Biomedical subjects
R D Leach
Publications and source records attributed to R D Leach.
Carcinoma of the rectum in male homosexuals.
Two male homosexuals with carcinomata of the rectum with transitional cell changes are reported, and the possible aetiology of these lesions is discussed.
Salicylates, steroids and benign gastrocolic fistula.
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Second-best prostatectomy?
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Flow rate determination using computed tomography.
A method of measuring flow in a large vessel by using a CT scanner is described. It has been shown that this is a simple, accurate and reproducible method in an experimental model. Possible clinical applications and limitations of this method of measuring flow are briefly considered.
Sir Gilbert Blane, Bart, MD FRS (1749-1832).
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Anaerobic axillary abscess.
Fifty-two patients with axillary abscesses were seen during two years. Staphylococcus aureus was isolated from 34, anaerobic bacteria from 12, and skin flora from five; in one case the pus was sterile. Seven patients with hidradenitis suppurativa had recurrent infection with abscess formation, which was bilateral in three. Anaerobes were isolated in five of these cases and skin flora alone in two. Anaerobes are secondary invaders in this condition, and histological examination shows that the primary abnormality is obstruction of pilosebaceous follicles and apocrine glands, associated with keratin plugging of the follicles. Chemotherapy offers little hope of cure, although metronidazole removes the offensive smell of the discharge. Radical surgery is usually indicated.
Anaerobic subareolar breast abscess.
15 non-puerperal women with breast abscess were seen during one year. In 8, anaerobes were cultured from pus obtained from the abscess, in 6, Staphylococcus aureus was grown, and in 1 the pus was sterile on culture. All 7 breast abscesses in puerperal women seen during the same period were staphylococcal. The anaerobic abscesses were all subareolar; they were recurrent in 4 patients and were associated with retracted nipples in 7. The anaerobes isolated were those found as normal commensals in the oropharynx and vagina but did not include the colonic commensal Bacteroides fragilis. Squamous metaplasia with keratin plugging of the breast ducts was identified histologically in the 2 non-puerperal patients in whom duct excision was performed. Surgical treatment of the underlying duct abnormality is important in the management of recurrent non-puerperal subareolar breast abscess.
Prostatectomy at a district general hospital.
The mortality and morbidity in 600 patients undergoing prostatectomy at a district general hospital are reviewed. Below the age of 70 years the operative mortality was 1% compared with an overall mortality of 2.3%. Cardiorespiratory disease accounted for the majority of deaths. The increase of postoperative stay due to complications may be reduced by lowering the complication rate and, in the long term, reducing pre-existing cardiorespiratory disease.
Right ventricular aberrant muscle bundle. Review of reported cases and recent case report.
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The medicine of ocean yacht racing.
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The relationship between venous pressure and vein wall fibrinolytic activity.
Vein wall fibrinolytic activity has been shown to be greater in the arms than the legs and it has been suggested that this difference is related to the greater hydrostatic venous pressure in the leg. Vein wall fibrinolytic activity and foot vein pressure has been measured in 40 legs from 30 patients, 25 with uncomplicated varicose veins and 15 with lipodermatosclerosis. No statistically significant correlation could be demonstrated between vein wall fibrinolytic activity and measured foot vein pressure.