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Biomedical subjects

R A Fraser

Publications and source records attributed to R A Fraser.

At least 73 records · Page 4Linked to original sources

Comparison of 1,25(OH)2D3 and 24,25(OH)2D3 in the long-term treatment of renal osteodystrophy.

24,25(OH)2D3 has been compared with 1,25(OH)2D3 in the treatment of renal osteodystrophy. Treatment with 24, 25(OH)2D3 2 micrograms/day for 5-7 months was accompanied by deterioration in clinical, biochemical, radiological and histological features of osteodystrophy with no increase in Ca absorption. In contrast, treatment with 1,25(OH)2D3 0.25--1 microgram/day for 6-15 months resulted in rapid improvement in clinical, biochemical, radiological and histological features and a return of Ca absorption to normal. It is concluded that in the dose used 24,25(OH)2D3 alone is not an effective treatment for renal osteodystrophy.

24,25-Dihydroxyvitamin D 3↗

Renal osteopenia - an assessment of long-term therapy with vitamin D analogues.

Renal bone disease was assessed for an average of 5.5 years in 9 patients on maintenance haemodialysis. The investigative methods included serial biochemical estimations, radiographic skeletal surveys and quantitative bone histology. Repeated bone mineral analyses and neutron activation analyses of a hand were also performed in order to monitor changes in skeletal calcium content. Before treatment, progressive osteodystrophy was demonstrated by all techniques. Following therapy with the vitamin D analogues, all patients noted symptomatic improvement; serum alkaline phosphatase reverted to normal and serum parathyroid hormone concentrations decreased. Radiographically, subperiosteal erosions healed while the histological features of osteomalacia and osteitis fibrosa were abolished. Both bone mineral and neutron activation analyses indicated that progressive skeletal demineralisation had been halted. However, a sustained increase in the overall mineral content of bone was not demonstrated. Thus, vitamin D therapy although improving the biochemical, radiological, and histological features of renal osteodystrophy may not restore bone mass to osteopenic bone.

Adult↗

Complications following intraspinal injections of steroids. Report of two cases.

Intrapinal steroids have been recommended for the treatment of sciatica and various other conditions. The procedure is controversial; moreover, evidence suggests that the steroid hormones can be delivered to the site of inflammation more easily by systemic administration. Serious complications that have arisen from the procedure are reviewed. The courses of two women who received intraspinal steroids for the treatment of sciatica and who developed severe meningitis as a consequence are reported. It is suggested that the value of intraspinal steroids in the treatment of disc-related sciatica is unproven and if they are used, one must be alert to the complications.

Adult↗

Bolus nephrotomography in diagnosis of lesions of kidney.

Bolus nephrotomography was employed in the study of 100 patients with renal adenocarcinoma and 100 patients with renal cyst. A retrospective review of the vascular and nephrographic phases of this study was made. A diagnosis of renal adenocarcinoma could be made with confidence by bolus nephrotomography in 82 per cent of cases with the remaining cases indeterminate and requiring further investigation; the vascular phase was of greater diagnostic value than the nephrographic phase. A diagnosis of renal cyst could be made with confidence by bolus nephrotomography in 85 per cent of cases with the remaining cases indeterminate and requiring further investigation; the nephrographic phase was of greater diagnostic value than the vascular phase.

Adenocarcinoma↗

The role of surgery in ischemic stroke.

Surgery in the management of stroke is useful primarily as a stroke-preventive measure for patients with extracranial carotid artery occlusive disease. Ideally, lesions that are potential sources of ischemia are removed before a fixed neurologic deficit can occur. Patients with transient ischemic attacks and no deficit or only minor neurologic deficit comprise the largest group of surgical candidates. Diagnostic angiography must be carried out before endarterectomy and should include aortic arch studies of both extracranial and intracranial carotid arteries. Placement of an intra-arterial catheter at the beginning of surgery provides the best method of monitoring arterial pressure. A postoperative angiogram allows visual confirmation of the patency of reconstructed vessels. Such confirmation is particularly important if patients have severely stenotic bilateral carotid artery disease. The surgical mortality for all patients with TIAs is between 1% and 2% in those clinics in which this type of operation is commonly done.

Acute Disease↗

Unilateral dilatation of the internal auditory canal.

An unusual and functionally insignificant variant of the internal auditory canal is presented. Marked dilatation of one canal was demonstrated by petrous bone tomography. Pantopaque cisternography revealed a large intracanalicular extension of the subarachnoid space with no evidence of tumor. No patients should undergo exploration of this region without prior Pantopaque studies.

Humans↗

Clinical evaluation of urinary and serum carcinoembryonic antigen in bladder cancer.

Urinary carcinoembryonic antigen-like activity was increased (more than 1.5 ng. per ml.) in 61 per cent of patients with transitional cell carcinoma of the bladder. The frequency of abnormal carcinoembryonic antigen values correlated with the extent and the grade of the tumor. However, urinary tract infection can produce abnormal carcinoembryonic antigen values in non-cancer patients. The use of urinary carcinoembryonic antigen measurement and urine cytologic examination for diagnosis of transitional cell carcinoma gave a better diagnostic yield than did use of either test alone. In transitional cell carcinoma patients with abnormal preoperative urinary carcinoembryonic antigen values, postoperative urinary carcinoembryonic antigen values were useful for determining completeness of tumor resection. However, with total cystectomy and creation of an ileal conduit or ureterosigmoidostomy, urinary carcinoembryonic antigen values increased markedly postoperatively. Serum carcinoembryonic antigen values were of little value in the diagnosis of transitional cell carcinoma.

Carcinoembryonic Antigen↗