Search PubMed⌕ Search

Biomedical subjects

J McIvor

Publications and source records attributed to J McIvor.

At least 37 records · Page 2Linked to original sources
PubMed1987

Neurological morbidity of arch and carotid arteriography in cerebrovascular disease. The influence of contrast medium and radiologist.

A prospective study of 230 arch and carotid arteriograms in 229 patients with symptomatic cerebrovascular disease revealed that neurological morbidity was not significantly affected by patient age, nature of neurological symptoms, duration of procedure, volume of contrast medium or degree of arterial stenosis. The total neurological morbidity of 132 examinations carried out with non-ionic contrast medium (iohexol) was slightly lower than that of 98 examinations carried out with ionic contrast medium (meglumine and sodium iothalamate) but the difference was not statistically significant. However, the morbidity of 185 examinations performed by an experienced vascular radiologist was significantly lower (p less than 0.025) than the morbidity of 45 examinations performed by a series of radiologists in training and the mean time required for the procedure was 18 min longer in the latter group (p less than 0.001). These findings suggest that the neurological morbidity of arch and carotid arteriography in patients with cerebrovascular disease depends largely upon catheter technique and will not be significantly reduced by the use of non-ionic contrast medium.

Cerebral Angiography↗
PubMed1986

Renovascular hypertension following radiotherapy and chemotherapy treated by transluminal angioplasty.

A man aged 33 with poorly controlled hypertension who had been treated with radiotherapy and combination chemotherapy for testicular teratoma 8 years earlier was found on arteriography to have 75% stenosis of the left renal artery and occlusion of the right renal artery. The stenosis was dilated by transluminal angioplasty and the hypertension adequately controlled. Patients who develop high blood pressure after abdominal radiotherapy with or without chemotherapy should be investigated for renal artery stenosis.

Adult↗
PubMed1986

Interpretation of negative results in fine needle aspiration of discrete pulmonary lesions.

A retrospective analysis was carried out on a consecutive series of 181 percutaneous fine needle aspiration biopsies of discrete pulmonary lesions, in which the outcome was established in 95%. In primary bronchial carcinoma the technique had a sensitivity of 86%. There was no relationship between the size, location, or radiological appearance of the lesion and the incidence of false negative results. The principal reason for failure to diagnose malignancy was inadequacy of the material provided for cytological examination. For metastatic neoplasms of non-bronchial origin the procedure had a sensitivity of 42% and a significantly greater false negative rate than for primary bronchial malignancy. For the entire series 72 (40%) of the procedures failed to produce a definite diagnosis, 29 (40%) of these cases subsequently proving to be malignant. A positive diagnosis was established in only 16% of patients with benign conditions. Review of published reports and consideration of the role of this and other biopsy techniques in the investigation of discrete pulmonary lesions lead to the conclusion that needle aspiration biopsy seems particularly appropriate in the investigation of inoperable patients with probable bronchial carcinoma in whom sputum cytology and bronchoscopy do not yield a diagnosis.

Biopsy, Needle↗
PubMed1986

Tracheo-oesophageal 'puncture speech'. An assessment technique for failed oesophageal speakers.

We describe the assessment procedures used at Charing-Cross Hospital to investigate laryngectomees who failed to develop oesophageal voice and give the results of assessment in 50 patients. Anatomical or physiological abnormalities in the reconstructed pharynx were found in all patients, and we feel these significantly contributed to the failure of achieving an oesophageal voice. The four cases of failure were due to hypotonicity of the pharyngo-oesophageal muscles, hypertonicity, frank spasm and stricture. This distinction can be used as a functional classification of failure as treatment for each group has to be different if successful surgical voice restoration is to be achieved. Patients with hypotonicity need to use external pressure; those with mild hypertonicity are able to use a low pressure tracheo-oesophageal voice prosthesis; those with spasm need a pharyngo-oesophageal myotomy prior to "puncture", while those with stricture need surgical correction.

Esophagus↗
PubMed1984

Prediction of early death after therapeutic hepatic arterial embolisation.

A consecutive series of 14 patients with hepatic malignant disease treated by palliative hepatic arterial embolisation was reviewed. Twelve patients had hepatic pain from their tumour and two were suffering from the carcinoid syndrome. Six patients died within four weeks of the procedure (group 1) and eight survived for at least 10 weeks (group 2). Factors were sought that might permit prediction of a high risk of early death (group 1). The pre-embolisation angiograms reviewed by a "blind" observer showed no differences in vascularity or tumour size between the groups and no difference in the extent of arterial occlusion after embolisation. The portal vein was patent in all patients. No significant difference was seen between the groups in the pre-embolisation biochemical values, with the exception of lower serum albumin concentrations and higher alkaline phosphatase activities in group 1. All those who died early had serum alkaline phosphatase activities of 45 KAU or above, while six of the eight who survived longer had activities below this value (p less than 0.02). These findings suggest that serum alkaline phosphatase activity of 45 KAU or more (normal range 3-13) might alone be a useful predictor of early death. Stepwise discriminant analysis using a weighted combination of serum alkaline phosphatase activity and albumin concentration predicted the outcome in all but one of the patients studied (p less than 0.002).

Adult↗
PubMed1984

Lymphatic hypoplasia without lymphoedema.

A prospective study of lymph vessel abnormalities in the lower limbs of 744 adult patients without lymphoedema revealed seven patients with lymphatic hypoplasia, a prevalence rate of 0.94% (95% limits of confidence 0.24-1.64%). The prevalence was higher in males (1.1%) than in females (0.5%) but the difference is not statistically significant. This is much higher than any available estimate of the prevalence of primary lymphoedema of the lower limbs and suggests that lymphatic hypoplasia is merely one factor in the aetiology of clinical lymphoedema.

Adolescent↗
PubMed1984

Tumour infarction after pre-operative embolisation of renal carcinoma.

Thirty kidneys containing renal carcinoma became available for complete histological examination 2-8 days after therapeutic embolisation with various combinations of gel-foam, dura mater, steel coils and thrombin. There was extensive tumour infarction (greater than 50%) in 25 kidneys and in the other five kidneys there was no tumour infarction detected histologically. In the 24 kidneys with a single renal artery, the number with tumour infarction exceeding 50% was significantly higher in cases where the post-embolisation arteriogram had shown complete occlusion of the renal artery close to its origin than in cases where the renal artery had been incompletely occluded (P = 0.0016). Fragments of gel-foam or dura mater were significantly less likely to produce complete arterial occlusion on the post-embolisation arteriogram than mixtures of embolic material containing coils (P = 0.016) or thrombin (P = 0.042). In the six kidneys with two renal arteries, tumour infarction exceeded 50% in the five kidneys where the post-embolisation arteriogram had shown complete occlusion of both renal arteries, and there was no tumour infarction in the single case where an accessory renal artery had been left patent. It is concluded that complete occlusion of the renal artery (or arteries) is essential if tumour infarction in excess of 50% is to be guaranteed, and that this is more readily achieved with mixtures of embolic materials containing fragments of gel-foam or dura mater plus coils or thrombin than with fragments of gel-foam or dura mater on their own.

Adult↗
PubMed1982

Control of severe vesical haemorrhage by therapeutic embolisation.

Therapeutic embolisation is now recognised as having a role in the management of bladder haemorrhage and is particularly valuable in severe cases where the patient's life is at risk. This paper describes the procedures which were used to manage two patients with massive haematuria, from a tumour in one case and from an arterial malformation in the other. Previous reports indicate that haemorrhage from a bladder tumour can usually be controlled by embolisation which is limited to the tumour itself but haemorrhage due to post-radiation telangiectasis requires more extensive arterial occlusion and this was taken into account in planning the embolisation procedure in the first case. Neither patient developed gluteal pain after embolisation which was probably due to the fact that the superior gluteal arteries were not completely occluded. The left axillary approach was used as a catheter passing down the aorta can usually be manipulated into the internal iliac arteries and their smaller branches on both sides without difficulty.

Adult↗
PubMed1980

Changes in lymph node size induced by lymphography.

Although the contraction of normal lymph nodes after lymphography has been measured the enlargment caused by lymphography has not. In this study the lengths and widths of 25 radiologically normal nodes were measured in five patients who had a second lymphogram carried out when these nodes were still outlined by contrast medium from the first lymphogram. If the mean length after the second lymphogram is taken as 100% then the mean length 24 h earlier measured 82%, and if the mean volume after the second lymphogram is taken as 100% then the mean volume 24 h earlier was 49%. These substantial increases are similar to the reductions which have been reported in some previous papers and are probably due to distension of lymph node sinuses by oily contrast medium. It is obviously important that changes in lymph node size which are induced by lymphography itself be taken into account when follow-up films and repeat lymphograms are used to assess the response of lymph nodes to treatment.

Adult↗
PubMed1979

Cutaneous arteritis with superior vena cava obstruction.

Superior vena cava (SVC) obstruction may occur in several disorders (Urschel & Paulson, 1966) and may be associated with arteritis in Behçet's disease (Chajek & Farinaru, 1975). We report a man who had arteritis and SVC obstruction without any of the known causes.

Adult↗
PubMed1977

Flying to work.

Explore the source record for details and available documents.

Aircraft↗