Colorectal cancer
Chamary, V.L., Loizidou, M., Boulos, P.B., Taylor, I. and Burnstock, G. (2006) Changes in vasoconstrictor and vasodilator neurotransmitters in nerves supplying arterioles in developing colorectal polyps. Colorectal Disease 8: 230-234
Objective To examine the changes that occur in the immunohistochemistry of vasoconstrictor and vasodilator transmitters in nerves supplying early and advanced colorectal polyps. Subjects and methods We studied the perivascular innervation of submucosal arterioles of colorectal polyps (n = 18) and the innervation of the epithelial layer of polyps compared to normal controls (n = 8), using immunohistochemical markers for the neurotransmitters; noradrenaline (NA) (marker used; tyrosine hydroxylase (TH)), neuropeptide Y (NPY), vasoactive intestinal polypeptide (VIP), substance P (SP), and calcitonin gene-related polypeptide (CGRP). (Advanced polyps; villous adenomas > 1.5 cm, polyps with severe dysplasia or partial carcinoma). Results In submucosal arterioles there was a progressive decrease from controls through early polyps to advanced polyps in TH and NPY perivascular immunoreactivity (P < 0.015 for both). VIP and SP immunoreactivity was higher in early polyps compared to controls, but markedly reduced in advanced polyps (P < 0.05 for VIP). Sparse CGRP immunoreactivity was present in polyps only. Neural VIP and SP immunoreactivity in the lamina propria of polyp mucosa was more intense than in controls. Conclusion There is a decrease in vasoconstrictor neurotransmitters NPY and NA (shown by TH) around submucosal arterioles of both early and advanced polyps, but an increase in the vasodilator neurotransmitters, particularly VIP, in early colorectal polyps. These results suggest a predominantly vasodilatory neural influence in early polyps, perhaps indicating a mechanism that maintains polyp growth.
Copyright 2006 Blackwell Publishing Inc. | PubMed entry | Request reprint
Chamary, V.L., Robson, T., Loizidou, M., Boulos, P.B. and Burnstock, G. (2000) Progressive loss of perivascular nerves adjacent to colorectal cancer. European Journal of Surgical Oncology 26: 588-593
Aims: The perivascular innervation of arterioles in colorectal cancer and adjacent submucosa was investigated. Methods Neurotransmitter markers, neuropeptide Y (NPY), vasoactive intestinal peptide (VIP), substance P (SP),calcitonin gene-related peptide (CGRP) and tyrosine hydroxylase (TH), were studied and immunoreactivity wascompared with that of control normal tissue. Results There was absence of perivascular nerves within tumours and loss of perivascular innervation in thesubmucosa adjacent to the tumour. The pattern of loss varied for different transmitters. The loss was progressivelygreater with advancing tumour stage for NPY (controls 95%, Dukes' A 68%, Dukes' B 13%, Dukes' C 6%) and VIP (50%, 23%, 20%, 17%). For TH there was extensive loss of innervation around tumours of all stages (69%, 5%, 7%,0%). SP immunoreactive peri-arteriolar nerves were similar in control tissue (39%) and tissue adjacent to Dukes' A tumours (40%) but diminished to 19% and 0% in tissue adjacent to Dukes' B and C tumours, respectively. In none of the tissues was CGRP immunoreactivity above 4%. The mean distance over which there was reduced NPYimmunoreactivity from the tumour edge was 2.43mm for Dukes' A/B tumours compared with 7.20mm for Dukes' C tumours; for VIP immunoreactivity this distance was 5.22mm for Dukes’ A/B tumours and 5.52mm for Dukes' C tumours. Conclusions The progressive loss, both in terms of vascular nerve immunoreactivity and distance from the tumouredge with tumour grade, suggests that the tumour itself may influence neural integrity in perivascular plexuses,perhaps via the secretion of an inhibitory factor.
Copyright 2000 Harcourt Publishers Ltd | PDF reprint of paper | PubMed entry | Top of page
Chamary, V.L., Belai, A., Loizidou, M., Jordan, R., Boulos, P.B., Taylor, I. and Burnstock, G. (1999) Perivascular innervation of submucosal arterioles of colonic polyps. Gut 44: TH561 Supplement 1
Abstract currently unavailable.
Copyright 1999 BMJ Publishing Group Ltd
Chamary, V.L., Robson, T., Loizidou, M., Boulos, P.B., Taylor, I. and Burnstock, G. (1998) Loss of perivascular nerves in the submucosa adjacent to colorectal cancer. British Journal of Surgery 85: 699
Abstract currently unavailable.
Copyright 1998 John Wiley & Sons Inc.
Miscellaneous papers
Chamary, V.L. (1995) An unusual cause of iatrogenic bladder stone. British Journal of Urology 76: 138
Best. Title. Ever.
Copyright 1995 American Urological Association | PubMed entry | Top of page
Chamary, V.L. (1993) Femoral hernia: intestinal obstruction is an unrecognized source of morbidity and mortality. British Journal of Surgery 80: 230-232
A total of 180 consecutive femoral hernia repairs, consisting of 100 emergency and 80 elective admissions between January 1979 and December 1986, were reviewed. Morbidity was greater in the emergency than in the elective group (P < 0.01) and was significantly related to intestinal obstruction (P < 0.001), a feature not previously highlighted. Intestinal obstruction also had an important association with mortality, which was confined to patients undergoing emergency surgery. Patients with intestinal obstruction are a high-risk group and require careful perioperative management. Wound infection predisposed to recurrence of femoral hernia (P < 0.01). Repair of recurrent hernia in patients treated electively was associated with an increased incidence of chest infection (P < 0.001). Prophylactic measures, including antibiotics, may help to reduce recurrence and its associated morbidity. Patients referred with an inguinal lump or hernia, as opposed to a femoral hernia, had a later outpatient appointment and consequently a later operation date (P < 0.02). All elderly patients referred with any groin lump should receive an early outpatient appointment.
Copyright 1993 John Wiley & Sons Inc. | PubMed entry
Barrier, J., Potel, G., Renaut-Hovasse, H., Hanh, T.H., Peltier. P., Chamary, V. and Grolleau, J.Y. (1993) The use of Doppler flow studies in the diagnosis of giant cell arteritis. Selection of temporal artery biopsy site is facilitated. The Journal of the American Medical Association 248: 2158-2159
Sixty patients, for whom a diagnosis of giant cell arteritis (GCA) was clinically suspected, underwent Doppler study as a method of guiding temporal artery biopsy. In group A (23 patients with normal Doppler results), only one had a positive histological lesion. In group B (14 patients with discrete Doppler abnormalities), none had inflammatory lesions. Twelve of the 23 patients in group C (stenosis or thrombosis) had a biopsy result corresponding to GCA. Forty-three percent of the patients in group C had degenerative arterial lesions leading to a decrease in blood flow. There is a small probability, according to this preliminary study, of diagnosing GCA by artery biopsy even when findings from the ultrasonic examination are normal or only slightly irregular. However, a negative Doppler result should in no case exclude a biopsy if the clinical picture is suggestive.