Search PubMed⌕ Search

Biomedical subjects

E Russell

Publications and source records attributed to E Russell.

At least 73 records · Page 4Linked to original sources
PubMed1990

Left hepatic duct anatomy: implications.

A review of the findings of a 10-year experience with biliary interventional procedures in 838 patients led to consideration of the anatomy of the left hepatic duct. To better illustrate the findings, 15 normal human livers obtained at autopsy were fixed and dissected. Fifty-five percent of the patients had a single left hepatic duct that was formed by the intrahepatic union of ducts draining segments II and III (segmental nomenclature follows Couinaud) lateral to the falciform ligament. Central to this ligament, the left duct became extrahepatic and was joined by ducts from segments I and IV. The real and theoretical implications of the unpredictable variability of biliary anatomy, the frequency of right lateral duct drainage into the left hepatic duct, and the extrahepatic contiguous relationship between the left hepatic duct and the left portal vein are discussed.

Bile Ducts, Intrahepatic↗
PubMed1990

Computed tomography: how accurate a predictor for cochlear implantation?

Cochlear implantation is an accepted medical treatment for profound bilateral postlinguistically acquired hearing loss. Because cochlear implants are still in the process of development, a detailed evaluation of the results of implantation is essential. However, the capability of predetermining the auditory benefit of a cochlear implant is limited and depends upon a number of factors. This report focuses upon the ability of computed tomography (CT) to predict surgical success and audiological results of multichannel cochlear implantation. It also addresses how the disease state might affect the functional benefit of the implant. After undergoing routine clinical and audiological evaluations, 28 cochlear implant candidates underwent CT scans in order to evaluate cochlear patency prior to surgery. Subsequently, 24 patients were implanted with either a single-or 22-channel device. Surgical findings were noted and postoperative audiological assessments of sound detection and speech discrimination were made. The CT risk factors that diminish the likelihood of a successful cochlear implant result are discussed based upon a retrospective comparison of preoperative CT results, surgical findings, and postsurgical audiological evaluations of the 14 patients who received a 22-channel implant. Analysis of the predictive capability of CT will allow clinicians to use that procedure more effectively in the presurgical assessment of cochlear implant candidates.

Adult↗
PubMed1990

General practitioner referral rates to district psychiatry and psychology services.

The number of referrals made to a district psychiatry service by each of the local general practitioners over a five year period was counted and a large variation in general practitioner referral rate was found. Ten referral letters from each of the general practitioners were independently assessed for the amount of detail included and a mean score for each general practitioner obtained. A significant negative correlation was found between referral rate and amount of detail in referral letters, that is low referrers wrote very detailed letters. The procedure was repeated over an 18 month period including referrals to the district psychology service. Referral rate to the psychologists was positively correlated with detailed referral letters, that is those who referred many patients to the psychologists wrote detailed letters. This study has indicated a wide variation in the use of the psychiatry and psychology services by general practitioners which cannot be explained solely on the basis of a general referral tendency. It is likely that constructive liaison between psychiatrists and general practitioners, especially those who refer a large number of patients, could enhance the care of patients with psychiatric disorder in general practice.

Clinical Competence↗
PubMed1990

Dissemination of research findings: who wants what?

There is growing concern to ensure that the results of health services research reach, and are understood by, those who plan and provide health services. Because of the complexity and variability of services, it is often difficult to translate findings from one setting to another. This paper discusses an attempt to disseminate the findings of one study, Patterns and Pathways of Care of Old People, by visiting local health services on request. The main conclusion is that, for a qualitative study such as this, considerable effort is needed to predetermine which relevant research aspects and local people to bring together to make the exercise useful to either party. If dissemination of National Health Service (NHS) funded research is to be promoted, a central issue to be addressed is who is responsible for initiating and funding this stage. The paper raises a number of options.

Aged↗
PubMed1990

[Hepaticojejunostomy with a subcutaneous blind jejunum segment. An alternative in the treatment of stenosing bile duct diseases].

The choledochojejunostomy and hepaticojejunostomy with a blind subcutaneous segment of the jejunum offer a safe, simple and nearly linear access for repeated retrograde balloon dilatations of the biliary tract. 81 patients, both with malignant as well as benign stenoses of the biliary system have been treated with this method during the last 8 years. Operative technique and preliminary results of this new procedure, which we believe to be the method of choice in recurrent or multiple iatrogenic or posttraumatic biliary strictures, are presented in this paper.

Aged↗
PubMed1989

Retention of chromosome 3 in extrapulmonary small cell cancer shown by molecular and cytogenetic studies.

In small cell lung carcinoma, one of the short arms of chromosome 3 is typically lost. To investigate chromosome 3 in extrapulmonary small cell carcinoma, we used DNA probes that detect restriction-fragment-length polymorphisms at loci on 3p. These probes were used to study DNA extracted from tumors and normal tissues and/or tumor cell lines from five patients with extrapulmonary small cell cancer. Tumor DNA from four of the five patients with extrapulmonary small cell cancer retained heterozygosity at loci on 3p. Cytogenetic studies of the tumor cell lines established from these four patients showed retention of both short arms of chromosome 3. We conclude that the loss of genetic material from 3p observed in small cell lung cancer is not typical in extrapulmonary small cell cancer.

Adult↗
PubMed1989

Hepaticodochojejunostomy with afferent limb: CT anatomy.

Hepaticodochojejunostomy with an afferent limb constructed to provide a permanent access route for retrograde biliary dilation has been described. The computed tomographic (CT) scans of 12 patients who had undergone this procedure were reviewed. The appearance of the afferent limb from its position within the subcutaneous tissues to its anastomosis with the biliary tree is described and illustrated. Recognition of the limb as a surgical pathway is important because familiarity with its anatomy will avoid errors in CT interpretation and aid in successful transjejunal catheterization of the bile ducts.

Adult↗
PubMed1989

Schoolchildren's knowledge of cervical cancer and smears.

A survey of 264 schoolchildren aged 15 and 16 in four Aberdeen schools revealed that 17% had never heard of cervical cancer or smears; proportionately more of the 244 were boys and were 15 years old. Of the other respondents, when asked to locate the cervix on an anatomical drawing, nearly three-quarters placed the cervix accurately or within the cervical canal. The same proportion knew that a cervical smear involved an internal examination. Not surprisingly, more girls than boys gave correct answers. The survey was carried out to assess the need for health education before the introduction of call-up for cervical cytology at the age of 20. It is recommended that further surveys of knowledge in older teenagers would be useful before effective health education programmes can be devised to ensure a high uptake of the new screening programme.

Adolescent↗
PubMed1988

Combined surgical and radiologic approach to recurrent cholangitis and intrahepatic pigment stones.

A 37-yr-old white woman from Australia presented with ascending cholangitis and jaundice and was found to have multiple brown, "earthy" pigment stones in the biliary tree, including the segmental ducts. Removal of these stones was accomplished via a subcutaneously placed afferent jejunal limb of a choledochojejunostomy using balloon dilators. The jejunal conduit also served as an access for periodic removal of newly formed stones. This combined surgical and radiologic approach is an effective way of removing recurring pigment stones. The afferent jejunal limb can also be used to perfuse dissolution agents, if necessary, via catheters placed in the biliary tree.

Adult↗
PubMed1987

myc family oncogene amplification in tumor cell lines established from small cell lung cancer patients and its relationship to clinical status and course.

44 small cell lung cancer cell lines established from 227 patients were studied for myc family DNA amplification (c-myc, N-myc, and L-myc). Two of 19 lines (11%) established from untreated patients' tumors had DNA amplification (one N-myc and one L-myc), compared with 11 of 25 (5 c-myc, 3 N-myc, and 3 L-myc) cell lines (44%) established from relapsed patients' tumors (P = 0.04). The 19 patients who had tumor cell lines established before chemotherapy treatment survived a median of 14 wk compared with 48 wk for the 123 extensive stage patients who did not have cell lines established (P less than 0.001). Relapsed patients whose cell lines had c-myc DNA amplification survived a shorter period (median of 33 wk) than patients whose cell lines did not have c-myc amplification (median of 53 wk; P = 0.04). We conclude that myc family DNA amplification is more common in tumor cell lines established from treated than untreated patients' tumors, and c-myc amplification in treated patients' tumor cell lines is associated with shortened survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Percutaneous biliary drainage in acute suppurative cholangitis.

One hundred and sixteen percutaneous drainage procedures of the biliary system were performed in a 2-year period. Eight of 9 acutely ill patients with the diagnosis of acute suppurative cholangitis were successfully treated nonoperatively. They represented 26% of all patients with benign or postsurgical obstruction referred for biliary decompression. Conversely, acute suppurative cholangitis only occurred in 2.3% of patients with underlying malignant disease. These observations are considered most relevant in predicting the purulent nature of the disease, with further implications for patient management. Early recognition and prompt decompression of the biliary system are mandatory, along with the appropriate antibiotic coverage. Our experience compares favorably with surgical results and the procedure is proposed as the method of choice for the initial treatment of acute suppurative cholangitis.

Acute Disease↗
PubMed1986

Suspected vascular trauma of the extremities: the role of arteriography in proximity injuries.

We reviewed 72 patients with penetrating trauma to the extremities who underwent arteriography for proximity injury only. None of the patients had clinical evidence of vascular trauma. There were 62 males and ten females, with a mean age of 29.9 years. Gunshot wounds were the most common cause of injury (91.7%) and the thigh was the most common site of injury (47.2%). A normal arteriogram was found in 55 of 72 patients (76.4%). The remaining 17 patients (23.6%) had arteriographic abnormalities that did not warrant surgery. Only one patient was explored (1.4%) for spasm of the popliteal artery. No vascular injury was found at surgery. This study suggests that routine arteriography in proximity injury only may be unnecessary and that these patients could safely be admitted to the hospital for a 24-hour period of observation.

Adult↗
PubMed1986

Percutaneous transjejunal biliary dilatation: alternate management for benign strictures.

Since 1980, 23 patients with diffuse benign biliary strictures underwent percutaneous retrograde biliary dilatation through a surgically created jejunal access route. Bile ducts of 15 patients with sclerosing cholangitis, five with traumatic strictures, and three with strictures of diverse etiology were dilated with 25-atm balloons during 88 separate sessions. Individual dilatation intervals ranged between 2 and 36 months. Three patients with sclerosing cholangitis died. One uncomplicated bile duct rupture occurred in the trauma group because of balloon oversizing. Our 5-year experience indicates that bile duct patency can be safely maintained by repeated retrograde dilatations without the need for biliary catheters or stents.

Adolescent↗
PubMed1986

Neuroradiological and electroencephalographic features in a case of temporal lobe status epilepticus.

A patient with medically intractable status epilepticus of temporal lobe origin is presented. A computed tomogram showed a low density area adjacent to the midbrain, possibly related to atrophy of the medial temporal lobe. Cerebral angiography revealed early filling veins and an anterior temporal blush. Magnetic resonance (MR) scanning (T2 weighted images) showed increased signal intensity in the region of the amygdala and anterolateral left temporal lobe. Ictal activity was recorded from scalp electrodes over the left temporal area, and many paroxysms were recorded from cortical surface electrodes. An anterior temporal lobectomy revealed only gliosis. The cerebral blood flow changes accompanying status epilepticus of focal origin are reviewed, and a possible relation of electroencephalographic, angiographic, and MR findings is discussed.

Adult↗
PubMed1986

Nonsurgical drainage of appendiceal abscesses.

Five patients with abdominal abscesses complicating appendicitis were successfully treated by catheter drainage. In two patients, the percutaneous procedure was performed after incomplete surgical drainage; in three patients it was used as the only means of initial drainage. No interval appendectomy was required and no complications were associated with the procedure. Percutaneous management of appendiceal abscesses can be proposed as an alternative to surgical drainage.

Abscess↗