnover. The CCPR was determined at various sites around the colon in the Wistar rat (using an in vivo technique)...
Rowley, S, Candinas, D, Mayer, A D, Buckels, J A, McMaster, P, Keighley, M R
This study reports on the outcome of four patients having ileal pouch anal anastomosis after orthotopic liver transplantation for sclerosing cholangitis complicating ulcerative colitis. There were no...
Lee, F I, Jewell, D P, Mani, V, Keighley, M R, Kingston, R D, Record, C O, ...
Distal ulcerative colitis can be treated with oral or rectal mesalazine, or both. A foam enema preparation has been developed and its efficacy investigated. The aim of this study was to evaluate the...
Keighley, M R, Asquith, P, Alexander-Williams, J
This study has investigated the possible association between duodenogastric reflux, gastritis, and symptoms in 35 patients with or without dyspepsia one to 15 years after gastric surgery. Five...
Keighley, M R, Drysdale, R B, Quoraishi, A H, Burdon, D W, Alexander-Willians, J
A randomised controlled trial has been performed in 150 patients undergoing biliary operations to determine whether an antibiotic which is excreted almost entirely in bile (rifamide) is to be...
Hoare, A M, Keighley, M R, Starkey, B, Alexander-Williams, J
We measured the concentration of bile acids in gastric aspirates from patients who had had operations for peptic ulcer. Some patients were asymptomatic and some had postoperative symptoms of the type...
White, C M, Harding, L K, Keighley, M R, Dorricott, N J, Alexander-Williams, J
A consecutive series of 12 patients with stenosis secondary to duodenal ulceration were treated by proximal gastric vagotomy (PGV) and duodenoplasty or PGV and dilatation of the stenosis. Three...
Influence of inflammatory bowel disease on intestinal microflora.
Keighley, M R, Arabi, Y, Dimock, F, Burdon, D W, Allan, R N, Alexander-Williams, J
The microflora of the jejunum, ileum, and colon has been studied from operative samples in Crohn's disease (n = 30), ulcerative colitis (n = 15), and controls (n = 40). There was no significant...
Rowachol--a possible treatment for cholesterol gallstones.
Doran, J, Keighley, M R, Bell, G D
It has been claimed that Rowachol, a proprietary choleretic, is occasionally successful in the treatment of gallstones. In gallstone patients we have examined its effect on the lipid composition of...
Manometric evaluation of rectal prolapse and faecal incontinence.
Sixty-three patients with complete rectal prolapse and/or faecal incontinence have undergone anal manometry and the results have been compared with an equal number of age- and sex-matched controls....
Relationship of proctitis and rectal capacity in Crohn's disease.
Buchmann, P, Mogg, G A, Alexander-Williams, J, Allan, R N, Keighley, M R
In patients with Crohn's disease involving the rectum (n=25), there was an inverse relationship between rectal capacity and the degree of proctitis. However, in patients with Crohn's disease not...
Keighley, M R, Buchmann, P, Lee, J R
Anorectal function has been assessed in 53 patients with Crohn's disease by measurement of resting and squeeze anal canal pressures and the maximum volume tolerated during distension of a balloon in...
Clostridium difficile toxin in acute diarrhoea complicating inflammatory bowel disease.
Keighley, M R, Youngs, D, Johnson, M, Allan, R N, Burdon, D W
The incidence of Clostridium difficile cytotoxin has been studied in 69 consecutive patients with inflammatory bowel disease complicated by severe diarrhoea or ileostomy flux during 74 admissions to...
Management of enterocutaneous fistulae in Crohn's disease.
Hawker, P C, Givel, J C, Keighley, M R, Alexander-Williams, J, Allan, R N
The outcome among 39 patients with enterocutaneous fistulae complicating Crohn's disease has been reviewed. The patients were considered in two groups: (1) no disease - all were early postoperative...
Keighley, M R, Youngs, D, Poxon, V, Morris, D, Muscroft, T J, Burdon, D W, ...
Three groups of patients studied after operations which had cured their duodenal ulcer were compared with a control group (no operation, n = 8). The surgical procedures included: proximal gastric...
Clinical impact of colectomy and ileorectal anastomosis in the management of Crohn's disease.
Ambrose, N S, Keighley, M R, Alexander-Williams, J, Allan, R N
We report the outcome of 63 consecutive patients with Crohn's colitis treated by colectomy and ileorectal anastomosis between 1951-1981. There were no operative deaths. Serious postoperative...
Mutagenicity in gastric juice.
Morris, D L, Youngs, D, Muscroft, T J, Cooper, J, Rojinski, C, Burdon, D W, ...
Mutagenicity has been measured in the gastric juice of 228 patients using the Ames bacteriological test system; while mutagenicity in control and duodenal ulcer patients did not differ from saline...
Higgens, C S, Keighley, M R, Allan, R N
One hundred and twenty seven patients undergoing elective surgery for inflammatory bowel disease were divided into three groups according to their preoperative ideal body weight (less than 80%,...
Crohn's disease in the elderly.
Fabricius, P J, Gyde, S N, Shouler, P, Keighley, M R, Alexander-Williams, J, Allan, R N
The natural history of Crohn's disease in 47 patients, 60 years of age or older at the time of diagnosis has been defined, and their clinical management and long term prognosis reviewed. Distal...
Prevalence of sexually transmitted disease among male patients presenting with proctitis.
Andrews, H, Wyke, J, Lane, M, Clay, J, Keighley, M R, Allan, R N
Fifty male patients with proctitis were examined and the clinical, microbiological, serological and proctological features compared with 51 known male homosexuals attending the genitourinary (GU)...
MacDonald, F., Morton, D. G., Rindl, P. M., Haydon, J., Cullen, R., Gibson, J., ...
OBJECTIVES--To evaluate the use of polymorphic DNA probes linked to the APC gene in the presymptomatic diagnosis of familial adenomatous polyposis. DESIGN--Four DNA probes were tested on an...
Micro-organisms in the bile. A preventable cause of sepsis after biliary surgery.
The bile is infected in 31% of patients undergoing an operation for biliary disease and these patients have a significantly greater risk of developing wound sepsis and septicaemia than patients with...
Comparison between general and local anaesthesia for repair of groin hernias.
Makuria, T., Alexander-Williams, J., Keighley, M. R.
A prospective study of 104 cases has been carried out to compare the use of local and general anaesthesia for the elective repair of groin hernias. There were no apparent disadvantages in using a...
Influence of diabetes on mortality and morbidity following operations for obstructive jaundice.
Keighley, M. R., Razay, G., Fitzgerald, M. G.
The influence of diabetes on mortality and morbidity following operations for obstructive jaundice has been assessed in 118 consecutive patients, all of whom received antibiotic cover, subcutaneous...
Long saphenous vein stripping under local anaesthesia.
Taylor, E. W., Fielding, J. W., Keighley, M. R., Alexander-Williams, J.
Stripping of the long saphenous vein under femoral nerve block has been preformed on 21 patients (27 limbs). There has been no complication from the nerve block and this form of anaesthesia was found...
Dorricott, N. J., Baddeley, R. M., Keighley, M. R., Lee, J., Oates, G. D., Alexander-Williams, J.
The complications and results of rectal anastomoses carried out with the end-to-end anastomosis (EEA) stapling instrument on 50 patients by 5 consultant surgeons are recorded. There was a clinical...
Keighley, M. R., Moore, J., Thompson, H.
We report a 91% accuracy with fine needle aspiration cytology in 46 patients found to have a mass in the pancreas at laparotomy. Results were compared with conventional biopsy at operation which was...
Peroperative detection of patients with rectal cancer at high risk of local recurrence.
Silverman, S. H., Moore, J., Thompson, H., Keighley, M. R.
Identification at the time of surgery of patients with rectal carcinoma at high risk of local recurrence may allow a more rational decision to be made regarding the operative procedure to be...
The surgical treatment of gastroduodenal Crohn's disease.
Shepherd, A. F., Allan, R. N., Dykes, P. W., Keighley, M. R., Alexander-Williams, J.
Crohn's disease can affect any part of the gastrointestinal tract. Gastroduodenal involvement is uncommon and was not recognised until 1949 (1). Since then approximately 200 cases have been described...
An aid to the assessment of bowel preparation prior to colonic resection.
Ambrose, N. S., Keighley, M. R.
The removal of solid and liquid faeces from the colon is a prerequisite for safe colonic resection. Previous studies attempting to quantify evacuation of the colon have relied on a subjective opinion...
Audit on complicated diverticular disease.
Shephard, A. A., Keighley, M. R.
Seventy-three patients were seen between 1970 and 1983 with complicated diverticular disease. There were only six hospital deaths (8%). Two out of 7 patients with faecal peritonitis died, 2 of 27...
Analysis of a hospital-based stomatherapy service.
Phillips, R., Pringle, W., Evans, C., Keighley, M. R.
We have analysed the activities of a hospital-based stomatherapy service between 1980 and 1983. The average numbers of patients seen per annum included 395 out-patients, 307 in-patients and 116 home...
Brearley, S., Hawker, P. C., Dorricott, N. J., Lee, J. R., Ambrose, N. S., Silverman, S. H., ...
Thirty-seven patients who had had either a colonoscopy or a selective mesenteric angiogram while being investigated for severe or persistent gastrointestinal bleeding of obscure origin were reviewed....
Enterovesical fistulas in Crohn's disease.
Heyen, F., Ambrose, N. S., Allan, R. N., Dykes, P. W., Alexander-Williams, J., Keighley, M. R.
A total of 19 enterovesical fistulas were recorded in a series of 799 patients with Crohn's disease (2.4%). The origin of the fistulas was: ileum (9), colon (6) and four were complex involving the...
Outpatient measurement of perineal descent.
One hundred and fifty-eight consecutive patients attending a rectal clinic have undergone measurement of perineal descent at rest and during straining by a simple noninvasive method. In nine patients...
Comparison of sutured and stapled closure of loop ileostomy after restorative proctocolectomy.
Bain, I. M., Patel, R., Keighley, M. R.
Twenty consecutive stapled loop ileostomy closures in patients treated by restorative proctocolectomy were compared with the previous 20 sutured loop ileostomy closures in a non-randomised audit....
Audit of topical glyceryl trinitrate for treatment of fissure-in-ano.
Hasegawa, H., Radley, S., Morton, D. G., Dorricott, N. J., Campbell, D. J., Keighley, M. R.
PURPOSE: To clarify the clinical role of topical glyceryl trinitrate (GTN) in the management of anal fissures. PATIENTS AND METHODS: Fifty-six consecutive patients with fissure-in-ano attending a...
Sakaguchi, M., Rowley, S., Kane, N., Imray, C., Davies, A., Jones, C., ...
Seventy-five nude mice received subcutaneous inoculation with 1 X 10(7) cells of the human colonic cancer cell lines COLO-320 or HT-29. Tumour growth was assessed over 4 weeks in animals given one of...