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Biomedical subjects

C Metreweli

Publications and source records attributed to C Metreweli.

At least 271 records · Page 15Linked to original sources
PubMed1988

Ultrasonographic diagnosis of clinically non-palpable primary colonic neoplasms.

Over a 2-year period, more than 1700 abdominal ultrasound scans were performed which included a search for bowel disease in the scanning routine. Features consistent with a primary colonic neoplasm were reported in 35 patients. In 14 patients, ultrasound indicated the possibility of a colonic neoplasm in the absence of a clinically palpable mass. An intraabdominal mass was confirmed in 12 patients (86%), and was a primary colonic neoplasm in 11 patients (79%). In one patient a metastatic malignant mass had been misinterpreted as arising from the colon. In two patients no lesion could be demonstrated to account for the ultrasonographic abnormality. In a further 21 patients in which an abdominal mass had been evident on clinical examination, ultrasound was performed for further elucidation and indicated the mass to be arising from the colon. In this group, a primary colonic neoplasm was the cause in 11 patients (52%), while other primary or metastatic malignancy was found in six patients (29%) and benign disease in four patients (19%). We conclude that ultrasound is a useful primary diagnostic technique for colonic neoplasms, with a predictive value of 79% in detecting clinically non-palpable lesions. In our experience, false positive results due to scanning artefacts are rare. We consider that examination of the bowel is a worthwhile addition to the routine scan in patients with non-specific abdominal complaints.

Adolescent↗
PubMed1988

A study of lymphocyte kinetics in nasopharyngeal carcinoma with indium III oxine-labelled lymphocytes.

The kinetics of lymphocyte migration in 12 pre-treatment patients with nasopharyngeal carcinoma (NPC) and three cancer controls in remission were studied with Indium III oxine-labelled autologous lymphocytes. The migratory patterns of the labelled lymphocytes were defined by serial gamma imaging and blood clearance of Indium over 72 h. Once in the systemic circulation the labelled lymphocytes migrated immediately to the liver and spleen. In all the subjects studied the lymphocytes began to migrate out of the liver at 0.5 h, only to return to the organ gradually between 2 and 72 h. In the control subjects the lymphocytes migrated out of the spleen from about 4 h. This coincided with a hump in the peripheral blood clearance curve after about 4 h signifying re-entry of the lymphocytes into the vascular space from the spleen. In the 'early' NPC subjects (Stage I-III) the rate at which the lymphocytes entered the spleen was much reduced from about 4 to 72 h, suggesting a prolonged transit time of the lymphocyte through the organ. However, there were still prominent humps in the blood clearance curves, suggesting significant re-entry of lymphocytes into the vascular space. In the 'late' NPC subjects (Stage IV-V), the activity of the spleen was low between 4 and 72 h and there was continuous sequestration of lymphocytes in the organ. Consequently the humps in the blood clearance curves were much reduced or absent. The activities of the metastatic lymph nodes were intense between 2 and 48 h, suggesting marked sequestration of lymphocytes in the diseased lymph nodes. Migration of lymphocytes in the metastatic area of the liver was notably absent and presented as cold areas on gamma scanning. The sequestration of lymphocytes in the spleen and metastatic lymph nodes in 'early' and 'late' NPC could lead to a contraction of intravascular lymphocyte pool and could explain the stage-dependent lymphopenia reported in NPC.

Adult↗
PubMed1987

Differentiating tumours of the deep and superficial lobes of the parotid gland by computed tomographic sialography.

Parotid computed tomography (CT) combined with sialography is an established method of determining intrinsic from extrinsic tumours in and around the parotid gland. However, differentiation of deep from superficial lobe tumours lacks reliability. Various anatomical landmarks including Stensen's duct, the retromandibular vein, the styloid process, the posterior belly of the digastric muscle and more recently an arc 8.5 mm from the posterior border of the mandible have been used to predict the course of the facial nerve and hence divide the parotid into its deep and superficial portions. Our recent experience of CT in 17 cases of intrinsic parotid tumours and the results of surgery have been reviewed in an attempt to assess the reliability of these various landmarks. In 14 out of the 17 cases (82%) the relationship of the Stensen's duct to the tumour was well shown, and correct differentiation of deep from superficial lobe tumours could be made. We conclude that the relationship of the tumour to the Stensen's duct is most accurate in differentiating tumours of the deep and superficial lobes of the parotid.

Adenolymphoma↗
PubMed1987

Changes in transplanted kidney volume measured by ultrasound.

A simple ultrasonic method was used for measuring transplanted kidney volume in 29 patients. Five of these patients developed diabetes mellitus and six women became pregnant following transplantation. Serial measurements were performed over periods of 6-12 months after transplantation. The kidney volume became stable 6 months after transplantation and this volume correlated positively with the renal function. Renal hypertrophy was noted in those transplant patients who developed diabetes mellitus following transplantation and this hypertrophy was associated with improvement in graft function. Transplant volume also rose in acute rejection and returned to normal after appropriate treatment. During pregnancy following transplantation, the transplant volume increased early in pregnancy to return to normal before delivery. This volume increase was also associated with graft function improvement.

Diabetes Complications↗
PubMed1987

Ultrasound-guided tissue-core biopsy of thoracic lesions with Trucut and Surecut needles.

The value of ultrasound-guided tissue-core needle biopsy was assessed in 54 patients with thoracic lesions adjacent to the chest wall. Of these, six were apical and two mediastinal. Biopsy was performed with Trucut or Surecut (modified Menghini) needles in 22 patients, and with both in 32 patients in order to compare the two types of needle. Definitive diagnosis was made in 46 patients (85 percent), of whom 41 had malignancy of various cell types, and five had benign lesions. Of the remaining eight, three had apical lesions, and two had consolidation distal to a proximal tumor. There was complete histologic agreement in 25 of 32 patients where biopsy was performed with both needles. Roentgenographic size of the lesion had relatively little influence on the diagnostic yield. Complications comprise moderate hemoptysis in one patient (2 percent), trivial hemoptysis or hemothorax in three, and symptomless pneumothorax in two which resolved spontaneously. We conclude that tissue core needle biopsy of thoracic lesions under ultrasound guidance is an accurate and safe technique which provides specimens adequate for routine histologic examination. The diagnostic yield from Trucut and Surecut biopsies is comparable.

Adult↗
PubMed1986

An unusual laryngeal foreign body in an infant.

A case is presented of laryngeal impaction in an infant by a cervical vertebra of a toad. Symptoms were mild initially but became progressive later with secondary laryngeal edema. Early diagnosis was not made, which resulted in considerable difficulty in management. Computerized tomography (CT) scan was found to be useful in identifying the foreign body and thereby facilitating management. CT is recommended for suspected foreign bodies in the air and food passages where more conventional methods fail to make a diagnosis.

Animals↗
PubMed1984

Echographic diagnosis of neonatal renal venous thrombosis.

The echographic appearances found in 23 newborn with clinically labelled renal venous thrombosis are described. There is a spectrum of abnormality which can be graded into mild, moderate and severe. These grades have some relation to prognosis and seem to be age related.

Child, Preschool↗
PubMed1983

The echography of pelvi-ureteric junction obstruction in children.

The echographic appearances seen in 47 children with dilatation of the pelvi-calyceal system but not ureter, in whom the diagnosis of pelvi-ureteric junction obstruction was strong enough to lead to surgical correction, were classed into two categories. Those children in whom the antero-posterior diameter of the pelvi-calyceal system exceeded 10 mm were classed as being 'suspicious' (of pelvi-ureteric junction obstruction). When dilatation of the pelvis was accompanied by dilatation of the calyces this appearance was classed as 'definite'. There was a high false positive rate but a very low false negative rate. A simple water load stress test performed in 17 children helped to decrease the false positives from 16 to 10 but the high false positive rate in the 'definite' group stresses the need for subsequent functional studies. Ultrasound is concluded to be a worthwhile screening test to select children requiring functional studies.

Child↗
PubMed1982

Renal failure due to 2,8-dihydroxyadenine urolithiasis.

A four-year-old girl presented in renal failure due to dihydroxyadenine urolithiasis. Prior to this she had been fed a high purine macrobiotic diet, rich in pulses and grain. She was comatose, anuric, requiring peritoneal dialysis, and bilateral radiolucent renal calculi were revealed by ultrasonography and retrograde pyelography. 2,8-dihydroxyadenine stones were found at pyelolithotomy, renal biopsy revealed interstitial birefringent crystals, and a complete lack of adenine phosphoribosyl transferase (APRT) was found subsequently in erythrocyte lysates. APRT levels were initially falsely raised due to a blood transfusion on admission. The mother was shown to have heterozygote levels. The child was treated successfully with allopurinol, and a reduction in dietary purine but with only partial return of renal function.

Adenine↗