Biomedical subjects
Publications and source records attributed to J E Galbraith.
A population-based survey of blindness was conducted in Vanuatu. Data were gathered on a sample of 3520 of the approximately 150,000 inhabitants of Vanuatu aged at least 6 years, in order to estimate the prevalence and causes of blindness among the whole population. An overall prevalence of blindness of 4.0 per 1000 was found, 85% of which was due to cataract, an avoidable cause of this disability.
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The first dedicated, public hospital day-case eye surgery unit opened in Melbourne in June 1987. This report details the mode of operation of this unit, and analyses the 218 procedures performed in the first 15 months of operation, and includes an assessment of the level of patient acceptance.
This prospective study correlates premortem coronary angiographic interpretation with pathologic findings including the use of postmortem coronary angiograms. The reliability of a single radiographic view, left anterior oblique or right anterior oblique, or combined views (left anterior oblique plus right anterior oblique) was examined. The most reliable interpretation, the combined view, has a specificity of 93 per cent, but sensitivity is less at 61 per cent. Using a single view enhances diagnosis (sensitivity), but it leads to overestimation more frequently (decreased specificity). Proximal segments of the coronary arteries are prone to a significant per cent of false positive readings. The most accurate assessment of the anterior descending coronary artery system occurs with the use of the right anterior oblique with multiple views. Less routine use of the left anterior oblique view with increased use of the hemiaxial view is suggested for the angiography of the left coronary artery. Initial cusp injections of the right coronary artery may avoid a high per cent of false positive readings in the proximal segment.
We describe a case of cutaneous malignant melanoma metastatic to the iris as the first presenting sign of metastases 10 years after excision of the primary tumour. The histology of the excised iris metastases and the primary skin melanoma are compared. Progressive intracranial metastatic growth did not correlate with the observed regression of the residual intraocular melanoma cells during cyclical cytotoxic therapy.
Clinicopathological correlation of premortem coronary angiograms and postmortem data was performed to determine the degree of interobserver variability in the clinical interpretation of coronary angiograms using the pathological findings as the standard of accuracy. Comparison of the independent interpretations of the antemortem coronary angiograms by three cardiologists showed no substantial difference in overall diagnostic accuracy among the three observers. In the majority of instances where a substantial angiographic lesion was found on coronary angiography, it was verified pathologically. In false-positive or false-negative interpretations, a majority opinion was accurate when compared with a pathological lesion in 50% of the instances. Despite the fact that coronary angiography is an excellent diagnostic tool, there remain limitations of the accuracy of interpretation not solved by a majority opinion.
The introduction of microsurgical procedures to ophthalmology has resulted in an increased success rate with established operations. New operations which can only be performed with the operating microscope have also been developed. As long as certain basic principles are followed, surgery with the microscope has wide application, and lies within the expertise of all surgeons.
Two cases of left ventricular-right atrial shunts inadvertently produced during aortic valve replacement are described. It is surprising that this complication is not more prevalent considering the close proximity of the aortic and mitral valves to the atrioventricular portion of the membranous septum. A left-to-right shunt should be a consideration in patients who fail to improve following aortic valve surgery, especially if the valve and subaortic region were heavily calcified or septal trauma occurred during the surgical procedure.
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