Biomedical subjects
Publications and source records attributed to J D Bennett.
In the 3 months from October 1990 to January 1991, 110 operations were performed at 33 Field Hospital, Royal Army Medical Corps at Al Jubayl, Saudi Arabia in collective protection against chemical warfare. The evolution of improvements in this environment is presented in the context of the first operative series undertaken.
Five patients with splanchnic arterial aneurysms and one patient with a tortuous splenic vessel presented with peripancreatic masses that exhibited an anechoic portion in real-time ultrasonography (US) images; the masses were incorrectly diagnosed as pseudocysts. In two patients a vascular abnormality was suspected, and colour-flow Doppler and pulsed Doppler US were performed; these techniques showed the presence of pseudoaneurysms. In the other four patients the possibility of a pseudoaneurysm was not entertained until further studies had been performed. These results emphasize the need for colour-duplex US evaluation of all peripancreatic fluid collections during the initial US examination to avoid the misinterpretation of an aneurysm or a pseudoaneurysm as a simple or complex fluid collection and to prevent the potential disaster of performing biopsy, surgery or other interventions.
Aneurysms of the inferior gluteal artery are uncommon, and have not previously been described in detail in the radiologic literature. The authors report the findings of computed tomography and angiography for a patient with a pseudoaneurysm of the inferior gluteal artery who was successfully treated by embolization alone.
The indications for the ruling for the Gulf Forces that emergency cricothyrotomy is to be performed where the airway is thought to be compromised are reviewed. The advantages of this procedure are outlined and some of the likely consequences regarding the incidence of complications and their management predicted.
A series of 12 neck space infections admitted to a military hospital in Germany in a 12 month period are presented. This represents an incidence of 1:1000 for the age group studied. The reappearance of the retropharyngeal abscess which has been rare since the widespread use of antibiotics, along with the generally high incidence of this group of infections, is probably a result of the more discriminating use of antibiotics in primary health care. The pitfalls in diagnosis and the preferred antibiotic cover are discussed.
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Nosebleeds are exceedingly common, and usually idiopathic. Cautery under local anaesthetic to the vessels of the nasal septum is often used successfully as a treatment for the recurrent condition. However, rarely, a nosebleed may be a symptom of a more serious underlying disorder and a suitable history and examination are required.
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Percutaneous needle biopsy of bone lesions has been done for over 50 years. Although initially not widely used, it has been increasingly accepted over the past several years. Large-bore needles were used at first. However, as cytopathological techniques have improved, fine-needle biopsy has become feasible, offering the advantage of reduced tissue trauma and increased flexibility in needle positioning. We have retrospectively reviewed our fine-needle bone biopsies performed from January 1985 to May 1988 in 53 patients. Repeat aspirations were required on only five patients. Adequate samples were obtained at initial biopsy in the remainder. Accuracy was 0.94 which is comparable with, or better than, reported results obtained using larger bone needles. Accuracy was not affected by site or number of lesions, nor was it markedly different in patients with and without known primary malignant lesions. Biopsy of bone lesions using a fine needle provides a flexible, accurate, and relatively atraumatic alternative to more invasive methods.
An 80-year-old man was seen in the clinic with a two month history of pain, bleeding and deafness in his left ear; accompanied by a left facial palsy. Six months earlier, anaplastic carcinoma of the bladder had been diagnosed and treated with radiotherapy. On examination there was a mass in his left external auditory canal and VII, VIII, IX and X left cranial nerve palsies. Histology of a biopsy was identical with his original bladder tumour. He received a course of palliative radiotherapy but died shortly after. Post-mortem demonstrated the left temporal bone metastasis extending into the middle and posterior cranial fossae. There was no evidence of residual bladder tumour, or other primary tumour. Temporal bone metastases are probably more common than generally thought. Presentations like this may become more common as cancer therapy improves, with patients surviving longer and presenting later with metastatic disease.
The Royal Army Medical Corps and its predecessors have always had an interest in the selection and training methods of the Army, especially when physiological principles are in question. Surgeon Major Davy appears to have suggested an early combat fitness test as a better method of assessing the suitability of recruits.
The problems posed by flat feet to recruitment for the Army are assessed and the methods by which the Army has responded to the challenge over the years are reviewed.
A case of multifocal avascular necrosis of the bone complicating systemic lupus erythematosis is presented in which the extent of involvement was incidentally identified by Tc-99m HMPAO leukocyte imaging. Leukocytes labeled with Tc-99m HMPAO may be an excellent bone marrow imaging agent.
A case of long standing halitosis due to a nasal foreign body is described, and the causes of halitosis are reviewed.
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Relationships among mine and injured miner characteristics and degrees of injury are examined for 91 404 injuries in underground bituminous coal mines in the United States from 1975 through 1982. Injury severity varies by the mining system, geographical region, circumstances surrounding the injury, the injured miner's age, whether the miner was using powered equipment, the year in which the injury occurred and the location in the mine where the injury happened. Injury severity is not related to the injured miner's total mining experience, job experience and experience in the mine in which the injury occurred.
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