Biomedical subjects

J L Bourke

Publications and source records attributed to J L Bourke.

5 recordsLinked to original sources

PubMed2006

Detection rate of periintestinal lymph nodes.

AIM: Compared to standard two-dimensional (2D) endosonography, three-dimensional (3D) endosonography has been presented as a possible improvement regarding imaging of the gastrointestinal (G-I) tract and detection of metastatic lymph nodes. The aim of this study was to evaluate the efficacy of detecting periintestinal lymph nodes in surgical specimens using 3D endosonography. PATIENTS AND METHODS: Surgical specimens from 31 patients with malignant G-I tumours were investigated by 3-D endosonography and histology with focus on the presence of periintestinal lymph nodes and presence of metastasis. The specimens were scanned submerged into water. Position and size of the lymph nodes were mapped on a photo of the specimen both by the pathologist and the examiners. RESULTS: Three-dimensional endosonography detected 48 out of 60 malignant lymph nodes (80.0 %), and 110 out of 219 benign lymph nodes (50.2 %). The positive predictive value for an endosonographic finding interpreted as a lymph node was 0.97. CONCLUSION: The detection rates for periintestinal lymph nodes were relatively high and seemed superior to the one usually assigned to 2D endosonography. Although distinguishing between metastatic and non-metastatic lymph nodes remains a problem, all patients with histologically confirmed metastasis to lymph nodes were detected by 3D endosonography, and the technique thus seems suitable for grouping of patients prior to surgery.

Colonic Neoplasms↗

PubMed2005

A nondimensional normalization scheme for oxygen utilization data.

The total oxygen required for gait (gross utilization) is a widely used indicator of locomotor efficiency. The standard scheme of mass normalization (dividing gross utilization by mass) is intended to eliminate confounding effects that arise from variations in age and size. Despite its prevalence, mass normalization has been shown to be inadequate, as the normalized quantity retains a marked dependence on clinically relevant factors. The current study proposes a new scheme for normalizing oxygen utilization data. The new scheme, called net-nondimensional normalization, is based on the use of net oxygen utilization (gross-rest) and nondimensional gait variables. Measures of statistical significance are employed to demonstrate that net nondimensional normalization is superior to mass normalization. Net nondimensional oxygen utilization is shown to be largely independent of the relevant physiological and anatomical factors, and is therefore well suited for studies where an independent measure of gait efficiency is needed.

Adolescent↗

PubMed2001

[Joint charts in drug handling. Toward increased drug safety].

INTRODUCTION: Medication errors contribute to 8% of all hospital admissions. Minimalization of the number of information transferrals and improvement in communication may increase the quality of drug treatment. MATERIAL AND METHODS: The effect of introducing joint charts for prescription and administration on the quality of drug handling in a hospital setting is reported. RESULTS: When separate charts were used the prescriptions in the case records and the nurses' charts for administration did not tally for any of 20 patients. One year after introducing the joint charts, prescriptions for the regular medication and medication on demand were correct and signed for 88% and 48%, respectively, on a patient basis. Ninety-five per cent of the regular administrations were correct and signed. Potential interactions were identified in 15% of the prescriptions. Discharge medication was stated in 65% of the discharge letters to the family doctors. Complete agreement on admission medication between the patient and family doctor was found in 39%. DISCUSSION: Joint charts for prescription and administration represent a significant step towards safe and rational medical treatment. It is more time-consuming. Improvement in communication between all parties involved in the treatment of the same patient represents an important potential for further improving the quality of care, including drug treatment.

Communication↗

PubMed2000

Doppler ultrasound (pre- and post-contrast enhancement) for detection of recurrent stenosis in stented renal arteries: preliminary results.

The purpose of the present paper was to assess whether conventional renal Doppler ultrasound and the commonly used parameters of peak systolic velocity and renal aortic ratio may be an appropriate modality for the follow-up of renal artery stents. A total of 19 arteries in 15 patients was examined with both renal Doppler ultrasound and angiography for the presence or absence of recurrent renal artery stenosis. Disease was considered present on angiography if the arterial diameter was more than 60% stenotic. Doppler criteria for stenosis were either a peak systolic velocity of > 180 cm/s or a renal aortic ratio of > 3.0. Echo enhancement with Levovist (Schering, Berlin, Germany) was used if studies were technically unsuccessful or to improve diagnostic confidence. Renal Doppler ultrasound detected 100% of renal artery stenoses. The specificity was 75%, the positive predictive value was 67% and the negative predictive value was 100%. Echo enhancement improved the technical success rate from 89 to 95% and also increased diagnostic confidence in six examinations. The present limited study suggests that similar renal Doppler parameters as used for the study of unstented renal arteries may be applied to the examination of renal arteries with renal stents in situ. It therefore suggests that Doppler ultrasound may provide an adequate non-invasive means of renal artery stent follow-up, particularly when combined with echo-enhancing agents. Further study is warranted to confirm these initial conclusions.

Adult↗

PubMed1999

Contrast-enhanced Doppler ultrasound for renal artery stenosis.

The use of renal artery Doppler ultrasound for the diagnosis of renal artery stenosis is a well-established technique in selected populations, but the technical failure rate of the examination leading to incomplete studies is a major drawback. The results of ultrasound contrast-enhanced renal artery Doppler for renal artery stenosis, using the echo-enhancing agent, Levovist, are reported here. Sixteen patients (22 arteries) were examined with Levovist. The technical success rate of these examinations was 91%, and all four renal artery stenoses were correctly identified. It is concluded that the use of ultrasound contrast (Levovist) increases the technical success rate of renal artery Doppler ultrasound in this setting, with similar accuracy to unenhanced Doppler examinations.

Adult↗