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Biomedical subjects

O Khan

Publications and source records attributed to O Khan.

At least 55 records · Page 3Linked to original sources
PubMed1983

Testicular venography in impalpable testis.

77 venographic studies of impalpable testes have been reviewed. All patients subsequently underwent surgical exploration. In 28 studies a pampiniform plexus was identified and in 27 a testis was present at the site of the pampiniform plexus. In 20 studies the testicular vein was blind-ending and in only 1 was testicular tissue present at the site of the blind-ending vein. Testicular tissue was absent in the remaining 19. There were 29 technical failures or an inability to identify the full length of the testicular vein because of patent valves. Testicular venography is most useful in localising the position of an impalpable testis but does not determine in all cases whether testicular tissue is present.

Cryptorchidism↗
PubMed1983

Role of ultrasound in the management of ovarian carcinoma.

The ultrasound findings of the pelvis, upper abdomen and peritoneal cavity were correlated with second-look laparotomy in 85 patients with Stage III or Stage IV ovarian carcinoma. High values of accuracy were obtained for the pelvis (90%) and liver (91%) but ultrasound was insensitive to peritoneal disease unless ascites was present.

Adult↗
PubMed1983

The role of computed tomography in the detection of bone metastases in breast cancer patients.

Computed tomography (CT) of bone was carried out in 20 patients with breast cancer, all of whom had abnormal radionuclide uptake on skeletal scintigrams but normal conventional radiographs. Twenty-eight sites were examined and 13 showed metastases in 11 patients. Five of these patients had no evidence of extra-skeletal recurrent disease. Follow-up at eight of these sites showed healing, sclerosis or progression, all of which correlated well with clinical findings. CT showed benign causes of radionuclide accumulation in three patients (7 sites) but no abnormality in six patients (8 sites). None of these patients has subsequently developed bone metastases. CT is superior to conventional radiographs in the diagnosis of skeletal metastases and should be carried out when skeletal scintigraphy is positive and conventional examinations are normal.

Adult↗
PubMed1983

A comparison between 180 degrees and 360 degrees data reconstruction in single photon emission computed tomography of the liver and spleen.

Single photon emission computed tomography (SPECT) of the liver and spleen has been studied using a GE400T/STAR rotating gamma camera/computer system. We have compared section image contrast, in both phantom and patient studies, produced by 180 degrees and 360 degrees reconstructions of data from a full 360 degrees data acquisition. There is little difference in overall image quality between the two reconstruction modalities. Quantitatively, however, appropriate 180 degrees reconstructions significantly improve lesion contrast in both organs by as much as a factor of two. In all cases studied, the values of image contrast achieved when the 180 degrees arc of reconstruction was centred about the region of interest were higher than the values obtained from the 360 degrees reconstructions. These results are shown to be independent of the corrections made for photon attenuation. Clinically this technique may prove useful in clarifying the presence or absence of disease, particularly in equivocal cases where lesions have poor contrast or are small in size. An extended clinical trial of the technique is now in progress.

Adult↗
PubMed1983

Is the undeniably palpable liver ever 'normal'?

A study of whether the lower border of the normal liver, if it extended below the costal margin, could be reliably identified by clinical examination was undertaken in 42 patients in whom there was no clinical, biochemical or scintographic evidence of liver disease. Two clinical observers independently agreed that in 10 of these patients the liver extended infracostally. However, scintiscanning demonstrated that 30 patients had livers extending below the costal margin and that 2 of the 10 livers clinically identified did not in fact lie infracostally. Thus whilst the normal liver commonly extended below the costal margin, recognition of this extension by clinical methods occurred no more frequently than would be expected by chance. It is concluded that the confident clinical finding of a liver projecting below the costal margin should suggest that the organ is abnormal.

Adult↗
PubMed1982

Prognostic factors influencing survival of patients receiving intravesical epodyl.

Results from a retrospective analysis of 139 patients with recurrent superficial bladder tumors treated by intravesical epodyl are reviewed. Of patients who had complete clearance of tumor from the bladder 95 per cent became free of disease within 12 months of starting intravesical therapy. No patient who had persistent tumors at 2 years was free of tumor subsequently. The majority of complete responders who suffered recurrences did so within 3 years and 80 per cent of a small series of patients who remained free of tumor after 3 years and then stopped treatment continued to be free of tumor for a further 2 years. Failure to respond within 12 months or early invasion of the submucosa on biopsy (stage P1b tumors) was associated with poor survival. In patients who underwent salvage cystectomy the demonstration that 35 per cent had involved metastatic lymph nodes and 38 per cent had invasion of muscle is a clear indication of the dangers of delaying radical treatment once the patient has failed to respond completely to intravesical therapy.

Antineoplastic Agents↗
PubMed1982

Prostacyclin in prostatic cancer: a better marker than bone scan or serum acid phosphatase?

Prostaglandins have been implicated in the development and spread of malignant tumours. Gas chromatography and mass spectrometry (GC-MS) analysis of prostaglandins in benign and malignant prostatic tissue showed that prostacyclin (PGI2), a prostanoid known to induce bone resorption, was the major component. PGI2 is hydrolysed to 6-oxo-PGF1 alpha. Plasma levels of 6-oxo-PGF1 alpha were measured as an index of PGI2 formation in patients with benign and malignant prostatic disease. The mean plasma 6-oxo- level in an age-matched control group was comparable to that of patients with benign prostatic hypertrophy. A significant elevation was found in patients with a TO carcinoma (P less than 0.05). Plasma 6-oxo- levels rise with advancing disease and the concentration varied with the degree of tumour differentiation. Plasma 6-oxo-levels were a more accurate monitor of disease progression than tartrate labile acid phosphatase in patients with M1 carcinoma. Persistently elevated levels were associated with a bad prognosis.

Acid Phosphatase↗
PubMed1982

Phaeochromocytomas of the bladder.

Phaeochromocytomas of the bladder are rare, only about 100 cases having been reported previously. Four adults with these lesions have been managed at Hammersmith Hospital in the past 10 years. Three patients had hypertension, together with syncopal attacks and/or headaches, induced by micturition. The fourth patient presented with haematuria. After control of blood pressure and localization of the tumours by various combinations of cystoscopy, intravenous urography, venous sampling, ultrasound, angiography and computerized coaxial tomography (CT scanning), 3 patients underwent partial cystectomy, and the fourth pelvic exenteration. Two patients were apparently cured of the disease, but 2 were not. One developed modal metastases and recurrence of hypertension after 18 months and one rapidly developed metastases in the lungs and elsewhere. Effective therapy probably requires a high index of suspicion in diagnosing the condition and possibly an aggressive surgical and radiotherapeutic policy.

Adult↗
PubMed1982

Emission tomography in embolic lung disease.

Ventilation-perfusion lung scans and emission tomography studies were performed in 84 patients with suspected embolic lung disease. Concordant data were obtained in 72 patients (57 positive, 15 negative); results were discordant in ten patients and indeterminate in two. Although the diagnosis of pulmonary embolism with the conventional two-dimensional planar projections of standard ventilation-perfusion lung scans is still the mainstay, a greater sensitivity in lesion detection can be expected with multiplane detection imaging.

Journal Article↗
PubMed1981

Comparison between emission and transmission computed tomography of the liver.

Emission computed tomography (emission CT) and conventional planar gamma-camera imaging of the liver were compared in 242 patients with suspected metastatic spread to liver. Concordant data were obtained in 171 patients (71%). Single large lesions, multiple small lesions, and diffuse disease were accurately defined with this new radionuclide tomographic technique. The smallest lesion detected by emission CT was 8 mm. Emission CT, planar gamma-camera imaging, and transmission (x-ray) CT were compared in 107 patients. All three methods gave identical results in 76 patients (71%). Assessed against other criteria, such as histological findings and follow-up data, emission CT yielded the highest range of accuracy (92-96%), while transmission CT and planar gamma-camera imaging had similar but lower accuracies (78-81%). Emission CT had a false-positive rate of 2.8% and a false-negative rate of less than 1%. Thus emission CT is highly sensitive in detecting space-occupying disease in the liver.

Adolescent↗
PubMed1981

Tuberculosis in patients undergoing maintenance haemodialysis and renal transplantation.

The difficulty in diagnosis of tuberculosis in patients with chronic renal failure or on immunosuppressive therapy is discussed. Anti-tuberculous therapy was required in 19 out of 315 patients who received a renal transplant in the Urology Unit, Hammersmith Hospital, between February 1961 and December 1979. Twelve patients were from overseas. Their management and the effect of anti-tuberculous therapy on the immunosuppressed patient were also studied. The disease was treated successfully in 18 patients, even though there were problems with diagnosis. The patient who died had active tuberculosis on post-morten examination. Prophylaxis should be considered in patients who have had tuberculosis in the past and may have received inadequate treatment.

Adult↗
PubMed1981

Emission computerized tomography: clinical applications.

Single photon emission tomography (SPET) is making its impact on the practice of clinical nuclear medicine. Special purpose and general purpose instrumentation has become available with significantly improved performance capabilities. The advantages to be expected from this new approach to noninvasive medical imaging methodology include improvement of contrast resolution of the image and the ability to quantify the information in the three-dimensional section scan. It has been shown that SPET can replace planar imaging of the brain and that it significantly improves lesion detection in the liver. Organ volume measurements can be achieved and tracer uptake parameters calculated. This field is still at its beginning. Instrumentation will change and significant improvements in reconstruction algorithms will extend the clinical usefulness of these techniques. Even if absolute measurements may not be achievable in the body, it is possible to distinguish an abnormal population from a normal one. Sequential data may then be recorded and integrated into serial treatment protocols. Progress in the labeling of clinically useful tracers with suitable radionuclides [123I, 99mTc, 197Rt, 81mKr, 111In, etc.) is needed in order to achieve further significant progress in the areas of clinical applications.

Brain↗
PubMed1981

Micturition with headache: phaeochromocytoma of the bladder.

A patient with a 20-year history of severe frontal headaches when passing urine was found to be severely hypertensive. Investigations confirmed a clinical diagnosis of phaeochromocytoma of the bladder. Treatment by a partial cystectomy and transuretero-ureterostomy resulted in a complete removal of the tumour, control of his hypertension and resolution of the headaches.

Adult↗
PubMed1981

Radionuclide section scanning of the lungs in pulmonary embolism.

A new approach to the radionuclide imaging of the lungs is illustrated in this paper, describing four patients who were subjected to section scanning of the chest in addition to conventional planar imaging. The significance of this new method in the investigation of patients suspected of having pulmonary embolism is discussed. The main advantages of the new approach include increased information with depth, clearer definition of the mediastinal space, and the detection in some instances of new lesions not seen by conventional means.

Adult↗