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Biomedical subjects

C J Mieny

Publications and source records attributed to C J Mieny.

At least 37 records · Page 2Linked to original sources
PubMed1986

[The dangers of mammography in diagnosing a palpable lump in the breast].

The success of mammography screening programmes in the detection of unsuspected and impalpable breast cancer has led to reliance on a negative mammographic report as assurance that no malignancy is present even in palpable breast lumps. Pre-operative mammography was performed on 38 patients with palpable lumps who were subsequently proven by histology to have carcinoma of the breast. In 4 patients (10.8%) the mammogram was negative; 3 were also assessed as benign clinically. In 5 cases (13.5%) the report was negative but biopsy was recommended; 3 of the 5 were assessed as benign clinically. Therefore, in 9 of the 38 patients (24%) malignancy was not diagnosed unequivocally on mammography, although 3 of these patients had clinical stigmata of malignancy. Twenty-nine patients (76%) were diagnosed correctly by mammography; 5 of these cases were assessed as benign clinically. Six of the 38 cases (16%) were thought to be benign on both mammography and clinical examination. Thus, even confirmation by mammography that a breast lump without clinical signs of malignancy is indeed benign, does not rule out the possibility of carcinoma.

Breast Neoplasms↗
PubMed1985

Successive urinary papillomavirus excretion, condylomata acuminata and urogenital epithelial malignant disease after renal transplantation.

Of 3 renal allograft recipients who were found to excrete papillomavirus in the urine, 1 has since developed a condyloma, 1 a condyloma and a keratinizing squamous carcinoma and 1 a transitional cell carcinoma. Peroxidase-antiperoxidase staining has confirmed the presence of papillomavirus antigen in the condylomas. The significance of these findings is discussed.

Adult↗
PubMed1982

Treatment of homozygous familial hypercholesterolaemia with portacaval shunt.

Thirteen patients with homozygous familial hypercholesterolaemia (HFH) were treated with portacaval shunt operations. One patient died postoperatively and the others were followed for 2-6 years. The main beneficial effects were regression of xanthomas and sustained falls in serum total and LDL cholesterol levels of about 18% in the majority of cases, sustained rises in HDL cholesterol values in most patients, and the long period of survival after the operation without further deaths or serious cardiac complications. Other favourable effects were improvement of angina pectoris, ejection systolic múrmurs or electrocardiograms in some cases. Growth and development of patients after the operation were normal and there were no clinical or biochemical signs of liver damage or portal systemic encephalopathy. Apart from the patient who died, negative or adverse effects of the operation included shunt closure causing portal hypertension and bleeding varices in 1 case, unsatisfactory clinical responses in half the patients, small or unsustained falls in serum total cholesterol in one third of cases, and failure of total cholesterol to fall below 12.0 mmol/l in any patient. Enlargement of the spleen appeared to be an invariable consequence of the operation and possible reasons for this are discussed. Finally the place of portacaval shunts in the management of HFH is reviewed.

Adolescent↗
PubMed1980

A host of hypercholesterolaemic homozygotes in South Africa.

From 1972 to 1979 34 patients with homozygous familial hypercholesterolaemia were seen in one clinic in Johannesburg. All were Afrikaners and most lived in Transvaal Province. Their epidemiological, genetic, clinical, and biochemical characteristics were studied. The course of the disease varied considerably among the 34 patients, with no fewer than six surviving into their fourth or fifth decades. In some patients arterial atheroma was severe while cutaneotendinous xanthomas were slight and vice versa. Coronary heart disease was common but peripheral and cerebral arterial disease was rare. Another prominent finding was high concentrations of low-density lipoprotein cholesterol coupled with low high-density lipoprotein cholesterol values. The prevalences of homozygotes and heterozygotes with familial hypercholesterolaemia in Transvaal Afrikaners, calculated from this group of patients, were 1 in 30,000 and 1 in 100 respectively. These figures are the highest ever reported and may help to explain why South African whites have the highest death rate from coronary heart disease in the Western world.

Adolescent↗
PubMed1979

Treatment of familial hypercholesterolaemia by partial ileal bypass.

Ten patients with heterozygous familial hypercholesterolaemia (Fredrickson type II) were treated by the operation of partial ileal bypass. Postoperatively, serum cholesterol levels fell by an average of 34% (P less than 0.005), and the decrease was satisfactorily sustained over a period of 12-30 months. Angina and xanthomas also improved in some patients. Postoperatively all patients experienced considerable diarrhoea, which lessened with time. Other complications of surgery included abdominal distension and cramps, colonic dilatation, sepsis and intestinal obstruction. It is concluded that partial ileal bypass significantly lowers serum cholesterol levels, but that in view of the complications the operation should be offered only to carefully selected patients who are intolerant of or unresponsive to conservative measures.

Adult↗
PubMed1977

Doppler ultrasound in the diagnosis of the popliteal artery entrapment syndrome.

Doppler pulse recordings in a patient with asymptomatic popliteal entrapment were compared with those in 25 normal subjects. A drop in pulse amplitude and ankle systolic pressure produced by forcible leg extension and active foot plantar flexion distinguished the patient with the anomaly from the controls, in whom no change was noted during these manoeuvres. This simple, non-invasive test thus diagnosed a potentially limb-threatening congenital abnormality in an asymptomatic patient with equivocal arteriographic findings.

Adolescent↗
PubMed1977

The incidence of malignancy in carotid body tumours.

Twenty-three patients with 24 carotid body tumours are reviewed. A high incidence of malignancy (30%) was encountered. It is recommended that all carotid body tumours be removed unless there are contraindicating medical or technical reasons.

Adult↗
PubMed1975

Biliary pancreatitis.

Seventy-one patients with acute pancreatitis are reviewed. Biliary disease was incriminated as an aetiological factor in 17 of these patients. During the period under review, 141 patients with acute cholecystitis were treated. The age and sex incidence in these 3 groups are compared, and some diagnostic problems are discussed.

Acute Disease↗