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Biomedical subjects

N D Carr

Publications and source records attributed to N D Carr.

46 records · Page 3Linked to original sources
PubMed1986

Ischaemic dilatation of the colon.

The present paper describes the presentation and management of 9 patients who developed dilatation in the colon during the course of spontaneous ischaemic colitis. The length of history varied from 16 hours to 6 weeks. The patients usually had diarrhoea and abdominal pain but no bleeding and posed a difficult diagnostic problem. At laparotomy, three distinct types of colonic dilatation were recognised. Dilatation of non-diseased colon proximal to localised ischaemic segments occurred in 2 patients, 3 patients exhibited dilatation of obviously gangrenous colon, 4 patients showed dilatation of ischaemic but possibly viable colon, yet in 1 of these, multiple sealed perforations were present. Resection of the obvious or possibly gangrenous colon was the treatment used but in the 2 patients with dilatation due to stricture, transverse colostomy alone was employed.

Adult↗
PubMed1985

Platelet count in radiation bowel disease: an aid to diagnosis.

This study reports the results of serial observations of simple haematological indices (haemoglobin concentration, white cell count and platelet count) in 25 patients who developed radiation bowel disease as a late complication of pelvic radiotherapy for malignancy. It is compared with a control group of 25 women patients who received pelvic radiotherapy but did not develop radiation bowel disease. There is a highly significant elevation in the platelet count (P less than 0.0001) at a time when the patients develop radiation bowel disease. The platelet count returns to normal after successful excision of the disease but the elevation recurs if further radiation disease develops in the urinary or gastrointestinal tracts. It is suggested that the platelet count may have a useful role in the diagnosis of radiation bowel disease.

Female↗
PubMed1984

A method for the determination of microvascular volume in tissue samples.

An estimate of the volume of the microvascular bed in injected tissue specimens of human bowel has been made by measuring the concentration of injected contrast material using X-ray fluorescent analysis. The contrast medium used was barium sulphate and this completely fills the microvasculature in excised specimens. The concentration of barium in excised tissue samples has been determined by measuring the ratio of gamma-ray induced X-ray fluorescence in the barium to the 90 degree Compton scattered 140 keV gamma rays from a collimated 99Tcm source. Barium concentration was estimated in tissue samples from 45 specimens of normal bowel and 11 specimens of radiation damaged bowel. The radiation group showed a highly significant reduction (p less than 0.001) in barium concentration and therefore vascular volume. The mean percentage error for barium concentration measured on two separate occasions in 45 randomly selected tissue samples was 5%.

Barium Sulfate↗
PubMed1984

Microvascular studies in human radiation bowel disease.

The microvasculature was investigated in the normal bowel (n = 43 patients) and in radiation bowel disease (n = 18 patients). Tissue samples obtained from postoperative colectomy specimens in which the intramural vessels had been perfused with barium sulphate suspension were examined. Microradiography was used to study vascular pattern which was abnormal in radiation bowel disease. A recently described radiograph fluorescence system was used to estimate barium concentration, and hence microvascular volume. The radiation group showed a highly significant reduction in barium concentration (p less than 0.001), when compared with the normal group. This reduction was diffuse in samples from 15 patients who had received combined intracavity and external radiotherapy, but localised in two patients who had received intracavity treatment only. It is concluded that microvascular compromise is an important factor in the natural history of radiation bowel disease.

Adult↗
PubMed1983

Bowel disease after radiotherapy.

The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery.

Female↗
PubMed1977

An unusual flexor of the fifth finger.

An unusual digastric flexor muscle of the 5th finger is described arising from the medial epicondyle of the right humerus and being inserted into the proximal phalanx of the 5th finger. Also observed was the absence of flexor digiti minimi and the unusual smallness of the tendon of flexor digitorum superficialis of this finger.

Fingers↗
PubMedDate not supplied

Omentopexy for reconstruction of the perineum following a radical vulvectomy: a case report.

Colorectal surgeons have used omentum based on the left gastric epiploic vessels after any major operation in the pelvis(1). Omental flaps reach very well into the pelvis by the retrocolic route and have been used in the past for better and quicker healing of perineal defects following abdominoperineal resections(2,3). Omentum has excellent healing properties, which can be, used even as free flaps(4).

Aged↗