A. Polglase - Academia.edu (original) (raw)

Papers by A. Polglase

The Medical journal of Australia, Jan 16, 1995

Australian family physician, 1981

Diseases of the Colon & Rectum, 1985

Hughes ESR, McDermott FT, Polglase AL, Nottle P. Total and subtotal colectomy for colonic obstruc... more Hughes ESR, McDermott FT, Polglase AL, Nottle P. Total and subtotal colectomy for colonic obstruction. Dis Colon Rectum 1985;28:162-163. Colectomy (total or subtotal) is not the operation of choice for elective colonic cancer unless the patient is under 50 years of age, is undergoing curative resection, and has associated adenomatous polyps. Routine Volume 28 Number 3 COLECTOMY FOR COLONIC OBSTRUCTION

Clinical Cancer Research, 2011

Oncogene mutations contribute to colorectal cancer development. We searched for differences in on... more Oncogene mutations contribute to colorectal cancer development. We searched for differences in oncogene mutation profiles between colorectal cancer metastases from different sites and evaluated these as markers for site of relapse. One hundred colorectal cancer metastases were screened for mutations in 19 oncogenes, and further 61 metastases and 87 matched primary cancers were analyzed for genes with identified mutations. Mutation prevalence was compared between (a) metastases from liver (n = 65), lung (n = 50), and brain (n = 46), (b) metastases and matched primary cancers, and (c) metastases and an independent cohort of primary cancers (n = 604). Mutations differing between metastasis sites were evaluated as markers for site of relapse in 859 patients from the VICTOR trial. In colorectal cancer metastases, mutations were detected in 4 of 19 oncogenes: BRAF (3.1%), KRAS (48.4%), NRAS (6.2%), and PIK3CA (16.1%). KRAS mutation prevalence was significantly higher in lung (62.0%) and brain (56.5%) than in liver metastases (32.3%; P = 0.003). Mutation status was highly concordant between primary cancer and metastasis from the same individual. Compared with independent primary cancers, KRAS mutations were more common in lung and brain metastases (P < 0.005), but similar in liver metastases. Correspondingly, KRAS mutation was associated with lung relapse (HR = 2.1; 95% CI, 1.2 to 3.5, P = 0.007) but not liver relapse in patients from the VICTOR trial. KRAS mutation seems to be associated with metastasis in specific sites, lung and brain, in colorectal cancer patients. Our data highlight the potential of somatic mutations for informing surveillance strategies.

ANZ Journal of Surgery, 1988

Giant inguinal herniae present a major challenge in management. This case details clinical featur... more Giant inguinal herniae present a major challenge in management. This case details clinical features of an enormous inguinoscrotal hernia associated with septic gangrene and elephantiasis of the scrotum. Two initial operations were required for control of sepsis, followed by a two-staged hernial repair, involving a total colectomy and a subsequent neoscrotal repair. The problems of loss of domain within the abdominal cavity and the special features presented by this case are discussed.

ANZ Journal of Surgery, 1993

A 57 year old female presented with symptoms from a large, sessile tubulovillous adenoma of the l... more A 57 year old female presented with symptoms from a large, sessile tubulovillous adenoma of the lower third of the rectum. Transanal excision was impracticable due to its size and anterior resection was necessary. The upper third of the rectum was mobilized percutaneously, using the laparoscope. The lower two-thirds of the rectum were mobilized transanally and a non-everted pull-through excision of the lower third was performed, with a hand sewn colo-anal anastomosis. A temporary loop ileostomy was established through a 2.5 cm abdominal incision. Postoperative recovery was uncomplicated. The operative technique, which may have other applications, is described in detail.

ANZ Journal of Surgery, 1983

Sixty-one (3.0%) of 2029 patients managed operatively for carcinoma of the large intestine had sy... more Sixty-one (3.0%) of 2029 patients managed operatively for carcinoma of the large intestine had synchronous carcinomas. In 47 (77.0%) of the 61 patients the carcinomas were in the same or adjacent segment(s) of large intestine. Adenomatous polyps were present in 18 (30%) patients compared to 269 (14%) of 1968 patients with a single cancer. A curative resection was performed in 40 of 61 patients, palliative resection in 16 and a non-resection palliative operation in five. Two patients required proctocolectomy and eight subtotal colectomy with ileorectal anastomosis. Cancer specific survival for the entire group and for those treated by curative resection did not differ significantly from that of patients with a single carcinoma. It is concluded that: (1) the presence of a second carcinoma does not significantly alter the survival prospects; (2) both pre-operative large intestinal examination and careful operative palpation of the entire large intestine should be performed, and (3) the significantly higher incidence of adenomatous polyps in patients with synchronous carcinomas is consistent with the polyp/cancer sequence hypothesis.

ANZ Journal of Surgery, 1997

A number of reports have appeared of post-traumatic stress symptoms occurring in physically ill p... more A number of reports have appeared of post-traumatic stress symptoms occurring in physically ill patients. This study sought to measure the extent of psychiatric disturbance and acute post-traumatic stress reactions occurring in surgical inpatients, and to examine their relationship with the stress of illness and hospitalization and the personal coping style of the patient. Thirty-seven admissions to a general surgical unit were assessed on admission and immediately prior to discharge. Measures were made of depression, anxiety, cognitive impairment, post-traumatic stress symptoms, severity of illness, level of physical functioning, degree of hospital stress and coping style. There was a significant reduction in anxiety scores postoperatively. Twenty-seven per cent of patients developed high levels of acute post-traumatic stress symptoms and these correlated with depression at admission and intra-hospital stress. Depression at discharge was related to depression at admission, physical functioning and coping style. In general, avoidance and acceptance-resignation were associated with a poorer psychiatric outcome. Postoperative psychiatric disturbance, including acute stress symptoms, can be understood as a reaction to the 'trauma' of illness and hospitalization, predisposed to by pre-existing depression. Interventions could be directed at screening for at-risk patients, minimizing stress, and encouraging adaptive mechanisms of coping in patients.

ANZ Journal of Surgery, 1993

The Medical journal of Australia, Jan 17, 1981

The Medical journal of Australia, Jan 8, 1983

The Medical journal of Australia, Jan 21, 1981

A prospective analysis of 110 consecutive right-sided infraclavicular subclavian catheterizations... more A prospective analysis of 110 consecutive right-sided infraclavicular subclavian catheterizations in 102 patients is presented. Alternate patients were assigned into one of two groups (55 patients in each), to assess the value of ipsilateral head turning and supraclavicular pressure in preventing internal jugular vein (IJV) malposition of the catheter tip. Two malpositions occurred in the trial group (3.6%) and five occurred in the control group (9.1%). Although the manoeuvre reduced the incidence of malposition, the difference was not statistically significant (P = 0.22). A further 100 infraclavicular catheterizations were analysed to assess a new auscultatory test to predict IJV malposition of subclavian catheters. The test led to accurate prediction of all six malpositions. There were no false negative findings, but one false positive prediction was made. Results of this study suggest that the routine use of head turning may not prevent IJV malposition. However, the auscultatory ...

The Medical journal of Australia, Jan 9, 1982

The Medical journal of Australia, Jan 13, 1984

Colo-rectal Surgery, 1982

World Journal of Surgery, 1982

Diseases of the Colon & Rectum, 1986

Cancer-specific survival prospects for rectal carcinoma in a series of 1306 patients managed from... more Cancer-specific survival prospects for rectal carcinoma in a series of 1306 patients managed from 1950 to 1979 by one surgeon worsened from 1970 to 1979. The prognosis was worse for all patients treated operatively from 1970 to 1979 compared with 1960 to 1969 (P less than 0.03). After potentially curative resection, survival was worse from 1970 to 1979 compared with 1950 to 1959 (P less than 0.02) and 1960 to 1969 (P less than 0.01), respectively; the corresponding five-year survivals were 72.5 percent, 72.3 percent, and 61.5 percent. The curative resection rate for the three decades was similar (66 to 70 percent). An increase in the incidence of Dukes' Stage C tumors from 23.3 percent to 32.3 percent (P less than 0.01) explains, at least partly, the decreased survival. The worsened survival prospects were not accounted for by changes in referral pattern, tumor site, or in the proportion of sphincter-saving resections performed. The worsening was paradoxically paralleled by earlier symptomatic presentation (P less than 0.001). Analyses of other Australian data are required to test the hypothesis that the worsened survival prospects are consequent to altered tumor biologic aggressiveness, possibly related to differences in the causal factors operating over the 30-year study period.

Diseases of the Colon & Rectum, 2007

The Medical journal of Australia, Jan 16, 1995

Australian family physician, 1981

Diseases of the Colon & Rectum, 1985

Hughes ESR, McDermott FT, Polglase AL, Nottle P. Total and subtotal colectomy for colonic obstruc... more Hughes ESR, McDermott FT, Polglase AL, Nottle P. Total and subtotal colectomy for colonic obstruction. Dis Colon Rectum 1985;28:162-163. Colectomy (total or subtotal) is not the operation of choice for elective colonic cancer unless the patient is under 50 years of age, is undergoing curative resection, and has associated adenomatous polyps. Routine Volume 28 Number 3 COLECTOMY FOR COLONIC OBSTRUCTION

Clinical Cancer Research, 2011

Oncogene mutations contribute to colorectal cancer development. We searched for differences in on... more Oncogene mutations contribute to colorectal cancer development. We searched for differences in oncogene mutation profiles between colorectal cancer metastases from different sites and evaluated these as markers for site of relapse. One hundred colorectal cancer metastases were screened for mutations in 19 oncogenes, and further 61 metastases and 87 matched primary cancers were analyzed for genes with identified mutations. Mutation prevalence was compared between (a) metastases from liver (n = 65), lung (n = 50), and brain (n = 46), (b) metastases and matched primary cancers, and (c) metastases and an independent cohort of primary cancers (n = 604). Mutations differing between metastasis sites were evaluated as markers for site of relapse in 859 patients from the VICTOR trial. In colorectal cancer metastases, mutations were detected in 4 of 19 oncogenes: BRAF (3.1%), KRAS (48.4%), NRAS (6.2%), and PIK3CA (16.1%). KRAS mutation prevalence was significantly higher in lung (62.0%) and brain (56.5%) than in liver metastases (32.3%; P = 0.003). Mutation status was highly concordant between primary cancer and metastasis from the same individual. Compared with independent primary cancers, KRAS mutations were more common in lung and brain metastases (P < 0.005), but similar in liver metastases. Correspondingly, KRAS mutation was associated with lung relapse (HR = 2.1; 95% CI, 1.2 to 3.5, P = 0.007) but not liver relapse in patients from the VICTOR trial. KRAS mutation seems to be associated with metastasis in specific sites, lung and brain, in colorectal cancer patients. Our data highlight the potential of somatic mutations for informing surveillance strategies.

ANZ Journal of Surgery, 1988

Giant inguinal herniae present a major challenge in management. This case details clinical featur... more Giant inguinal herniae present a major challenge in management. This case details clinical features of an enormous inguinoscrotal hernia associated with septic gangrene and elephantiasis of the scrotum. Two initial operations were required for control of sepsis, followed by a two-staged hernial repair, involving a total colectomy and a subsequent neoscrotal repair. The problems of loss of domain within the abdominal cavity and the special features presented by this case are discussed.

ANZ Journal of Surgery, 1993

A 57 year old female presented with symptoms from a large, sessile tubulovillous adenoma of the l... more A 57 year old female presented with symptoms from a large, sessile tubulovillous adenoma of the lower third of the rectum. Transanal excision was impracticable due to its size and anterior resection was necessary. The upper third of the rectum was mobilized percutaneously, using the laparoscope. The lower two-thirds of the rectum were mobilized transanally and a non-everted pull-through excision of the lower third was performed, with a hand sewn colo-anal anastomosis. A temporary loop ileostomy was established through a 2.5 cm abdominal incision. Postoperative recovery was uncomplicated. The operative technique, which may have other applications, is described in detail.

ANZ Journal of Surgery, 1983

Sixty-one (3.0%) of 2029 patients managed operatively for carcinoma of the large intestine had sy... more Sixty-one (3.0%) of 2029 patients managed operatively for carcinoma of the large intestine had synchronous carcinomas. In 47 (77.0%) of the 61 patients the carcinomas were in the same or adjacent segment(s) of large intestine. Adenomatous polyps were present in 18 (30%) patients compared to 269 (14%) of 1968 patients with a single cancer. A curative resection was performed in 40 of 61 patients, palliative resection in 16 and a non-resection palliative operation in five. Two patients required proctocolectomy and eight subtotal colectomy with ileorectal anastomosis. Cancer specific survival for the entire group and for those treated by curative resection did not differ significantly from that of patients with a single carcinoma. It is concluded that: (1) the presence of a second carcinoma does not significantly alter the survival prospects; (2) both pre-operative large intestinal examination and careful operative palpation of the entire large intestine should be performed, and (3) the significantly higher incidence of adenomatous polyps in patients with synchronous carcinomas is consistent with the polyp/cancer sequence hypothesis.

ANZ Journal of Surgery, 1997

A number of reports have appeared of post-traumatic stress symptoms occurring in physically ill p... more A number of reports have appeared of post-traumatic stress symptoms occurring in physically ill patients. This study sought to measure the extent of psychiatric disturbance and acute post-traumatic stress reactions occurring in surgical inpatients, and to examine their relationship with the stress of illness and hospitalization and the personal coping style of the patient. Thirty-seven admissions to a general surgical unit were assessed on admission and immediately prior to discharge. Measures were made of depression, anxiety, cognitive impairment, post-traumatic stress symptoms, severity of illness, level of physical functioning, degree of hospital stress and coping style. There was a significant reduction in anxiety scores postoperatively. Twenty-seven per cent of patients developed high levels of acute post-traumatic stress symptoms and these correlated with depression at admission and intra-hospital stress. Depression at discharge was related to depression at admission, physical functioning and coping style. In general, avoidance and acceptance-resignation were associated with a poorer psychiatric outcome. Postoperative psychiatric disturbance, including acute stress symptoms, can be understood as a reaction to the 'trauma' of illness and hospitalization, predisposed to by pre-existing depression. Interventions could be directed at screening for at-risk patients, minimizing stress, and encouraging adaptive mechanisms of coping in patients.

ANZ Journal of Surgery, 1993

The Medical journal of Australia, Jan 17, 1981

The Medical journal of Australia, Jan 8, 1983

The Medical journal of Australia, Jan 21, 1981

A prospective analysis of 110 consecutive right-sided infraclavicular subclavian catheterizations... more A prospective analysis of 110 consecutive right-sided infraclavicular subclavian catheterizations in 102 patients is presented. Alternate patients were assigned into one of two groups (55 patients in each), to assess the value of ipsilateral head turning and supraclavicular pressure in preventing internal jugular vein (IJV) malposition of the catheter tip. Two malpositions occurred in the trial group (3.6%) and five occurred in the control group (9.1%). Although the manoeuvre reduced the incidence of malposition, the difference was not statistically significant (P = 0.22). A further 100 infraclavicular catheterizations were analysed to assess a new auscultatory test to predict IJV malposition of subclavian catheters. The test led to accurate prediction of all six malpositions. There were no false negative findings, but one false positive prediction was made. Results of this study suggest that the routine use of head turning may not prevent IJV malposition. However, the auscultatory ...

The Medical journal of Australia, Jan 9, 1982

The Medical journal of Australia, Jan 13, 1984

Colo-rectal Surgery, 1982

World Journal of Surgery, 1982

Diseases of the Colon & Rectum, 1986

Cancer-specific survival prospects for rectal carcinoma in a series of 1306 patients managed from... more Cancer-specific survival prospects for rectal carcinoma in a series of 1306 patients managed from 1950 to 1979 by one surgeon worsened from 1970 to 1979. The prognosis was worse for all patients treated operatively from 1970 to 1979 compared with 1960 to 1969 (P less than 0.03). After potentially curative resection, survival was worse from 1970 to 1979 compared with 1950 to 1959 (P less than 0.02) and 1960 to 1969 (P less than 0.01), respectively; the corresponding five-year survivals were 72.5 percent, 72.3 percent, and 61.5 percent. The curative resection rate for the three decades was similar (66 to 70 percent). An increase in the incidence of Dukes' Stage C tumors from 23.3 percent to 32.3 percent (P less than 0.01) explains, at least partly, the decreased survival. The worsened survival prospects were not accounted for by changes in referral pattern, tumor site, or in the proportion of sphincter-saving resections performed. The worsening was paradoxically paralleled by earlier symptomatic presentation (P less than 0.001). Analyses of other Australian data are required to test the hypothesis that the worsened survival prospects are consequent to altered tumor biologic aggressiveness, possibly related to differences in the causal factors operating over the 30-year study period.

Diseases of the Colon & Rectum, 2007