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Biomedical subjects

A D Walls

Publications and source records attributed to A D Walls.

10 recordsLinked to original sources

Needle core biopsy of the breast with a spring-loaded device.

Over a 2-year period, 151 outpatients with a palpable breast lump requiring needle core biopsy were randomized to a Tru-Cut 14-G (T14), Bioptycut 14-G (B14) or Bioptycut 18-G (B18) needle. Use of a Biopty gun resulted in less pain than a Tru-Cut needle. An inadequate sample was obtained after two needle passes in 11 of 49 (T14), none of 51 (B14) and two of 51 (B18) patients (chi 2 = 14.6, 2 d.f., P = 0.0007). Tissue samples were assessed by a single pathologist for tissue volume and overall diagnostic value; the B14 group scored better than the B18 and T14 for both of these parameters (P < 0.003). The sensitivities were 68 (T14), 88 (B14) and 96 (B18) per cent (overall chi 2 = 7.3, 2 d.f., P = 0.026). The Biopty gun with a 14-G needle results in a higher sampling success rate, greater diagnostic sensitivity and a better specimen quality than the Tru-Cut, and is much easier to use.

Adult

Central venous catheterisation.

Eighty-one central venous catheter placements have been carried out with a serious-complication rate of 3.7%. Major long-term complications occurred in 5 patients. Malplacement of the catheter was more common when the infraclavicular subclavian route was used. Inadvertent removal occurred on 10 occasions and a new design of catheter hub is expected to eliminate this problem.

Catheterization

A five-year follow-up of Lord's dilatation for haemorrhoids.

100 consecutive patients treated by Lord's dilatation for haemorrhoids were followed up for a mean of 5-1 years. 2 patients could not be traced, and 1 had died. 75 patients were symptom-free or greatly improved. For 22 patients the treatment was unsatisfactory and 19 have since undergone haemorrhoidectomy. The outcomes at six months and five years were the same in 87%. The results of this follow-up study indicate that treatment of haemorrhoids by Lord's dilatation produces satisfactory long-lasting results in most patients.

Adult