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R N Rankin

Publications and source records attributed to R N Rankin.

At least 55 records · Page 3Linked to original sources
PubMed1989

Patent ductus venosus: problems in assessment and management.

A congenitally patent ductus venosus is the rarest form of portosystemic shunt. Although it occurs in the absence of serious parenchymal liver disease, it may be associated with hepatic encephalopathy. This case report describes a 49-year-old man with a patent ductus venosus who presented with recurrent bouts of encephalopathy but few other features of chronic liver disease. Ligation of the shunt was followed by life-threatening complications. The portal venous system must be carefully assessed before closure of a patent ductus venosus is attempted.

Hepatic Encephalopathy↗
PubMed1988

Percutaneous drainage and aspiration of fluid collections: emphasis on pancreatic collections and transplant patients.

Percutaneous aspiration or drainage was the initial treatment of 104 fluid collections in 92 patients. Our success rate was 91%, with a 7% recurrence, 3% complication rate, and 4% mortality rate. Percutaneous drainage (PD) was beneficial in all but two patients, and open surgical drainage was avoided in 84 patients. Included are 18 patients who had pancreatic fluid collections treated, with one drainage failure and one death in this subgroup. Of these patients, 50% had fistulae discovered after drainage, a higher rate than in the patients without pancreatic disease (33%). There are also 10 patients with transplants and subsequent fluid collections, all successfully treated by PD. We conclude that percutaneous abscess drainage techniques are as valuable in the more difficult pancreatic and transplant patients as they are in other patients.

Abscess↗
PubMed1988

Deep-vein thrombosis and continuous passive motion after total knee arthroplasty.

Seventy-five of 150 consecutive patients who underwent total knee arthroplasty had routine physiotherapy and seventy-five had continuous passive motion of the lower limb that had been operated on as well as routine physiotherapy. A pulmonary embolus did not develop in any patient, but about 40 per cent had thrombosis in the veins of the calf, whether passive motion had been administered or not. Radiographically, the deep-vein thrombosis was seen to extend into or proximal to the popliteal vessel in 5 per cent of the patients in each group. Sex, age, obesity, or a history of hypertension or diabetes did not influence the incidence of venous thrombosis, but there was a higher incidence in patients in whom cement was used for fixation of the total knee components, irrespective of the use of continuous passive motion of the limb.

Adult↗
PubMed1988

Giant-cell tumour of the sacrum in a child.

Giant-cell tumours rarely are seen in children before epiphyseal fusion occurs and such tumours in the spine are uncommon. The authors report the case of a giant-cell tumour of the sacrum that developed in a 12-year-old girl before epiphyseal fusion. Embolization with activated microfibrillar collagen relieved her symptoms and was carried out twice before progression of the tumour necessitated radiotherapy. Giant-cell tumours of the spine are particularly difficult to manage since the accepted treatment for such tumours at other sites is wide resection, excisional curettage or surgical curettage with chemical cautery. However, embolization alone or combined with other methods of treatment is valuable, particularly in non-resectable giant-cell tumours of the spine.

Child↗
PubMed1987

Intravenous digital subtraction angiography and duplex ultrasonography in postoperative assessment of carotid endarterectomy.

Seventy-four consecutive patients who had undergone carotid endarterectomy procedures were examined with intravenous digital subtraction angiography (IV-DSA) and duplex ultrasonography (DUS) at intervals ranging from 1 to 14 months postoperatively. Ninety-one percent of the DUS and 74% of the DSA images were of diagnostic quality. The two modalities agreed in the assessment of the endarterectomy appearance in 84% of the arteries, with 85% showing no evidence of significant residual disease. There were no arteries with severe restenosis or complete occlusion. In the 10 vessels in which the two modalities disagreed in disease assessment, the IV-DSA images were often degraded by artifact or vessel overlap leading to underestimation of disease. The authors conclude that DUS is the examination of choice for routine follow-up studies of carotid endarterectomy.

Arteriosclerosis↗
PubMed1986

Arteriovenous fistulas after replantation surgery.

The delayed appearance of congenital arteriovenous fistula precipitated by local trauma is a rare event. However, these reports may provide some insight into pathogenetic mechanisms responsible for the opening of subclinical arteriovenous communications. This case of multiple arteriovenous fistulas in a previously "normal" hand followed a sharp, incomplete amputation at the wrist level with replantation.

Amputation, Traumatic↗
PubMed1986

Dextran microsphere embolization: experimental and clinical experience with radiologic-pathologic correlation. Work in progress.

The radiologic and pathologic effects of canine renal embolization with dextran microspheres of two size ranges (40-150 micron and 100-300 micron) were studied 30 minutes and 1, 2, 4, and 6 weeks after embolization. Dramatic occlusions occurred with very small quantities of these particles, which reached more distally and were suspended and embolized more easily than other solid embolic agents. Because of these qualities, however, they should be used with more caution. They can be injected through 2-F catheters, calibrated-leak balloons, and open-ended guide wires. Embolization with dextran microspheres was also used for epistaxis, meningioma, dural arteriovenous malformation, renal tumors, bone metastasis, multiple myeloma, or peripheral angioma in ten patients. The technique was safe and effective, but special attention should be directed to proper dilution and gentle embolization with careful monitoring to avoid excessive embolization or reflux.

Animals↗
PubMed1985

An arteriovenous malformation in pregnancy: a case report and review of the literature.

A case is described of a young woman with progression of a macrofistulous arteriovenous malformation during pregnancy. This resulted in severe symptoms necessitating cesarean section, following which there was a dramatic postpartum recovery. The arteriovenous malformation was confirmed by angiography. The literature related to arteriovenous malformations in pregnancy is reviewed.

Adult↗
PubMed1985

High resolution ultrasound of macro-orchidism in mental retardation.

Asymptomatic testicular enlargement is common in mentally retarded males. This enlargement includes males with non-specific forms of mental retardation as well as a subgroup of males who have a chromosomally recognizable feature involving the X-chromosome ("fragile X" chromosome). We examined the testes of a group of 25 mentally retarded males with macro-orchidism including both fragile X and non-fragile X patients. Apart from large size, the testes scanned were all normal in appearance. In particular, there was no evidence for neoplasia. There were no distinguishing features between the fragile X and the non-fragile X groups.

Evaluation Studies as Topic↗
PubMed1985

Computerized tomography in the diagnosis of lymphangioleiomyomatosis.

We describe a subject with lymphangioleiomyomatosis who presented with chylothorax but who had an otherwise normal chest radiograph. The diagnosis was established by means of whole-body computerized tomographic scanning, which demonstrated asymptomatic involvement of the lungs, lymphatics, and kidneys. This diagnostic modality offers the potential for noninvasive serial monitoring of this rare condition, and in doing so provides an opportunity to obtain a better understanding of the disease process.

Adult↗
PubMed1985

Postoperative abdominal wall hematomas have a distinctive appearance on ultrasonography.

In six patients a large abdominal wall hematoma developed 1 1/2 to 6 months after operation. In each case differentiation of incisional hernia from hematoma was difficult, but the distinctive appearance on ultrasonography of an ovoid mass with thick straight internal septae, characteristic of hematoma, was noted in all. Ultrasonography also showed the multilocular nature of the lesion which made percutaneous aspiration difficult.

Abdominal Muscles↗
PubMed1985

A comparison of angiography, intravenous digital subtraction angiography and duplex ultrasound in the diagnosis of carotid artery atherosclerosis.

Duplex ultrasonography and intravenous digital subtraction angiography (IV-DSA) were used as the initial diagnostic studies in 124 patients referred for evaluation of neurological disorders possibly related to carotid bifurcation disease in the neck. Conventional angiograms were subsequently performed in 29 patients. Diagnostic images were obtained in 100% of the angiograms, 94% of the duplex ultrasonograms and 89% of the IV-DSA studies. Using the angiogram as the reference standard for plaque detection, duplex ultrasonography had a sensitivity of 0.93 and specificity of 0.83. Doppler velocity ratio alone was used to detect all patients with angiographically demonstrated disease but demonstrated a specificity of only 0.35. IV-DSA showed a sensitivity of 0.93 and specificity of 0.91. IV-DSA and duplex ultrasonography agreed in the assessment of degree stenosis in over 90% of cases and we conclude that these two modalities have approximately the same sensitivity and specificity for detecting atherosclerotic disease at the carotid bifurcations.

Adult↗