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Biomedical subjects

R H Wilkinson

Publications and source records attributed to R H Wilkinson.

At least 55 records · Page 3Linked to original sources
PubMed1982

Breast cancer: a 21 year experience with conservative surgery and radiation.

Evidence is presented from a study of 680 patients followed over a period of 21 years that conservative treatment of breast cancer by local excision of the primary tumor followed by breast irradiation yields results equivalent to the traditional radical approach, with the added benefit of an excellent cosmetic result and improved quality of life. The relative survivals were 8.3% at 5 years and 71% at 10 years. There was no difference in survival when radiation was given. Breast irradiation significantly reduced relapse in the breast, but axillary irradiation did not influence relapse at this site. Relapse in the breast alone was not detrimental to survival if treated appropriately. Axillary relapse indicated a much poorer prognosis as might be expected.

Brain Neoplasms↗
PubMed1981

Prognostic significance of peritoneal cytology in patients with endometrial cancer and preliminary data concerning therapy with intraperitoneal radiopharmaceuticals.

One hundred sixty-seven patients with clinical State I carcinoma of the endometrium were treated primarily by operation consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, selective pelvic and para-aortic lymphadenectomy, and cytologic testing of peritoneal washings. Twenty-six (15.5%) of the 167 patients had malignant cells identified on cytologic examinations of peritoneal washings. Recurrence developed in 10 of these 26 (34.0%) compared to 14/141 (9.9%) patients with negative cytologic testing. Of the 26 patients, 13 (50%) had disease outside of the uterus at operation and seven have died of disease (54%). Thirteen patients had malignant cells in the peritoneal washings but no disease outside of the uterus and six (46%) of these have died of disseminated intra-abdominal carcinomatosis. On the basis of the poor outcome of those patients who had malignant cells in the peritoneal washings in the 167 patients studied, a plan of treating such patients with intraperitoneal radioactive chromic phosphate suspension (P-32) was instituted. Twenty-three subsequent patients with clinical Stage I carcinoma of the endometrium were found to have malignant cells in the peritoneal fluid. All 23 received intra-abdominal P-32 suspension instillation after operation. There have been three recurrences with two patients dying of disease. All of the three recurrences appeared at sites distant from the abdominal cavity. Peritoneal cytologic examination appears to be an important factor in the prognosis of endometrial cancer and, when the washings are positive for malignant cells, intraperitoneal chronic phosphate therapy appears to be efficacious.

Adenocarcinoma↗
PubMed1981

Microfiche as a medium for the long-term storage of laboratory computer records.

The chemical pathology requests on 180 000 patients a year are stored on microfiche, occupying 72 mm of shelf space. They are produced by a sequence of three computer programs which remove data from disc on to magnetic tape using the laboratory's Digital Equipment Corporation PDP 11/34 minicomputer. Processing on to microfiche is performed by a bureau. The magnetic tape is available for retrospective research and management studies in one-month periods.

Chemistry, Clinical↗
PubMed1981

Avulsion injuries of the pelvis and proximal femur.

Twenty cases of avulsion fractures of the apophyses of the pelvis and proximal femur were reviewed. Most occurred in male adolescents engaged in active sports. Pain, often with little external evidence of trauma, was the most frequent presenting symptom. Conservative, nonsurgical treatment was successful in all the patients. The radiographic appearance of each type of apophyseal injury is demonstrated. Recognition of the initial deformity and of the patterns of repair is important to avoid unnecessary evaluation (tomography, radionuclide scans) and inappropriate therapy. While productive changes with healing are most likely to occur in the region of the ischium, any of the other sites may heal with abundant bone and may mimic neoplasm. In the proper clinical setting, bony changes at these sites should prompt the radiologist to consider a traumatic etiology.

Adolescent↗
PubMed1979

Case report 90.

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Adolescent↗
PubMed1979

Variability of unilateral epiphyseal dysplasia (dysplasia epiphysealis hemimelica).

Nine cases of dysplasia epiphysealis hemimelica (Trevor disease) are reviewed. This osteocartilaginous process arises from the epiphysis and most commonly involves the ankle and knee. While usually mild, 3 cases of greater severity were found with associated arrest of the growth plate. One mild and 2 severe cases are presented in greater detail. The term unilateral epiphyseal dysplasia is proposed as the condition may involve the upper extremity and often involves more than half the epiphysis.

Ankle↗
PubMed1979

Chronic and occult stool retention: a clinical tool for its evaluation in school-aged children.

A scoring method was developed to assess severity of stool retention using plain abdominal radiographs. To determine whether the technique was clinically valid in identifying chronic stool retention, the method was used to evaluate films taken of children with known stool retention before and after therapy. The method showed significant statistical differences between symptomatic pre-therapy films and controls and between pre- and post-therapy films of treatment "successes." No significant differences were found between pre- and post-therapy "failures." Use of radiographs is not a substitute for careful history taking and examination, but this scoring method for evaluating stool retention can be recommended prior to more extensive, invasive investigations in children presenting with functional abdominal complaints.

Abdomen↗
PubMed1979

Radiographic evaluation of the spine after surgical correction of scoliosis.

Scoliosis is frequently a progressive deformity despite the best efforts at external bracing and various exercises. In childhood, scoliosis is usually insidious and is rarely symptomatic. In later years, however, scoliosis leads to cardiopulmonary compromise, neurologic dysfunction, degenerative joint disease, and cosmetic deformities. Therefore, surgical correction is indicated in selected patients. Internal fixation with spinal fusion is more effective than fusion alone. Postoperative radiographs must be examined closely for general as well as orthopedic complications. Loss of correction and failure of hardware are signs of pseudarthrosis. Radiographic follow-up evaluation should include two views whenever possible.

Bone Nails↗
PubMed1978

Congenital pseudarthrosis of the radius.

Five children with six congenital pseudarthroses of the long bones of the forearm are described. Four cases were the result of neurofibromatosis, one was related to fibrous dysplasia, and one appears to be idiopathic. Whereas congenital pseudarthrosis of the leg primarily involves the tibia, congenital pseudarthrosis of the forearm primarily involves the radius. Four of the children were treated with bone grafts of the radius, three requiring repeated grafting. The etiology, differential diagnosis, long term prognosis, and treatment correlate with the data of similar lesions in the tibia. Thus the reason for poor fusion is probably unrelated to weight bearing but is rather the result of underlying bone pathology.

Child, Preschool↗
PubMed1977

Radiographs.

Physicians performing radiology for children should utilize modern equipment, expose children to the least amount of radiation possible, and avoid unnecessary examinations. Those interpreting radiographs must be familiar with the wide range of normal variations of the skeleton and/or be prepared to refer to texts and atlases dealing with these. Careful examination of soft tissues greatly increases the accuracy of diagnostic radiology in the search for trauma and infection.

Bone Diseases↗
PubMed1977

A comparison of cholestyramine and nicotinic acid in the treatment of familial type II hyperlipoproteinaemia.

1 The effects of cholestyramine and nicotinic acid on plasma lipid concentration have been compared in patients with type IIa hyperlipoproteinaemia. 2 During a 3-month period, cholestyramine resulted in a mean decrease in cholesterol levels of 26%. Triglyceride levels rose in eight of the ten patients during treatment with this drug but in the majority of patients remained within the normal range. 3 During nicotinic acid therapy, cholesterol fell by a mean of 21% and triglyceride by a mean of 23%. 4 The slow release preparation of nicotinic acid used was acceptable to the majority of the patients studied and the results therefore suggest that this drug may be a useful alternative to the more widely used agent, cholestyramine.

Adolescent↗
PubMed1977

Correlation of clinical, biochemical and skeletal responses to 1alpha-hydroxyvitamin D3 in renal bone disease.

Thirty-five patients with bone disease and chronic renal failure (twenty-four on maintenance haemodialysis) were treated for 7--39 months with 1alpha-hydroxyvitamin D3, 2--2.5 microgram daily by mouth. Symptoms (bone pain and muscle weakness) and radiographic appearances improved and plasma alkaline phosphatase returned to normal in the majority of patients (87, 76 and 75% respectively). In contrast, histological appearances in bone improved in only 46% twenty-three patients from whom paired biopsies were available, and this change was not greatly different from that seen in a comparable group of untreated patients. Significant correlations were noted in individual patients between the changes in symptoms, X-rays, plasma alkaline phosphatase and immunoreactive parathyroid hormone and these, in turn, were related to histological changes in bone, although these latter changes were often small. It is concluded that 1alpha-hydroxyvitamin D3 is a useful new drug in the treatment of renal bone disease, but that the evaluation of the response depends critically on the method of assessment used.

Adolescent↗