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Biomedical subjects

A Cuschieri

Publications and source records attributed to A Cuschieri.

At least 343 records · Page 19Linked to original sources
PubMed1981

The place of hepatobiliary isotope scanning in the diagnosis of gallbladder disease.

The present trend towards a more aggressive operative policy in acute cholecystitis has led to a search for more accurate methods of diagnosis. A possible contender in this field is hepatobiliary isotope scanning. Ninety-nine patients with right-sided upper abdominal pain were studied after the intravenous injection of 99Tcm-pyridoxylideneglutamate. In addition, contrast radiology was performed in 87 of these. Subsequently 23 were shown to have acute cholecystitis, 45 to have other gallbladder disease and 31 to have no evidence of cholecystic pathology. Isotope scanning was found to be reliable when negative at excluding acute cholecystitis (predictive value 100 per cent) and when positive at confirming gallbladder disease (predictive value 100 per cent). In these respects it compared favourably with contrast radiology (corresponding predictive values 80 per cent and 94 per cent) but was greatly inferior for the exclusion of cholelithiasis. A practical method of scanning for routine clinical use is outlined and it is suggested that the method may be clinically useful as a first investigation in those patients presenting with acute right-sided upper abdominal pain. It may also be helpful in confirming pathology in a nonfunctioning gallbladder on oral cholecystography. When the isotope scan is negative (normal) contrast radiology is still required to exclude cholelithiasis. By a combination of the two techniques the correct diagnosis was arrived at in each of the 99 patients studied, suggesting that the methods may have complementary roles.

Acute Disease↗
PubMed1981

Scintiscanning of the breast with 99Tcm-diethylene triamine penta-acetic acid--a prospective blind evaluation.

In this blind prospective study of breast scintiscanning with 99Tcm-diethylene triamine penta-acetic acid (DTPA) in 67 female patients presenting at a primary breast referral clinic, we have observed that this investigation has a high diagnostic accuracy in distinguishing benign from malignant lesions of the breast. The predictive value of the test when positive in establishing the presence of cancer is 94 per cent with a false negative rate of 6 per cent. The predictive value of the test when negative in excluding cancer in 97 per cent with a false positive rate of 3 per cent. Initial studies also indicate the potential value of DTPA breast scintiscanning in delineating the activity of painful benign lesions of the breast.

Adult↗
PubMed1981

Familial jejunal atresia with 'apple-peel' variant.

We report two siblings who had jejunal atresia which we believe to be familial. The parents of these siblings were first cousins. The first child had jejunal atresia with mesenteric agenesis and 'apple-peel' configuration; the second child had jejunal atresia with a V-shaped mesenteric defect. Other reported cases of familial atresia of the small intestine are reviewed.

Humans↗
PubMed1981

The effect of isoperistaltic jejunal interposition upon gastric emptying.

Ten patients with severe postgastrectomy-postvagotomy symptoms, all of whom had the features of vasomotor dumping, underwent gastric emptying studies, using a 300 milliliter meal of 15 per cent dextrose labeled with 99mTc-sulphur colloid. Studies were repeated two to 11 months following remedial operative treatment, using a 12.5 to 15.0 centimeter isoperistaltic jejunal interposition. Preoperatively, all patients had rapid gastric emptying with a typical biphasic pattern. Following isoperistaltic interposition, the rate of gastric emptying was similar to that found in control patients. Gastric emptying reverted to a more normal pattern but, as in the preoperative studies, was best described by a double exponential function, consisting of slow and fast components. Analysis of these particular functions suggests the manner in which isoperistaltic interposition modified the underlying disorder of gastric motility.

Adult↗
PubMed1980

Evidence for the flutter valve mechanism of the lower oesophageal high pressure zone.

Simultaneous oesophageal manometry and pH monitoring was performed at rest and during abdominal compression in 189 subjects. The force exerted by the high pressure zone (HPZ) and by its intra-abdominal segment was reduced to the same extent in the 102 subjects who refluxed and the 87 who did not. Reflux during abdominal compression occurred in the subjects whose HPZ force fell into a critical range and in whom the contribution by the abdominal segment was reduced to less than 50 per cent of the total force exerted by the HPZ. These results are more in keeping with a mechanical flutter valve theory of lower oesophageal competence than sphincteric reflux control. Furthermore, the results indicate that measurements of oesophageal pressure, length or force in the resting state do not account for reflux or gastrooesophageal competence, but that it is the reserve of pressure, length or force during stress which is responsible.

Abdomen↗
PubMed1979

Needle aspiration of the breast with immediate reporting of material.

Needle aspiration with immediate cytological reporting has been practised in a breast clinic for one year. Patients benefit by receiving immediately the provisional diagnosis and, when indicated, appointments for metastatic surveys. Close co-operation between surgeon and cytologist has resulted in increased skill in aspiration, better preparation of samples, and greater accuracy in interpretation of reports. Since 5% of clinically benign lesions have proved malignant, even on immediate reporting, we would recommend cytological examination of all breast lumps.

Biopsy, Needle↗
PubMed1979

Distribution of plasma-bound hydroxyproline in breast cancer, benign breast disease and healthy females.

In normal adult females, patients with benign breast disease and patients with breast cancer, hydroxyproline (OHPro) was found in the plasma attached to the protein fractions which were separated by Sephadex gel filtration. In addition, a distinct moiety, probably a protein sub-unit, containing substantial amounts of this imino acid, occurred in between gel filtration fractions III and IV. Quantitative differences in the OHPro content of these various fractions were observed in the groups of patients studied. Significant elevations in the peptide-bound OHPro (fraction IV) were found only in patients with breast cancer and the level appeared to correlate with the degree of advancement of the disease. Similar findings relate to the OHPro content of the sub-protein moiety which is found between gel filtration fractions III and IV. A reduced level of high molecular weight hyproprotein (fraction I) was found in the breast cancer group.

Breast Diseases↗
PubMed1979

Compartmental analysis of the plasma clearance of tetrabromsulphthalein and dibromsulphthalein in the normal dog and in patients with liver disease.

A comparison has been made of the plasma clearances of the anionic dye analogues, tetrabromsulphthalein (BSP) and dibromsulphthalein (dBSP), analysed by means of a two-compartmental model. In the normal conscious dog all three transport rate constants and initial and steady state plasma clearances were greater with dBSP than BSP. On the other hand the equivalent liver volume (ELV) and storage capacity were lower with dBSP. In patients with various hepatic disorders dBSP values were greater than those obtained with BSP apart from rate constant b (liver to plasma). Patients with advanced liver impairment in general exhibited lower hepatic uptake, clearance and storage of both dyes compared to patients with mild forms of liver disease. The ratio of ELV values for BSP and dBSP appeared to be related to overall hepatic function, with ratios greater than 1 in the normal dogs and less than 1 in the patients.

Adult↗
PubMed1979

A new approach to a final examination in surgery. Use of the objective structured clinical examination.

In an attempt to overcome the disadvantages of the conventional final examination an objective structured clinical examination (OSCE) was introduced into the final examination in surgery at the University of Dundee. In this approach are tested at 20 stations through which the candidates rotate. At some stations the students are assessed, by an examiner using a check list, on their ability to take a history or examine a patient. At other stations objective questions are used to assess the students' findings and their interpretation, his (or her) management of the patient, and his assessment of laboratory investigations. This approach to the final examination is more reliable and more valid than traditional methods and has practical advantages over them.

Clinical Competence↗
PubMed1978

Laparoscopic assessment of the jaundiced patient: a review of 53 patients.

Laparoscopy in the investigation of patients with jaundice allows visualization of intra-abdominal pathology, target biopsy of intra-abdominal lesions and percutaneous fine-needle cholangiography, all to be carried out at the one procedure. Formal laparotomy can then be planned electively or avoided completely in appropriate cases. In our experience we have found laparoscopy with percutaneous fine-needle cholangiography and biopsy to be a useful procedure in the diagnosis and management of jaundiced patients.

Adolescent↗