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Biomedical subjects

G M Fraser

Publications and source records attributed to G M Fraser.

At least 73 records · Page 4Linked to original sources
PubMed1980

Grey-scale ultrasonography and percutaneous transhepatic cholangiography in biliary tract disease.

Fifty-one patients with suspected obstructive jaundice and 14 without jaundice in whom disease of the biliary tract was suspected but infusion cholangiography had been unhelpful were examined by grey-scale ultrasonography and percutaneous transhepatic cholangiography and the findings analysed retrospectively. Grey-scale ultrasonography distinguished between obstructive and hepatocellular jaundice in 35 out of 46 patients (76%) and indicated the site of the obstruction in 27 (58%) and the cause of the obstruction in 13 (28%). Percutaneous transhepatic cholangiography distinguished between obstructive and hepatocellular jaundice in 42 of the patients (91%) and indicated the site of the obstruction in 42 (91%) and the cause in 29 (63%). In the 14 patients without jaundice percutaneous transhepatic cholangiography showed bile-duct stones in one an ampullary stenosis in three. It is concluded that grey-scale ultrasonography and percutaneous transhepatic cholangiography are complementary examinations and that ultrasonography should always be undertaken first as it is a non-invasive procedure that may provide the surgeon with all the diagnostic information he requires. Percutaneous transhepatic cholangiography should be performed when grey-scale ultrasonography has shown dilated bile ducts but failed to provide adequate diagnostic information. Cholangiography is also required when preoperative percutaneous drainage of the bile duct is contemplated. In those patients in whom grey-scale ultrasonography shows non-dilated ducts endoscopic retrograde cholangiopancreatography is probably the contract examination of choice.

Biliary Tract Diseases↗
PubMed1980

Industrial accidents and their prevention.

Accident prevention is a task for all sections of the community; it should be part of the industrial process and not separated. It depends primarily on attitudes, communication and industrial relations. Money spent by management on safety is necessary, but it is not the only prerequisite. In the framework of workmen's compensation legislation where payment of lump sums for injury is the philosophy, the disability of the worker is the predominant factor. This is a negative attitude and early rehabilitation with the assessment of the worker's ability to perform is closely allied to accident prevention.

Accidents, Occupational↗
PubMed1978

Percutaneous transhepatic cholangiography with the Chiba Needle.

Percutaneous transhepatic cholangiography using the Chiba needle has been performed on 102 patients. There was an overall success rate of 86 out of 102 cases (84%). Dilated bile ducts were successfully demonstrated in 61 out of 65 patients (94%) and non-dilated ducts in 25 out of 37 patients (70%). Gallbladder filling was achieved in 40 out of 70 cases (67%). The hepatic lymphatics were filled in 32 cases but dilated lymphatics were mainly seen in patients with biliary cirrhosis, inflammatory liver disease or lymphoma. It is suggested that an excessive radiation dose may be given to the radiologist's fingers unless the fluoroscopy diaphrams are kept well coned down. Complications requiring active medical intervention occurred in three cases and emergency surgery in one case.

Bile Ducts, Intrahepatic↗
PubMed1978

The double contrast barium meal in patients with acute upper gastrointestinal bleeding.

One hundred and seven patients admitted to a small general hospital with acute upper gastrointestinal bleeding have been examined by the double contrast barium meal technique. The presumed bleeding site was identified in 75 cases (70%). Twenty-eight patients showed radiological evidence of recent or active bleeding. These were all examined within 24 h of the bleed and 18 (64%) continued to bleed or had a further bleed whereas of 79 patients who did not show radiological signs of recent or active bleeding only 10(13%) continued to bleed or had a further bleed. The radiological features of recent or active bleeding seen on the double contrast barium meal are: 1, Blood clot in an ulcer or adherent to a recently bleeding lesion. 2. An artery in the base of an ulcer. 3. Active bleeding during the course of the examination seen as a dynamic alteration or disturbance in the barium as it flows over the bleeding site.

Acute Disease↗
PubMed1977

Disseminated peritoneal leiomyomatosis.

Disseminated peritoneal leiomyomatosis is an unusual condition characterized by the development of numerous nodules in the peritoneal cavity which histologically have the appearance of smooth muscle tumors. The ninth proven case of this ill-understood disorder is presented here, with comments on some of the other published instances. Most reported cases were diagnosed in pregnant women, and there is good reason to believe that endocrine factors are of importance in the development of this condition. Attention is drawn to experimental studies in which an apparently similar condition has been produced in guinea pigs by endocrine manipulation. Clinically, the condition appears to be benign and the correct diagnosis is, therefore, of great importance. In the case presented here histological involution of the leiomyomatous peritoneal nodules could be demonstrated for the first time by two biopsies at an interval of 4 months--in the absence of any therapy apart from the termination of pregnancy.

Adult↗
PubMed1977

Aneurysms of the coronary arteries in infants and children. A review, and report of six cases.

In recent years large numbers of the so-called "mucocutaneous lymph node syndrome" or "Kawasaki's disease" have been described by Japanese workers, but instances of this disorder are only now being reported as isolated cases by European or North American physicians. The disease has, therefore, been considered to be a new entity. One of its most striking features is the development of aneurysms of the coronary arteries in infants or children, which may lead to sudden death. Aneurysms of the coronary arteries in childhood are rare, and hence it was considered relevant to report six such cases, and to examine their possible relationship to Kawasaki's disease. The pathological changes underlying the latter disorder are not well known; they are considered to be indistinguishable from infantile polyarteritis nodosa. A diagnosis of polyarteritis nodosa was also thought to be most likely to apply in the cases presented here, particularly in view of the frequency with which aneurysms of the coronary arteries have been found in this disorder. In the absence of valid pathological distinctions between Kawasaki's disease and infantile polyarteritis nodosa, the question arises whether these entities are, in fact, different, and whether Kawasaki's disease is the new entity it is assumed to be.

Age Factors↗
PubMed1976

Radiology and endoscopy in acute upper gastrointestinal bleeding.

Of 112 patients admitted with acute upper gastrointestinal bleeding, the presumed bleeding site was detected in 61-5% of cases by radiology and in 57% of cases on endoscopy. Thirty-one patients who had barium-meal examination were operated on and the surgical and radiological findings agreed in 26 (84%). Twenty-three patients who had endoscopy were operated on and the surgical and endoscopic findings agreed in 15 (65%). In 10 cases radiology detected a lesion not identified on endoscopy and in nine endoscopy detected a lesion not seen at radiology. We suggest that when there are two potential sources of bleeding radiology as well as endoscopy can detect the actively bleeding lesion. The supplementary nature of radiology and endoscopy is emphasised and we conclude that both methods should be used if there is any doubt at the initial radiological or endoscopic examination about the source of the bleeding.

Acute Disease↗
PubMed1976

The double contrast enema in ulcerative and Crohn's colitis.

One hundred double contrast enema examinations using a colonic activator (veripaque in the preliminary cleansing enema and 51 conventional barium enema examinations without a preliminary veripaque enema have been performed on 94 patients with either ulcerative colitis or Crohn's disease of the colon. The severity of the disease at barium enema examinations has been graded and compared with the severity of the disease found at sigmoidoscopy. In the double contrast examination, there was agreement between the radiological and sigmoidoscopic findings in 77% of cases and a disagreement of one grade in the remaining 23% of cases. The double contrast enema demonstrated lesions in the colon proximal to the range of the sigmoidoscope of a greater severity than that seen at sigmoidoscopy in 30% of cases. It was not found possible to use the same grading method with the conventional enema, and unless frank ulceration is present, it is considered that the conventional enema is unreliable in assessing the state of the colonic mucosa. It is concluded that the double contrast enema, using a colonic activator in the preliminary cleansing enema, causes no greater risk of complications than either the conventional enema or sigmoidoscopy.

Barium Sulfate↗