Peter Cruse | University of Reading (original) (raw)
Papers by Peter Cruse
Journal of the American College of Surgeons, 1998
Background: Papillary cystic neoplasm (PCN) is a rare malignant tumor of the pancreas that typica... more Background: Papillary cystic neoplasm (PCN) is a rare malignant tumor of the pancreas that typically occurs in young females and has an excellent prognosis. Study Design: We report a retrospective review of 12 patients treated during a 16-year period. Pre-, intra-, and postoperative data were evaluated in all patients to determine optimal management with specific reference to surgical strategy. Results: All 12 tumors occurred in young women (mean age 22 years, range 14-36 years). Six patients presented with an epigastric mass, and three with severe abdominal pain. The correct diagnosis was made preoperatively in only five patients. Incorrect diagnoses included hepatoma, pancreatic pseudocyst, and hydatid cyst. The PCNs had a mean diameter of 12.5 cm (range 8-20 cm), and occurred in the head (four), neck (three), body (three), and tail (two) of the pancreas. All were resected. Operations performed were pylorus-preserving pancreaticoduodenectomy (three), central pancreatectomy with pancreaticogastrostomy (three), distal pancreatectomy (three), and local resection (three). In one patient two liver metastases were resected in addition to the pancreatic primary. One patient presented with tumor rupture and a major bleed into the lesser sac and died of multiple organ failure after resection. Postoperative complications included a stricture at the hepaticojejunostomy after pancreaticoduodenectomy, which resolved after temporary stenting, and a pancreatic duct fistula after local tumor resection, which required a distal pancreatectomy. Eleven patients are well at followup (mean 6.6 years; range 6 months to 15 years). Conclusions: PCN should be considered in the differential diagnosis of large pancreatic masses, especially in young females. Conservative resection, where technically feasible, is safe and effective and represents the therapy of choice.
The Lancet, 1985
The report of Dr Lucas and colleagues (Oct 12, p 843) prompts us to record a very similar case. A... more The report of Dr Lucas and colleagues (Oct 12, p 843) prompts us to record a very similar case. A 43-year-old man presented with a 2-day history of increasing
European Surgical Research, 1982
South African Journal of Science, 1996
South African Journal of Science, 1997
Samj South African Medical Journal, 1997
South African Journal of Science, 1999
Cholesterol feeding of rats with colon cancer induced by dimethylhydrazine results in reduced sur... more Cholesterol feeding of rats with colon cancer induced by dimethylhydrazine results in reduced survival and an increased incidence of metastatic colon cancer. As cholesterol may be implicated in the induction or maintenance of the metastatic process, an experiment was designed to determine whether rats with colon cancer would benefit from the removal of cholesterol from the diet. Female Wistar rats were treated with a colon cancer-inducing regimen of dimethylhydrazine (40 mg/kg/week for 10 weeks) while being fed on a standard cholesterol-containing rat pellet diet. After two rats had died spontaneously of histologically proven adenocarcinoma of the colon at 24 weeks, the remaining rats were randomly allocated in groups of 15 to one of three dietary regimens. Group S continued to receive standard pellet diet, group V were fed on Vivonex alone and group VC were fed Vivonex plus cholesterol (10 mg/100 ml Vivonex). Each group was assessed for survival and incidence of histologically prov...
Springer eBooks, 1989
Colorectal cancer is a serious public health problem on which improved diagnosis and treatment ha... more Colorectal cancer is a serious public health problem on which improved diagnosis and treatment have made little impact over several decades. This relative lack of progress indicates a fundamental weakness in the strategies with which we are attacking the disease as diagnosis and treatment are both focused on the established cancer and ignore its primary cause(s).
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2000
The syndrome of hereditary non-polyposis colorectal cancer (HNPCC) can be diagnosed fairly accura... more The syndrome of hereditary non-polyposis colorectal cancer (HNPCC) can be diagnosed fairly accurately using clinical criteria and a family history. Identifying HNPCC helps to prevent large-bowel cancer, or allows cancer to be treated at an early stage. Once the syndrome has been diagnosed a family member's risk can be judged approximately from a family tree, or it can now be predicted accurately if the causative mutation is known. This study involved attempts to improve the management of a family with HNPCC over a period of 10 years. Clinical diagnostic criteria, colonoscopic surveillance, surgical treatment, genetic counselling, molecular genetic research, and finally predictive genetic testing were applied as they evolved during this time. A rural general practitioner first noted inherited large-bowel cancer in the family and began screening subjects as they presented, using rigid sigmoidoscopy at the local hospital. At the time that the disorder was recognised as being HNPCC ...
Histopathology, 1979
The paper describes the changes in the cricopharyngeal muscle in seven cases of dysphagia resulti... more The paper describes the changes in the cricopharyngeal muscle in seven cases of dysphagia resulting from obstruction at this level which was relieved by myotomy. Histological features included degeneration and regeneration in the muscle fibres with interstitial fibrosis which was severe in some of the cases. It is considered that this restrictive fibrosis is the cause of the dysphagia and that it is secondary to muscle fibre damage, the cause of which is at present obscure. Minor degrees of muscle damage and regeneration were seen rarely in controls and fibrosis was never present. There was no evidence of underlying vascular or neurological disease in six cases; the seventh had a previous history of scleroderma but this was not thought to be the cause of the cricopharyngeal lesion. The age incidence ranged from 1 to 5 years at the onset of dysphagia; in six of the seven it was 50 years or more.
European Surgical Research, 1982
British Journal of Cancer, 1987
People at risk from coronary heart disease and large bowel cancer are drawn from the same urbanis... more People at risk from coronary heart disease and large bowel cancer are drawn from the same urbanised, industrialised Western populations. Whilst changes in blood lipids are well recognised in heart disease, little is known of their role in large bowel cancer. This study investigates serial alterations in blood lipids in the 1,2-dimethylhydrazine (DMH) rat model of colon cancer. Eighty Wistar rats received a 5 weekly regimen of DMH. At week 10, and at 5 weekly intervals until week 40, random groups of 10 rats were killed and blood taken for total and free cholesterol, phospholipids, triglycerides and liver enzymes. All colonic neoplasms were histologically classified either as adenomas or carcinomas with groups being allocated into tumour-free (n = 16) or tumour-bearing (n = 54), the latter group being further subdivided into animals with adenoma alone (n =8) and those with carcinoma (n = 46). Results were considered both sequentially and according to tumour status. Sequential results showed that with increase in colonic neoplasms with time there were accompanying increases in free and % free cholesterol and in phospholipids (P<0.001). There were no changes in total cholesterol, triglycerides or liver enzymes. Results according to tumour status showed that whilst there was no difference in total cholesterol or triglycerides between tumour-free and tumour-bearing rats, there was a significant increase in free (P<0.01) and % free cholesterol (P<0.001) and a decrease in phospholipids in the tumour-bearing animals (P<0.001). There was no difference in any serum lipid between tumour-free and adenoma-bearing rats. In animals with carcinoma, while there was no difference in total cholesterol or triglycerides, there was an increase in free (P<0.005) and % free cholesterol (P<0.001) and a decrease in phospholipids (P<0.001) compared to tumour-free rats. The data show for the first time a clear relationship between blood lipids and the presence or absence of large bowel cancer.
Oncology research, 1998
At least seven human mucin genes have been described, which express glycoproteins MUC1-7 in vario... more At least seven human mucin genes have been described, which express glycoproteins MUC1-7 in various tissues. It has been shown that different mucins are expressed in various gastric disease states compared to the normal. In this study we used histochemical and immunohistochemical methods to determine the type and pattern of mucin in 54 patients with a variety of gastric conditions [i.e., normal controls, fetal stomachs, gastritis, low-grade dysplasia, intestinal metaplasia (associated with gastritis, benign ulcers, dysplasia, and cancer), early and advanced intestinal type adenocarcinoma, and diffuse adenocarcinoma]. We report for the first time the use of all seven MUC antibodies in the various conditions. Normal controls were immunoreactive for MUC4, 5, and 6 , and gastritis specimens showed similar results, although the latter showed more MUC1 immunoreactivity. Whereas early fetal stomach showed no MUC immunoreactivity, MUC4, 5, and 6 were present from the early second trimester ...
British journal of experimental pathology, 1988
Human metabolic studies have suggested a positive association between dietary intake, faecal bile... more Human metabolic studies have suggested a positive association between dietary intake, faecal bile acid excretion and the development of colon cancer. Similar investigations in experimental models of this disease have also implicated faecal bile acids but in both animals and man the results remain equivocal. This study sequentially examines the outputs and concentrations of faecal bile acids in dimethylhydrazine (DMH) treated groups of rats (n = 10), killed at 5-weekly intervals from the 10th to 40th week following the first injection. The sequential results showed that both the output and concentration of faecal bile acids decreased with time and accompanied an increase in both the incidence and numbers of colonic neoplasms over the 40 weeks of the study. When the animals were grouped according to the histological classification of their tumours, the faecal bile acids did not differ between animals with and without tumours. Further, when the latter group were sub-divided into those ...
The Lancet, 1978
The ability of dietary fibre to prevent colon cancer was tested in rats injected with 1,2-dimethy... more The ability of dietary fibre to prevent colon cancer was tested in rats injected with 1,2-dimethylhydrazine (D.M.H.), a substance which induces cancer of the colon. 60 rats were fed the same formula solid diet but allocated three different amounts of dietary fibre--20 were given 4.8% w/w crude fibre, 20 were given 20% w/w bran, and 20 received no fibre. Half of the animals in each fibre group received a course of subcutaneous D.M.H. and half were given subcutaneous saline. After a year's observation, there was no significant difference in the incidence of, or mortality from, colonic carcinoma between the D.M.H.-treated groups.
Gynecologic Oncology, 1999
The aim of this study was to assess the relationship between survival and erb-b2 immunohistochemi... more The aim of this study was to assess the relationship between survival and erb-b2 immunohistochemical staining in patients with early stage cervical carcinoma. Archival specimens for 126 patients with stage IB/IIA cervical carcinoma treated with radical hysterectomy and bilateral pelvic node dissection (RH-BPND) were retrieved and submitted to immunohistochemistry for ERBB2 expression. The association between positive results and poor survival was assessed in a multivariate analysis. Erb-b2 immunostaining was significantly associated with poor survival (P = 0.0284) but less so than parametrial extension (P = 0.0014) and nodal disease (P = 0.0106). Tumor type (squamous/adenosquamous/adenocarcinoma) and the status of surgical margins were not significantly associated with survival. These results supported further investigations of ERBB2 expression as a marker of high-risk disease in patients treated with RH-BPND.
Journal of the American College of Surgeons, 1998
Background: Papillary cystic neoplasm (PCN) is a rare malignant tumor of the pancreas that typica... more Background: Papillary cystic neoplasm (PCN) is a rare malignant tumor of the pancreas that typically occurs in young females and has an excellent prognosis. Study Design: We report a retrospective review of 12 patients treated during a 16-year period. Pre-, intra-, and postoperative data were evaluated in all patients to determine optimal management with specific reference to surgical strategy. Results: All 12 tumors occurred in young women (mean age 22 years, range 14-36 years). Six patients presented with an epigastric mass, and three with severe abdominal pain. The correct diagnosis was made preoperatively in only five patients. Incorrect diagnoses included hepatoma, pancreatic pseudocyst, and hydatid cyst. The PCNs had a mean diameter of 12.5 cm (range 8-20 cm), and occurred in the head (four), neck (three), body (three), and tail (two) of the pancreas. All were resected. Operations performed were pylorus-preserving pancreaticoduodenectomy (three), central pancreatectomy with pancreaticogastrostomy (three), distal pancreatectomy (three), and local resection (three). In one patient two liver metastases were resected in addition to the pancreatic primary. One patient presented with tumor rupture and a major bleed into the lesser sac and died of multiple organ failure after resection. Postoperative complications included a stricture at the hepaticojejunostomy after pancreaticoduodenectomy, which resolved after temporary stenting, and a pancreatic duct fistula after local tumor resection, which required a distal pancreatectomy. Eleven patients are well at followup (mean 6.6 years; range 6 months to 15 years). Conclusions: PCN should be considered in the differential diagnosis of large pancreatic masses, especially in young females. Conservative resection, where technically feasible, is safe and effective and represents the therapy of choice.
The Lancet, 1985
The report of Dr Lucas and colleagues (Oct 12, p 843) prompts us to record a very similar case. A... more The report of Dr Lucas and colleagues (Oct 12, p 843) prompts us to record a very similar case. A 43-year-old man presented with a 2-day history of increasing
European Surgical Research, 1982
South African Journal of Science, 1996
South African Journal of Science, 1997
Samj South African Medical Journal, 1997
South African Journal of Science, 1999
Cholesterol feeding of rats with colon cancer induced by dimethylhydrazine results in reduced sur... more Cholesterol feeding of rats with colon cancer induced by dimethylhydrazine results in reduced survival and an increased incidence of metastatic colon cancer. As cholesterol may be implicated in the induction or maintenance of the metastatic process, an experiment was designed to determine whether rats with colon cancer would benefit from the removal of cholesterol from the diet. Female Wistar rats were treated with a colon cancer-inducing regimen of dimethylhydrazine (40 mg/kg/week for 10 weeks) while being fed on a standard cholesterol-containing rat pellet diet. After two rats had died spontaneously of histologically proven adenocarcinoma of the colon at 24 weeks, the remaining rats were randomly allocated in groups of 15 to one of three dietary regimens. Group S continued to receive standard pellet diet, group V were fed on Vivonex alone and group VC were fed Vivonex plus cholesterol (10 mg/100 ml Vivonex). Each group was assessed for survival and incidence of histologically prov...
Springer eBooks, 1989
Colorectal cancer is a serious public health problem on which improved diagnosis and treatment ha... more Colorectal cancer is a serious public health problem on which improved diagnosis and treatment have made little impact over several decades. This relative lack of progress indicates a fundamental weakness in the strategies with which we are attacking the disease as diagnosis and treatment are both focused on the established cancer and ignore its primary cause(s).
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2000
The syndrome of hereditary non-polyposis colorectal cancer (HNPCC) can be diagnosed fairly accura... more The syndrome of hereditary non-polyposis colorectal cancer (HNPCC) can be diagnosed fairly accurately using clinical criteria and a family history. Identifying HNPCC helps to prevent large-bowel cancer, or allows cancer to be treated at an early stage. Once the syndrome has been diagnosed a family member's risk can be judged approximately from a family tree, or it can now be predicted accurately if the causative mutation is known. This study involved attempts to improve the management of a family with HNPCC over a period of 10 years. Clinical diagnostic criteria, colonoscopic surveillance, surgical treatment, genetic counselling, molecular genetic research, and finally predictive genetic testing were applied as they evolved during this time. A rural general practitioner first noted inherited large-bowel cancer in the family and began screening subjects as they presented, using rigid sigmoidoscopy at the local hospital. At the time that the disorder was recognised as being HNPCC ...
Histopathology, 1979
The paper describes the changes in the cricopharyngeal muscle in seven cases of dysphagia resulti... more The paper describes the changes in the cricopharyngeal muscle in seven cases of dysphagia resulting from obstruction at this level which was relieved by myotomy. Histological features included degeneration and regeneration in the muscle fibres with interstitial fibrosis which was severe in some of the cases. It is considered that this restrictive fibrosis is the cause of the dysphagia and that it is secondary to muscle fibre damage, the cause of which is at present obscure. Minor degrees of muscle damage and regeneration were seen rarely in controls and fibrosis was never present. There was no evidence of underlying vascular or neurological disease in six cases; the seventh had a previous history of scleroderma but this was not thought to be the cause of the cricopharyngeal lesion. The age incidence ranged from 1 to 5 years at the onset of dysphagia; in six of the seven it was 50 years or more.
European Surgical Research, 1982
British Journal of Cancer, 1987
People at risk from coronary heart disease and large bowel cancer are drawn from the same urbanis... more People at risk from coronary heart disease and large bowel cancer are drawn from the same urbanised, industrialised Western populations. Whilst changes in blood lipids are well recognised in heart disease, little is known of their role in large bowel cancer. This study investigates serial alterations in blood lipids in the 1,2-dimethylhydrazine (DMH) rat model of colon cancer. Eighty Wistar rats received a 5 weekly regimen of DMH. At week 10, and at 5 weekly intervals until week 40, random groups of 10 rats were killed and blood taken for total and free cholesterol, phospholipids, triglycerides and liver enzymes. All colonic neoplasms were histologically classified either as adenomas or carcinomas with groups being allocated into tumour-free (n = 16) or tumour-bearing (n = 54), the latter group being further subdivided into animals with adenoma alone (n =8) and those with carcinoma (n = 46). Results were considered both sequentially and according to tumour status. Sequential results showed that with increase in colonic neoplasms with time there were accompanying increases in free and % free cholesterol and in phospholipids (P<0.001). There were no changes in total cholesterol, triglycerides or liver enzymes. Results according to tumour status showed that whilst there was no difference in total cholesterol or triglycerides between tumour-free and tumour-bearing rats, there was a significant increase in free (P<0.01) and % free cholesterol (P<0.001) and a decrease in phospholipids in the tumour-bearing animals (P<0.001). There was no difference in any serum lipid between tumour-free and adenoma-bearing rats. In animals with carcinoma, while there was no difference in total cholesterol or triglycerides, there was an increase in free (P<0.005) and % free cholesterol (P<0.001) and a decrease in phospholipids (P<0.001) compared to tumour-free rats. The data show for the first time a clear relationship between blood lipids and the presence or absence of large bowel cancer.
Oncology research, 1998
At least seven human mucin genes have been described, which express glycoproteins MUC1-7 in vario... more At least seven human mucin genes have been described, which express glycoproteins MUC1-7 in various tissues. It has been shown that different mucins are expressed in various gastric disease states compared to the normal. In this study we used histochemical and immunohistochemical methods to determine the type and pattern of mucin in 54 patients with a variety of gastric conditions [i.e., normal controls, fetal stomachs, gastritis, low-grade dysplasia, intestinal metaplasia (associated with gastritis, benign ulcers, dysplasia, and cancer), early and advanced intestinal type adenocarcinoma, and diffuse adenocarcinoma]. We report for the first time the use of all seven MUC antibodies in the various conditions. Normal controls were immunoreactive for MUC4, 5, and 6 , and gastritis specimens showed similar results, although the latter showed more MUC1 immunoreactivity. Whereas early fetal stomach showed no MUC immunoreactivity, MUC4, 5, and 6 were present from the early second trimester ...
British journal of experimental pathology, 1988
Human metabolic studies have suggested a positive association between dietary intake, faecal bile... more Human metabolic studies have suggested a positive association between dietary intake, faecal bile acid excretion and the development of colon cancer. Similar investigations in experimental models of this disease have also implicated faecal bile acids but in both animals and man the results remain equivocal. This study sequentially examines the outputs and concentrations of faecal bile acids in dimethylhydrazine (DMH) treated groups of rats (n = 10), killed at 5-weekly intervals from the 10th to 40th week following the first injection. The sequential results showed that both the output and concentration of faecal bile acids decreased with time and accompanied an increase in both the incidence and numbers of colonic neoplasms over the 40 weeks of the study. When the animals were grouped according to the histological classification of their tumours, the faecal bile acids did not differ between animals with and without tumours. Further, when the latter group were sub-divided into those ...
The Lancet, 1978
The ability of dietary fibre to prevent colon cancer was tested in rats injected with 1,2-dimethy... more The ability of dietary fibre to prevent colon cancer was tested in rats injected with 1,2-dimethylhydrazine (D.M.H.), a substance which induces cancer of the colon. 60 rats were fed the same formula solid diet but allocated three different amounts of dietary fibre--20 were given 4.8% w/w crude fibre, 20 were given 20% w/w bran, and 20 received no fibre. Half of the animals in each fibre group received a course of subcutaneous D.M.H. and half were given subcutaneous saline. After a year's observation, there was no significant difference in the incidence of, or mortality from, colonic carcinoma between the D.M.H.-treated groups.
Gynecologic Oncology, 1999
The aim of this study was to assess the relationship between survival and erb-b2 immunohistochemi... more The aim of this study was to assess the relationship between survival and erb-b2 immunohistochemical staining in patients with early stage cervical carcinoma. Archival specimens for 126 patients with stage IB/IIA cervical carcinoma treated with radical hysterectomy and bilateral pelvic node dissection (RH-BPND) were retrieved and submitted to immunohistochemistry for ERBB2 expression. The association between positive results and poor survival was assessed in a multivariate analysis. Erb-b2 immunostaining was significantly associated with poor survival (P = 0.0284) but less so than parametrial extension (P = 0.0014) and nodal disease (P = 0.0106). Tumor type (squamous/adenosquamous/adenocarcinoma) and the status of surgical margins were not significantly associated with survival. These results supported further investigations of ERBB2 expression as a marker of high-risk disease in patients treated with RH-BPND.