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Biomedical subjects

R Clements

Publications and source records attributed to R Clements.

At least 37 records · Page 2Linked to original sources
PubMed1991

Transrectal ultrasound of the ejaculatory apparatus.

Most interest in transrectal ultrasound (US) of the prostate has concentrated on its role in the diagnosis and management of prostatic cancer. The increasingly detailed investigation of male patients with infertility has recently led to interest in the use of US in investigating the structure and function of the ejaculatory ducts and seminal vesicles. The anatomy and pathology of the ejaculatory ducts and seminal vesicles as demonstrated by transrectal US are discussed and illustrated.

Ejaculatory Ducts↗
PubMed1990

Coarse mucosal folds in the duodenum: a twenty-year follow-up.

In a 20-year follow-up of 40 patients with coarse duodenal folds, details were obtained about 34 patients of whom 11 had died. Clinical details were reviewed from the remaining 23 patients, and recent barium meal examinations were reviewed from eight patients. Ten of the 23 surviving patients continued to have recurrent dyspepsia, and the radiological appearance in three of the eight recent barium meals showed that coarse mucosal folds persisted. The clinical course of those with coarse duodenal folds is similar to that of peptic ulcer, with recurrent symptoms in some patients continuing for many years, and in others complicated by development of peptic ulcer. Coarse mucosal folds in the duodenum are usually associated with a high acid secretion and treatment to reduce acid secretion is appropriate in view of the severity of symptoms and risk of ulceration.

Aged↗
PubMed1990

Transrectal ultrasound in the investigation of haemospermia.

The transrectal ultrasound findings in 52 patients with haemospermia were reviewed. Scan abnormalities were demonstrated in 43 patients (83%). These included benign prostatic hyperplasia (24 patients), seminal vesicle abnormalities (10 patients), prostatic calcification (32 patients) and two patients with prostatitis. No patient was proven to have prostatic malignancy. Transrectal ultrasonography can suggest a cause of haemospermia in the majority of patients without resort to invasive investigations, and can exclude underlying prostatic malignancy. It is recommended as the first radiological investigation in patients presenting with haemospermia.

Adult↗
PubMed1990

Experience with ultrasound guided transperineal prostatic needle biopsy 1985-1988.

A consecutive series of 143 ultrasound guided biopsies of the prostate have been analysed. In 84 patients, in whom carcinoma was suspected by both digital examination and ultrasound, 49 cancers were confirmed histologically. In 29 patients in whom digital examination suggested cancer but ultrasound was normal, 2 cancers were confirmed. In 20 patients with a normal digital examination but a suspicious ultrasound appearance, no cancers were proven.

Adenocarcinoma↗
PubMed1989

Transrectal ultrasound in monitoring response to treatment of prostate disease.

Transrectal ultrasound provides a safe method for repeated assessments of the prostate gland in the follow-up of prostatic cancer. Changes in the echo pattern of the gland may be observed following treatment, but these may be difficult to interpret. The capsule may be restored; the tumor may appear smaller, and in some cases, ultrasound identification of the tumor may become impossible. The total gland volume decreases with chemotherapy and hormonal manipulation (subcapsular orchidectomy or drug-induced). The volume generally decreases after radiotherapy but may show a transient increase if there is some associated radiation proctitis. The rate of decrease of total prostatic volume has not been established as a reliable indicator of the subsequent prognosis. Future studies should assess whether sequential measurements of the tumor volume rather than the total prostatic volume may be a more useful guide to prognosis.

Humans↗
PubMed1988

Analysis of degradation of the basement membrane protein nidogen, using a specific monoclonal antibody.

A monoclonal antibody was produced against purified nidogen extracted from a mouse basement-membrane-producing tumor. This antibody reacted with a determinant on Nd-40, a rod which separates the globular domains of nidogen. Antigenicity depends on intrachain disulfide bonds within this rod. The monoclonal antibody was used to detect nidogen fragments after proteolytic cleavage of isolated nidogen, and nidogen complexed to laminin. The data indicate that thrombin and thermolysin generated very different patterns of degradation, but in both cases no differences were found between isolated and complexed nidogen. In contrast, nidogen in the laminin-nidogen complex was much less degraded by trypsin than isolated nidogen, indicating that an interaction between these basement membrane components reduces the susceptibility of nidogen to trypsin digestion. Immunofluorescent studies, using the monoclonal antibody on sections of the EHS tumor after proteolytic digestion, showed that the retention or disappearance of the Nd-40 determinant correlated with the in vitro digestion pattern of the laminin-nidogen complex.

Animals↗
PubMed1988

How accurate is the index finger? A comparison of digital and ultrasound examination of the prostatic nodule.

The per-rectal ultrasound scans and digital assessments of 193 patients with prostatic nodules were analysed retrospectively. There were 88 histologically proven cancers and per-rectal ultrasound demonstrated extracapsular spread of tumour in 36 of these patients. In the diagnosis of prostatic cancer, ultrasound had a sensitivity of 97.6% and a specificity of 93.8% whereas digital examination had a sensitivity of 96.5% and a specificity of 53.3%.

Adult↗
PubMed1987

The ultrasound appearances of prostatic cancer with histological correlation.

An analysis of the ultrasound appearances of the prostate with its capsule and periprostatic structures was performed in 221 patients with a histologically confirmed diagnosis of prostatic cancer. The cancers were histologically graded into well, moderate and poorly differentiated adenocarcinoma and transitional cell carcinoma. The results of this study indicate that an ill-defined hypoechoic area is the commonest appearance of prostatic cancer; this was seen in 96% of our 221 patients. The cancers were staged by ultrasound into confined (T0, T1, T2) and unconfined (T3) cancers. A breach of the capsule was seen in 55% of cases. In this unconfined group all cancers were hypoechoic in comparison with 92% in the confined group. In the confined cancer group the areas of abnormal echogenicity were present in more than one prostatic quadrant in 76%. Mostly commonly two prostatic quadrants were affected. The abnormal echogenicity was noted in the posterior quadrants of the prostate more commonly (58%) than in the anterior quadrants. The prostate gland appeared round in 67%, semicircular in 25% and crescentic in 8%. The gland was symmetrical in 68%. The prostatic capsule appeared regular in 86% of patients with a confined cancer. In 70% of cases of extensive but confined cancer there was loss of demarcation between the central and peripheral zones of the gland. The unconfined cancer group all had a breach of the capsule and all glands were heterogeneous due to hypoechoic areas. The breach affected more than one quadrant in 81% and most commonly the capsular breach involved two prostatic quadrants. An anterior breach of the capsule was noted much more frequently than a posterior breach. Forty-four per cent of cases had three or four quadrants of the gland involved. In 3% of cases of proven prostatic cancer no definite ultrasound abnormality could be detected. Calcification was seen within the gland in association with the cancer in 63% with approximately equal frequency in confined and unconfined disease. The seminal vesicles showed definite evidence of infiltration in 10%. Both seminal vesicles were seen in 61% and thought to be normal. In 8% only one was seen. Failure to demonstrate either seminal vesicle occurred in 21%. There was no correlation between the ultrasound appearances of prostatic cancer and the histological grading of the tumour.

Adenocarcinoma↗
PubMed1987

Percutaneous transluminal angioplasty of renal transplant artery stenosis.

Renal transplant artery stenosis occurs in approximately 10% of renal transplants, and antihypertensive drugs, vascular reconstructive surgery, and percutaneous transluminal angioplasty may be used in its treatment. Details of 28 cases of renal transplant artery stenosis were collected from a postal survey of United Kingdom transplant centres. The success rate for angioplasty (63% clinical cure or improvement) is lower than in previous reports.

Angioplasty, Balloon↗
PubMed1987

Prostatic ultrasound.

Ultrasonography is a useful method of imaging the prostate gland. Perrectal ultrasonography may be used in the assessment of the enlarged or nodular prostate. Benign hyperplasia, prostatitis and prostatic carcinoma can be differentiated. In the management of patients with prostatic cancer, per-rectal ultrasound scanning is invaluable in the diagnosis, staging, treatment and follow-up of the disease.

Humans↗
PubMed1986

Laryngeal papillomatosis.

Four cases of laryngeal papillomatosis are presented to illustrate the clinical and radiological features associated with this condition. In children the papillomas are usually multiple and benign but they frequently recur after surgical treatment. In adults they are generally solitary and have a very low recurrence rate. Xeroradiography of the neck is useful in assessing the extent of papilloma spread.

Adolescent↗
PubMed1986

Hydatid disease of the pelvis.

The clinical and radiological features of five patients with hydatid cyst of the pelvis are presented. The cysts were found in the following sites: the broad ligament, the pararectal soft tissues, the greater omentum, the ala of the sacrum and in the retrovesical space. Hydatid disease should be considered in the differential diagnosis of unusual cystic swellings in the pelvis, particularly in patients who have lived in endemic areas.

Adult↗
PubMed1986

Radiological appearances of hydatid disease in Wales.

Thirty six patients with hydatid disease have been investigated in the Radiology Departments of Cardiff hospitals between June 1973 and June 1984; thirty two of these patients are likely to have acquired the disease in Wales. There were 16 hepatic cysts, 3 renal cysts, 2 cerebral cysts, 15 pulmonary cysts, 1 pleural cyst, 1 recurrent spinal cyst, and 1 cyst of the broad ligament. The radiological features are discussed. These patients emphasize the higher incidence of hydatid disease in Wales, compared with other regions of the United Kingdom, and the need to consider this diagnosis in Welsh patients from rural areas, who have large pulmonary opacities, or hepatic, renal, or cerebral cystic abnormalities.

Adult↗