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Papers by Alexander Engel

Australian Prescriber, 2015

Annals of surgery, Jan 8, 2016

The study aims to investigate the prognostic value of the lymphocyte-to-monocyte ratio (LMR) in p... more The study aims to investigate the prognostic value of the lymphocyte-to-monocyte ratio (LMR) in patients with colorectal cancer (CRC) undergoing curative resection and to compare it to established biomarkers including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), modified Glasgow prognostic score (mGPS), and combined BRAF-mismatch repair (MMR) status. The prognostic significance of systemic inflammatory markers in CRC such as the NLR, PLR, and mGPS has been well defined. Commonly used genetic markers such as combined BRAF-MMR status have also been found to be prognostic. Recent evidence, although limited, suggests that the preoperative LMR may be prognostic in CRC. Data from the Northern Sydney Local Health District from January 1998 to December 2012 were retrospectively collected. Of 3281 consecutive patients identified, 1623 patients who underwent curative resection were deemed eligible for inclusion. The relation between the LMR, clinicopathologic ...

$Research paper thumbnail of Fissurectomy and isosorbide dinitrate for chronic anal fissure refractory to conservative treatment$

Eur J Gastroenterol Hepatol, 1998

ABSTRACT Although lateral sphincterotomy heals chronic fissure in ano in over 90 per cent of case... more ABSTRACT Although lateral sphincterotomy heals chronic fissure in ano in over 90 per cent of cases it is a surgical technique with inherent complications. To avoid such complications, chronic fissure in ano was treated by fissurectomy in this study. To enhance postoperative tissue perfusion allowing stable wound healing, fissurectomy was combined with temporary chemical sphincterotomy by a nitric oxide donor cream. Seventeen consecutive patients (ten women) with chronic fissure in ano not responding to conservative management underwent diathermy fissurectomy. After operation patients used a 1 per cent isosorbide dinitrate cream. Postoperative follow-up continued until wounds had healed, at which time anal endosonography was performed. A telephone inquiry into fissure recurrence and continence status was made. Seventeen patients underwent fissurectomy, without postoperative complications. All wounds had healed within 10 weeks. No fissure recurrence was seen after a median follow-up of 29 months. Histopathology showed non-specific scar tissue without signs of internal anal sphincter fibrosis. Postoperative endosonography showed no evidence of new internal sphincter defects. In the treatment of chronic anal fissure not responding to chemical sphincterotomy with nitric oxide donors, fissurectomy in combination with isosorbide dinitrate cream may be a sphincter-sparing surgical technique.

Colorectal Disease, 2013

In a landmark 2005 paper Jorge Hirsch proposed the h index to quantify the scientific impact of i... more In a landmark 2005 paper Jorge Hirsch proposed the h index to quantify the scientific impact of individual researchers . In a most elegant study he posited the h index to be the number of papers (n) that have attracted at least n citations. He also introduced m which is the h index divided by the years a researcher has been publishing his research, usually from the date of a PhD onwards. Hirsch concluded, cautiously, that for physicists the h and m index could have meaning for faculty and tenure decisions, grant approvals and attachment to the National Academy of Sciences. For example m = 2 (i.e h index of 40 over 20 years of research) would identify an outstanding scientist and an h index of 18 should permit a scientist to advance to full professorship.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2015

IRE Transactions on Nuclear Science, 1962

Liquid Hydrogen is used as a propellant for Project Rover nuclear-powered rocket engines. An inst... more Liquid Hydrogen is used as a propellant for Project Rover nuclear-powered rocket engines. An instrumentation system is described which measures, records and displays vertical temperature profiles in two 50,000 gallon liquid hydrogen dewars. Platinum-resistance thermometers in each dewar are sampled sequentially. Measurements are digitized, printed, transmitted by PCM for remote recording, and reconverted to analog form for real-time graphical display. Measuring ranges are 30 to 460 degrees Rankine (OR), with 1% absolute accuracy, and 30 to 53°R, with 0.5% absolute accuracy.

The JBI Database of Systematic Reviews and Implementation Reports, 2014

Scandinavian Journal of Gastroenterology, 2006

Nodal staging accuracy is important in the prognosis and selection of patients for chemotherapy. ... more Nodal staging accuracy is important in the prognosis and selection of patients for chemotherapy. This prospective study aims to assess the feasibility and accuracy of the sentinel lymph node procedure (SNP) using radiocolloid and blue dye in colon carcinoma. In 56 patients, lymphatic mapping was accomplished by means of intraoperatively injecting patent blue and nanocoll subserosally around the tumour. Sentinel nodes (SNs) were harvested ex-vivo. Nodes were stained with H&amp;amp;amp;amp;amp;amp;amp;amp;E. If lymph nodes were interpreted as negative for metastatic tumour, serial sectioning and immunohistochemical staining were performed. At least one SN was detected in 49 of 53 patients (92.5%). Three patients were excluded because of preoperatively detected metastases. Overall, 121 SN were harvested with a mean of 2.2 SN/patients. Eighteen patients had tumour positive nodes. In four patients, pathological nodes were palpable during operation and were excluded. The SN was histologically negative in 2 of 14 patients with positive nodes (false-negative rate 14.3%). In 5 of 14 patients with positive nodes, the SN was the exclusive site of regional nodal metastasis. Four patients were upstaged by immunohistochemical staining (28.6%). The negative predictive value was 93.9% and the overall accuracy 95.6%. Scintigraphy was done in 17 patients. In three patients the SN was detected only by this modality. The SN biopsy with the combined technique proved a feasible technique with a steep learning curve. It can change the initial staging from stage II to stage III colon carcinoma. Scintigraphy can improve the success rate of the technique.

Journal of Hand Surgery (European Volume), 2009

International Journal of Colorectal Disease, 1994

International Journal of Colorectal Disease, 1995

We aimed to determine if the type of clinical

Human Factors: The Journal of the Human Factors and Ergonomics Society, 2011

The aim of this study was to investigate whether people change their isometric pinch grip generat... more The aim of this study was to investigate whether people change their isometric pinch grip generation depending on the surface they gripped. Specifically, the effect of grip surface friction condition on (a) maximum force produced in the direction normal to the contact surface, (b) fluctuation of normal force, and (c) the digit force&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s angular deviation from the direction normal to the grip surface was quantified. Isometric pinch grip has been traditionally thought to be independent from the friction condition between the finger and gripped surface, which may be questionable. For this study, 12 healthy participants performed maximum isometric pinch grip exertion on high-friction rubber and low-friction paper surfaces. Maximum normal force, normal force variance,and digit force&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s angular deviation from the normal direction were quantified. Pinch grip on the high-friction rubber surface was associated with 10% greater maximum normal force and 50% reduced normal force variance, compared with the low-friction paper surface (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Digit force&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s angular deviation was not significantly different between the two surface friction conditions. The data support that people do change their pinch grip generation (maximum normal force and normal force variance) depending on the surface they gripped, potentially by using sensory feedback. The results of this study demonstrate that even a simple isometric pinch grip (no lifting associated) is affected by grip surface friction. Grip surface condition should be considered for clinical assessments, biomechanical investigation, and motor control studies to ensure consistency in measurements and validity of comparisons.

Gut, 1994

Two female patients aged 62 and 44 years with progressive systemic sclerosis and passive faecal i... more Two female patients aged 62 and 44 years with progressive systemic sclerosis and passive faecal incontinence are described. Both had the typical gut motility disorders of dysphagia, heartburn, and constipation. Anorectal physiology tests showed a low resting pressure in both and an absent rectoanal inhibitory reflex in one. In both patients anal endosonography showed a thin internal anal sphincter with changed reflectivity suggestive of fibrosis. In both patients anorectal sensation and pudendal nerve function were normal. Histological examination of the rectum in one patient showed collagenous replacement of the rectal muscularis propria with prominent atrophy of the musculature. This study suggests that the internal sphincter may be selectively affected by progressive systemic sclerosis, which may lead to passive faecal incontinence.

Gut, 1996

Background-The aetiology and pathology of rectal prolapse and solitary rectal ulcer are poorly un... more Background-The aetiology and pathology of rectal prolapse and solitary rectal ulcer are poorly understood. Aims-To examine the full thickness rectal wall in these two conditions. Methods-The pathological abnormalities in the surgically resected rectal wall were studied from nine patients with solitary rectal ulcer syndrome, 11 complete rectal prolapse, and nine cancer controls. Routine haematoxylin and eosin and Van Gieson staining for collagen were performed. Results-The rectal wall from solitary rectal ulcer syndrome specimens was thickened compared with complete rectal prolapse and controls. The major difference was in the muscularis propria (2.2 v 11 v 12 mm, medians, p<0.005) and par-

European Journal of Gastroenterology & Hepatology, 1999