Biomedical subjects

M J Michell

Publications and source records attributed to M J Michell.

27 records · Page 2Linked to original sources

PubMed1991

The mammographic parenchymal patterns of nulliparous women and women with a family history of breast cancer.

One-hundred-and-thirteen mammograms of nulliparous women and 44 mammograms of women with a family history of breast cancer were graded according to Wolfe's parenchymal pattern classification. These were compared to 437 mammograms of women without these risk factors. Mammograms were read by two independent observers in order to evaluate inter- and intra-observer variation. The interobserver variation was reduced from 17% to 5% by combining high risk patterns (P2 and DY) and low risk patterns (N1 and P1). A significantly higher proportion of high risk patterns was found in nulliparous women compared to parous women (P less than 0.01). The proportion of high risk patterns decreased significantly with the number of children (P less than 0.01). Women with a family history of breast cancer had almost the same parenchymal patterns as women without a family history. In conclusion, while nulliparity and family history are recognized risk factors for developing breast cancer, only nulliparity would appear to influence the mammographic parenchymal pattern. This probably reflects the different mechanism by which the two factors affect breast tissue.

Breast Neoplasms↗

PubMed1991

The mammographic parenchymal patterns of women on hormonal replacement therapy.

In this study 383 mammograms of women on hormone replacement therapy (HRT) for more than one year and 216 mammograms of women performed before HRT was started were examined to identify any mammographic features which are associated with a higher incidence of developing breast cancer according to Wolfe's criteria. There was no significant difference in the proportion of high and low risk parenchymal patterns as the duration of HRT increased. A significantly higher proportion of low risk patterns with ageing was observed in 216 women who had never been on HRT when compared to 194 mammograms of women who had been on HRT for more than 5 years. This difference becomes more obvious in women on HRT with less than three children compared to a similar group not taking HRT. Women who had not taken HRT appeared to undergo normal involutional changes which were reflected by an increase in the proportion of low risk patterns with increasing age. We may conclude from these findings that HRT appears to inhibit involutional processes within the breast and therefore this group have higher risk parenchymal patterns for a longer period of time and subsequently may have a higher risk of developing breast cancer.

Age Factors↗

PubMed1991

The use of real-time ultrasound in the management of scrotal trauma.

27 patients were studied with real-time ultrasound following severe scrotal trauma. 22 (81.5%) had ultrasound features of scrotal trauma and, of these, five (18.5%) had signs of testicular rupture. Four of these five patients underwent surgery following ultrasound. This confirmed the diagnosis of rupture and the tests were repaired. Ultrasound should be offered to all patients presenting with scrotal trauma to select patients with testicular rupture for surgery.

Adolescent↗

PubMed1990

Indolent gastric epithelioid leiomyosarcoma in Carney's Triad.

We report a patient with gastric epithelioid leiomyosarcoma and multiple pulmonary chondromata who remains asymptomatic 38 years after initial resection of the gastric tumour and 4 years after representation with recurrent tumour and multiple liver metastases. This represents an incomplete form of Carney's Triad, and illustrates the unusually indolent natural history of the gastric tumour in this condition. The radiological appearances are described.

Chondroma↗

PubMed1989

The use of real-time orbital ultrasound in Graves' ophthalmopathy: a comparison with computed tomography.

Evaluation of the severity of orbital involvement and likelihood of the development of optic neuropathy in Graves' disease can be clinically difficult. We describe the use of real-time orbital ultrasound scanning to measure the medial rectus muscle width in 20 patients with Graves' ophthalmopathy and 21 normal individuals. The normal reference interval (to 2 SDs) was 1.75 to 4.07 mm. Significantly (p less than 0.001; Mann Whitney U-test) larger values were observed in the patients compared with controls, and there was good correlation between medial rectus width and a clinical index of disease severity in individual eyes (p less than 0.001; Spearman rank correlation coefficient). Comparison of the medial rectus measurements obtained using orbital computed tomography and ultrasound showed positive correlation at the p less than 0.001 significance level. Computed tomographic medial rectus measurements also correlated with horizontal and vertical muscle indices for that orbit. We suggest that real-time ultrasound of medial rectus width, using widely available equipment, provides an accurate, simple and non-invasive means of evaluating the orbits of patients with Graves' disease. Repeated measurements may be of value in identifying patients at high risk of visual failure, and in following prospectively the orbital response to therapy in patients with Graves' ophthalmopathy.

Adult↗

PubMed1987

Surgical treatment of acne scarring: non-linear scar revision.

Non-linear scar revision techniques involve levelling facial skin. Classification as to the nature of the pitting allows the surgeon to select techniques to improve the facial cosmetic appearance. The types of intradermal pitting and subcutaneous atrophy along with nodular scarring produce the lack of levelling and the depression that the patients want corrected. The useful modalities available to level facial skin are dermal levelling, injectable substances, dermal punch grafting, excision and facelifting. The selection of these techniques is dependent on the above classification and the patient's desire for improvement.

Acne Vulgaris↗

PubMed1986

Radiological investigation of liver trauma.

Difficult diagnostic problems may occur both acutely and in the long term in patients who have suffered severe upper abdominal trauma. Radiological investigation accurately demonstrates the presence and extent of liver damage. This article discusses the indications for both diagnostic and therapeutic radiological techniques and their roles in patient management.

Abdominal Injuries↗

PubMed1985

Ultrasound examination of the scrotum.

The technique of real time ultrasound examination of the scrotum is described. The examination was performed on 120 patients and was found to be a helpful diagnostic aid in scrotal swelling and in the acute painful scrotum. It is recommended as a useful investigation for scrotal abnormalities.

Genital Diseases, Male↗

PubMed1984

Hyperfunctional, hyperacidic, and intubation granulomas.

Twenty-seven cases of contact granulomas were seen by us during the past 24 months. Granulomas of the larynx resulting from local irritative and mechanical forces have clinically similar findings and symptom complexes. They differ in etiologic factor but are similar in pathologic appearance, except in unusual cases.

Gastric Acid↗