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Biomedical subjects

F W Smith

Publications and source records attributed to F W Smith.

At least 199 records · Page 11Linked to original sources
PubMed1981

Nuclear magnetic resonance tomographic imaging in liver disease.

The non-invasive diagnostic technique of whole-body nuclear magnetic resonance (NMR) imaging was evaluated in 30 patients with established liver disease and 20 patients without liver disease. Comparison with diagnostic ultrasound and radionuclide liver scan shows that NMR easily differentiates malignant tumours from benign cystic lesions and provides useful information in patients with cirrhosis and metastatic deposits. In the demonstration of space-occupying lesions in the liver, NMR is as sensitive as ultrasound and more so than radionuclide liver scans when the metastases are less than 1.5 cm in diameter. In the demonstration of cirrhosis it is more sensitive than both ultrasound and radionuclide liver scan. The specificity of NMR is superior to both ultrasound and radionuclide liver scan, both of which only demonstrate the presence of lesions, whereas NMR tomographic imaging based on the proton spin-lattice time (T1) of tissue accurately indicates the nature of the lesion.

Cysts↗
PubMed1981

Diagnosis of deep vein thrombosis using autologous indium-III-labelled platelets.

Forty-eight patients who had undergone surgical reduction of a fractured neck of femur or in whom deep vein thrombosis was suspected clinically were studied by ascending phlebography and imaging after injection of autologous indium-111-labelled platelets to assess the accuracy and value of the radioisotopic technique in diagnosing deep vein thrombosis. Imaging was performed with a wide-field gammacamera linked with data display facilities. Phlebography showed thrombi in 26 out of 54 limbs examined and a thrombus in the inferior vena cava of one patient; imaging the labelled platelets showed the thrombi in 24 of the 26 limbs and the thrombus in the inferior vena cava. The accumulation of indium-111 at sites corresponding to those at which venous thrombi have been shown phlebographically indicates that this radioisotopic technique is a useful addition to methods already available for the detection of deep vein thrombosis.

Femoral Neck Fractures↗
PubMed1981

Oesophageal carcinoma demonstrated by whole-body nuclear magnetic resonance imaging.

The quality of the images produced by nuclear magnetic resonance (NMR) imaging has steadily improved over the past five years. Images of the head, thorax, and abdomen have clearly shown the normal anatomy. A clinical trial of NMR imaging has therefore been started in Aberdeen to assess its diagnostic accuracy and compare it with conventional radiography and other imaging technique. The first patient examined by whole-body NMR imaging had carcinoma of the oesophagus diagnosed on barium meal examination. A technetium-99m-sulphur colloid liver scan also showed hepatic metastases. NMR imaging showed a large tumour in the lower third of the oesophagus, and areas of increased proton spin-lattice relaxation time (T1) on a section through the liver corresponded with the metastases shown on the radionuclide scan. Increased areas of T1 were present in some vertebrae, and a technetium-99m bone scan confirmed the presence of bone metastases. The NMR images in this patient compared well with the images from other techniques. The continuing clinical trial may show that NMR is an accurate diagnostic aid which will complement existing techniques for diagnosing intrathoracic and intra-abdominal conditions.

Adenocarcinoma↗
PubMed1981

Whole-body nuclear magnetic resonance imaging: the first report of its use in surgical practice.

This is the first report of whole-body nuclear magnetic resonance (NMR) imaging being of value in clinical surgery. Following aortobifemoral grafting, a 54-year-old man developed a pyrexia and hypotension which did not respond to antibiotic therapy and which was thought to be caused by early graft infection. Whole-body NMR imaging showed the graft and iliac arteries to be normal and an empyema of the gallbladder to be present, NMR imaging is a safe, non-invasive technique for imaging the body in transverse sections and specifically measures the water concentration of tissues, enabling normal and inflamed tissues to be differentiated.

Aorta, Abdominal↗
PubMed1981

A clinical trial of the value of a tomographic section view to identify liver abnormalities by radionuclide imaging, with special reference to metastatic disease.

A prospective trial was carried out to assess the value of a radionuclide transverse section view in addition to conventional radionuclide scans of the liver. Reports for 373 patients were analysed and compared with the final independent clinical diagnosis. Although several individual cases were more accurately diagnosed using the tomographic section view, the trial did not demonstrate a significant increase in accuracy of diagnosis in liver disease. Some possible reasons for this are discussed, mainly the difficulty of identifying and quantifying truly abnormal features of liver radioisotope scans.

Evaluation Studies as Topic↗
PubMed1981

Intravenous radionuclide cystography for the detection of vesicorenal reflux.

Intravenous radionuclide cystography using a single intravenous injection of 99mtechnetium diethylenetriaminepentaacetic acid, provides information on individual kidney function, coarse anatomy and vesicorenal reflux. This study investigates the effectiveness of intravenous radionuclide cystography in detecting reflux. In 58 children intravenous radionuclide cystography detected 53 ureters with reflux compared to 32 detected by voiding cystography. This difference was investigated further with patients in whom other test suggested reflux. While there was no statistically significant difference for patients having pyelonephritis or hydronephrosis, intravenous radionuclide cystography detected significantly more ureters with reflux in patients with abnormal ureteral orifices or infected urine and, therefore, predisposed to reflux. Intravenous radionuclide cystography is a more comprehensive and sensitive test for vesicorenal reflux than voiding cystography.

Adolescent↗
PubMed1981

Indium (111In)-labelled platelets in the diagnosis of renal transplant rejection: preliminary findings.

Eleven patients with recent kidney transplants have undergone serial pelvic imaging after autologous platelet labelling with indium-111. Rejection was accompanied by marked platelet deposition in the graft, whereas acute tubular necrosis was characterized by minimal platelet accumulation. The method has been quantified by comparing counts over the graft to counts from a similar area on the opposite site, and appears to distinguish between the two main causes of renal failure after transplantation. In addition, complications of transplant surgery may be demonstrated.

Acute Kidney Injury↗
PubMed1981

Modification of gallium-67 citrate distribution in man following the administration of iron.

Current imaging techniques with 67Ga citrate for the localization of malignant or inflammatory lesions have a number of major limitations. In an effort to improve the lesion-to-background ratio and to reduce the time between 67Ga citrate injection and performing the scan, the 67Ga citrate injection is now routinely preceded by injection of iron-sorbitol citric acid (Jectofer). A series of 147 patients has been studied and shows that (a) the diagnosis can be made at 24 h in 80% of the cases, and (b) when 24 h and 48 h images are read together, diagnosis is at least as accurate as by the standard method, which requires a 72 h interval between injection and scanning. The major differences in appearance are lower activity in the soft-tissue background, relative absence of colonic activity at 24 h and visualization of the bladder in about 40% of cases. We believe that by saturating the free transferrin with iron, uptake into soft tissues and bone is sufficiently modified to enhance the lesion-to-background ratio, thereby making earlier imaging and diagnosis possible.

Colon↗
PubMed1981

Profile of a unique community-based clinical pharmacy family practice program.

The provision of clinical pharmaceutical services in family practice offices has aroused considerable national interest among both pharmacists and physicians. Many of these clinical pharmaceutical services and educational programs have been university-funded and/or rely on colleges of pharmacy for fiscal support. Few examples of community-funded, ambulatory care clinical pharmaceutical programs have been reported. Community Health Care, Inc., and Davenport Medical Education Foundation, Inc., are two health care programs which sponsor an innovative ambulatory care clinical pharmacy program. Community Health Care is a nonprofit corporation which utilizes a multidisciplinary team concept to provide comprehensive ambulatory care services to patients. Davenport Medical Education Foundation is a nonprofit corporation that provides a community-based family practice residency program. Because the two separate parent organizations have distinct goals requiring individualized clinical pharmaceutical services, the responsibilities of the clinical pharmacist have evolved to be comprehensive in scope.

Family Practice↗