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Biomedical subjects

O Hennessy

Publications and source records attributed to O Hennessy.

At least 37 records · Page 2Linked to original sources
PubMed1992

A comparison between M.R.I. and C.T. in acute spinal trauma.

Magnetic Resonance Imaging (MRI) at 0.3T and Computed Tomography (CT) were compared in the retrospective evaluation of 34 patients with acute spinal cord injury. MRI was highly accurate in the imaging of vertebral body fracture, and spondylitic changes, and is the method of choice for imaging ligament injury, traumatic disc protrusion and spinal cord compression. It was also useful for the identification of subtle subluxations in the sagittal plane. CT remains the method of choice for imaging neural arch fractures. MRI at 0.3T is a valid technique for assessing patients with acute spinal trauma.

Acute Disease↗
PubMed1992

A comparison between M.R.I. and C.T. in the investigation of neurological deterioration in longstanding spinal trauma.

MRI at 0.3T and CT with myelographic contrast (CTM) were compared in the retrospective evaluation of 35 patients investigated for the development of new neurological symptoms following longstanding spinal cord injury. Compared with MRI, CTM was relatively accurate for the demonstration of spinal cord compression, but failed to identify 23% of patients with spinal cord atrophy, and 43% of patients with post-traumatic syrinx formation. However, 5 patients had unsatisfactory MR imaging, either due to motion or metallic artifact, and in 3 of these, CTM demonstrated a syrinx. Although MRI is the method of choice in the investigation of this problem, CTM may still be required for patients with an unsatisfactory MR examination. Magnetic Resonance (MR) imaging is now an established technique for imaging the spine, with accurate depiction of the spinal cord, as well as the adjacent soft tissues (1, 2). However, the cost of this technique, and its as yet limited availability in Australasia, has resulted in the necessity to demonstrate its superiority over other imaging modalities for any specific clinical problem (3). One of the major areas of impact of MR has been in the investigation of the problem of acute neurological deterioration in patients with past spinal trauma (4, 5, 6). Some of these patients will have treatable causes of deterioration, either a post-traumatic syrinx, or spinal cord compression (6), and MR can be used to image these conditions (7), which, until recently, were investigated with computed tomography with myelographic contrast medium (CTM), (8, 9).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Neoplastic involvement of the sacroiliac joint: MR and CT features.

The radiological findings in five patients with pelvic soft tissue neoplasms directly involving the sacroiliac joint, are described. All patients had Computed Tomography (CT) examinations, two of the patients also having Magnetic Resonance Imaging (MRI). The role of imaging in this uncommon entity is discussed as well as the importance of making this diagnosis, thereby excluding unilateral sacroiliitis. The therapeutic implications of this diagnosis relate to local neural involvement, especially the sciatic nerve, and the fact that involvement of the sacroiliac joint by tumors significantly compromises chances of a successful surgical outcome. The role of MR in this condition is not yet certain, but it may prove to be the method of choice in view of its excellent depiction of skeletal neoplasms.

Adult↗
PubMed1992

Prophylaxis against venous thrombosis after total hip arthroplasty.

Venous thrombosis rates were compared in 200 patients undergoing total hip arthroplasty and randomized to receive either fixed mini-dose warfarin (1 mg daily) or adjusted-dose warfarin to maintain an international normalized prothrombin ratio (INR) of 2.0-4.0. Bilateral lower limb venography was performed between days 11 and 13 inclusive. Fixed mini-dose warfarin was associated with a significantly higher rate of total thrombosis (P less than 0.05). General anaesthesia was associated with a significantly higher rate of thrombosis than spinal anaesthesia (P less than 0.05). Adjusted-dose warfarin was associated with more bleeding complications than mini-dose warfarin although these were not attributable to excessive anticoagulation. A single death from pulmonary embolus occurred in the early postoperative period in a patient receiving adjusted-dose warfarin.

Anesthesia, General↗
PubMed1991

Computed tomographic and ultrasound appearances of focal spared areas in fatty infiltration of the liver.

Computed tomography (CT) and ultrasound (US) appearances of diffuse and focal fatty infiltration of the liver (FIL) are well recognized. We have recently seen 10 cases with "fat spared" areas in FIL presenting as pseudo tumours of the liver. Characteristic appearances of fat free areas in FIL which help differentiate these areas from other focal liver lesions include (i) location in the medial segment of the left lobe of the liver, (ii) absence of mass effect on surrounding vessels and liver tissue, and (iii) presence of typical changes of FIL elsewhere in the liver on CT or US examination.

Fatty Liver↗
PubMed1990

Balloon dilatation of biliary strictures: experience and review of the literature.

Patients who develop strictures after repeated biliary surgery are a complex management problem. Reoperation in these patients, who may also have cirrhosis, portal hypertension and non-dilated ducts, is hazardous even in experienced centres. The new technique of percutaneous balloon dilatation has been used increasingly in such cases. A review of the literature and the experience with this technique in five patients with recurrent biliary strictures is presented. Its use is recommended in patients who present with recurrent problems when a previous biliary-intestinal anastomosis has failed as well as in those who develop stricture following multiple procedures involving the biliary system.

Bile Duct Diseases↗
PubMed1989

Pre-operative albendazole therapy for recurrent hydatid disease.

Two patients with recurrent hydatid disease had a 1-month course of albendazole before surgery. In one case with a thick-walled host capsule, the scolicidal effect was incomplete, but, in the second case, in which thin-walled cysts were present, albendazole entered the cyst and was completely effective as a scolicidal agent. For thick-walled cysts, it may be necessary to use albendazole for more than 1 month pre-operatively in order to achieve a scolicidal effect.

Abdomen↗
PubMed1988

Percutaneous extraction of retained common bile-duct stones via the T-tube track.

A total of 86 procedures were performed in 58 patients referred in the postoperative period, for percutaneous stone extraction through the T-tube track. In 43 patients, the stone or stones were extrahepatic, intrahepatic in nine, and both intrahepatic and extrahepatic in six patients. Of the 58 patients with residual bile-duct stone(s), 48 (83%) were treated successfully by percutaneous removal, seven (12%) had an endoscopic sphincterotomy following unsuccessful T-tube track extraction, one (2%) had a re-operation and two (3%) remain with residual stones. No major complications occurred in this series. In contrast to endoscopic sphincterotomy, percutaneous T-tube extraction of retained bile-duct stones is associated with no mortality and low morbidity and is advocated as the procedure of choice in the presence of a T-tube.

Adult↗
PubMed1988

Percutaneous drainage of subphrenic biliary collections using a Ring-McLean sump catheter.

This communication reports three consecutive cases of subphrenic biliary collections, resulting from biliary procedures. All were successfully treated percutaneously using a 16 French Ring-McLean sump drainage catheter without the need for secondary surgical intervention. Although percutaneous drainage of fluid collections is now commonplace, this is the first reported use of this drainage catheter for subphrenic biliary collections.

Adult↗
PubMed1985

Therapeutic embolisation of the hepatic artery: a review of 75 procedures.

In 75 procedures carried out in 57 patients, hepatic arterial embolisation was shown to be a safe and effective treatment for hepatic arterial bleeding and benign vascular tumours and malformations. The median survival of patients with malignant hepatic tumours in our series compares favourably with that recorded for other methods of treatment in patients with similar tumours. Embolisation ameliorated the symptoms produced by malignant hepatic tumours, particularly those occurring in patients with functioning endocrine tumours. The commonest side-effects of embolisation were pain, pyrexia, leucocytosis, intrahepatic gas formation, and nausea. Serious complications were rare and included hepatic abscess (4 patients), septicaemia (2 patients), renal failure (2 patients), and bowel infarction (1 patient). The 2 patients with septicaemia died within a week of embolisation, and these were the only deaths directly attributable to the procedure.

Arteriovenous Malformations↗
PubMed1985

The pre-operative embolisation of vascular malformations.

Large arteriovenous malformations frequently require surgical excision in order to prevent or treat the potentially serious problems they can cause ranging from haemorrhage and pain to cardiac failure. The surgery itself is usually difficult and often dangerous due to the serious risk of major intraoperative haemorrhage. Transcatheter arterial embolisation has greatly facilitated the management of small arteriovenous malformations but may only afford temporary relief of symptoms in very large lesions. Recanalisation of occluded vessels and revascularisation via previously insignificant collateral vessels means that large lesions cannot be effectively managed by this method alone. Previous surgery and ligation of feeding vessels may make effective embolisation difficult or impossible and a combined radiological and surgical approach to these lesions may permit definitive treatment. We present three cases in whom the pre-operative embolisation of buttock arteriovenous malformations facilitated successful surgical excision.

Arteriovenous Fistula↗
PubMed1984

Actinomycetes as the causative organism of osteomyelitis in sickle cell disease.

The case of a 17-year-old girl with sickle cell anaemia who presented with extensive osteomyelitis due to actinomycetes is reported. Osteomyelitis in the long bones due to actinomycosis is extremely rare. A review of the literature reveals only six cases in which actinomycetes have been isolated from lesions affecting a long bone. The occurrence of this condition in sickle cell haemoglobinopathy has not been previously reported.

Actinomycosis↗