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Biomedical subjects

S F Millward

Publications and source records attributed to S F Millward.

At least 37 records · Page 2Linked to original sources
PubMed1996

Oversized inferior vena cava: use of a single Vena Tech--LGM filter.

The authors describe placement of the LG-Medical filter (B. Braun/Vena Tech, Evanston, Ill.) in four patients with an oversized inferior vena cava. The corrected caval diameter at the level of the most inferior renal vein was greater than 28 mm in each patient. However, in each case the vena cava tapered inferiorly to a segment with a diameter less than 28 mm, and the filter was placed at this site. Filter placement was accomplished without difficulty or complication in all cases. One patient died of underlying disease. The three surviving patients were followed for 119 to 374 (mean 276) days. There was no evidence of filter migration, recurrent pulmonary embolism, occlusion of the venacava, access-site thrombosis or other complication. The authors concluded that placement of bi-iliac filters can be avoided by this technique.

Constriction, Pathologic↗
PubMed1996

Papillary transitional cell carcinoma arising in a calyceal cyst and masquerading as a renal cyst.

We report the case of a 74-year-old man with a papillary transitional cell carcinoma, grade 1-2/3, growing within a bilobated calyceal cyst, measuring up to 8.5 cm in diameter, and masquerading as a simple renal cyst. The cyst was lined by atrophic simple and transitional epithelium and showed intracystic hemorrhage. Leakage of blood into the calyx was probably the cause of the hematuria for which the patient presented. However, with retrograde pyelography and careful gross examination of the excised kidney, no communication of the pyelocalyceal system with the cyst could be identified. By ultrasound examination and computerized tomographic scan the lesion showed several small renal cysts, measuring up to 1.1 cm in diameter, as well as several hepatic parenchymal cysts. To our knowledge, this is the first report of a papillary transitional cell carcinoma arising from a cyst of calyceal origin.

Aged↗
PubMed1994

Technical report: fallopian tube recanalization--a simplified technique.

A simplified technique of fallopian tube catheterization is described in which the tube is recanalized with a guidewire alone. The technique has been used to treat 13 infertile women, age range 27-39 years (mean 32 years), with a diagnosis of proximal tubal obstruction. One tube was perforated; all other tubes were successfully recanalized. Three women conceived within 10 months of the procedure. The technique has results similar to the standard coaxial catheter method but is simple and quick.

Adolescent↗
PubMed1994

Ureteral response to the placement of metallic stents: an animal model.

Metallic self-expanding mesh stents are increasingly used in the urinary tract. Little is known about the histological reactions that such prostheses have on the surrounding tissue. The effects of self-expanded metallic stents in the histologically normal ureter were examined in four dogs. Three-mm. Gianturco-Roubin coronary artery stents were introduced into the distal left ureter after dilatation. Follow-up excretory urography, retrograde pyelograms and autopsy were performed on 2 dogs at 1 month and on 2 dogs at 6 months. In all 4 dogs, the ureters remained patent. Histologic examination of the ureter showed that the stents had not become incorporated within the wall of the ureter. Reactive changes seen in the epithelium included penetration of both epithelium and submucosa between the wire struts and areas of fibrosis in the submucosal layer. The use of metallic stents in histologically normal ureters may be limited in the long term by this inflammatory response.

Animals↗
PubMed1992

Thrombus-trapping efficiency of the LGM (Vena Tech) and titanium Greenfield filters in vivo.

To assess the trapping efficiency of two vena cava filters, 326 radiopaque thrombi 5 mm in diameter were injected into adult sheep: four with LG-Medical (LGM) and four with titanium Greenfield (TG) filters. Thrombi were sequentially injected and not removed. Trapping was monitored fluoroscopically, and the pressure gradient across the filter was measured. The LGM filter trapped 70% of 5 x 5-mm and 100% of 5 x 10-mm thrombi; the TG, 26% of 5 x 5-mm, 34% of 5 x 10-mm, and 37% of 5 x 30-mm thrombi. The LGM filter required an average of 2.0 mL of trapped thrombus to occlude the filter, compared with 6.4 mL for the TG. These differences were statistically significant. These data indicate that in this model, the LGM filter traps thrombi more efficiently than the TG filter but is more likely to produce caval occlusion.

Animals↗
PubMed1992

Fat-filled postoperative renal pseudotumour: variable appearance in ultrasonography images.

A hyperechoic renal pseudotumour caused by packing an operative renal defect with retroperitoneal fat has been previously described. The authors describe eight patients who underwent such packing of a renal defect and for whom ultrasonography was later performed to determine the frequency of pseudotumours and their ultrasonographic appearance. In four patients an obvious surgical defect but no pseudotumour was apparent in the renal parenchyma. In the others a pseudotumour had developed: in two the mass was hyperechoic, as previously reported, but in two the mass was isoechoic. The isoechoic pseudotumours were initially diagnosed as probable carcinomas by the ultrasonographer. Correlation with the surgical history and computed tomography scans led to the correct diagnosis.

Adipose Tissue↗
PubMed1991

LGM (Vena Tech) vena cava filter: clinical experience in 64 patients.

LG-Medical (LGM) vena cava filters were inserted percutaneously in 64 patients. Each case was followed after the filter insertion. Clinical follow-up was available in all patients; in 11 patients it was the only form of follow-up. Findings were available from autopsies in seven patients, plain abdominal radiographs in 42, and duplex sonograms of the insertion vein and inferior vena cava (IVC) in 46. A filter was inserted without major complication in all patients. The filter failed to open fully in four patients and was tilted in the IVC in 15. Recurrent pulmonary embolism was found in two patients (fatal in one), and inconsequential filter migration occurred in 11. Introduction vein thrombosis occurred in four patients. IVC thrombosis, demonstrated at autopsy or sonography, was found in 14 patients (22%) and was symptomatic in six (9%). This report suggests that the LGM filter is easy to introduce, and few complications are associated with insertion. The rate of caval thrombosis, however, may be higher than previously reported.

Adult↗
PubMed1991

Effect of a metallic balloon-expanded stent on normal rabbit ureter.

Two-millimeter balloon-expanded Gianturco-Roubin coronary artery stents were placed in the 1-mm-diameter distal ureters of five normal rabbits. Retrograde pyelograms obtained immediately after stent placement showed no obstruction or extravasation of contrast material. Follow-up excretory urograms were obtained for each animal between 4 and 17 days, and autopsy was performed between 35 and 42 days. Findings at excretory urography and autopsy demonstrated severe obstruction at the level of the stent in each animal. Histologic examination of the resected ureter was performed. In four animals, the stent had penetrated into the wall of the ureter and a fibrous reaction had obliterated the lumen. In one animal, although the stent was still present within the lumen of the ureter, a fibrous reaction within the wall had destroyed the muscle layers and narrowed the lumen at the distal end of the stent. It is concluded that the 2-mm Gianturco-Roubin stent is unsuitable for placement in the 1-mm rabbit ureter.

Animals↗
PubMed1991

Contrast venography in patients with very edematous feet: use of transdermal illumination to aid in vein puncture.

Contrast venography can be technically difficult or impossible in patients with very edematous feet. The authors report a simple technique that uses transdermal illumination of the edematous subcutaneous tissue to enable visualization of a vein and also guide the needle into the vein. This technique has been used successfully in eight patients in whom conventional attempts at vein puncture had failed.

Edema↗
PubMed1989

Percutaneous transluminal angioplasty of stenosis at the common iliac artery origin using a single-balloon technique.

The "kissing balloon" technique has been recommended for percutaneous transluminal angioplasty of common iliac stenoses located at or near the aortic bifurcation, because of the theoretical risk of contralateral embolization or stenosis if a single balloon is used. A single-balloon technique was used to dilate 20 atherosclerotic stenoses at this site in 19 patients. Technical success was achieved in 18. No complications occurred. Follow-up studies at intervals ranging from three to 51 months showed a patency rate similar to that achieved with the kissing balloon method. We believe that the use of kissing balloons is unnecessary since single-balloon angioplasty is safe and effective.

Adult↗
PubMed1986

Percutaneous drainage of iliopsoas abscess in Crohn's disease.

Iliopsoas abscess is a rare but serious complication of Crohn's disease. Initial treatment by surgical drainage of the abscess alone or in combination with bowel resection has been recommended. Percutaneous catheter abscess drainage (PAD) has not been described. We report 3 patients with this uncommon complication of Crohn's disease in whom PAD was attempted. It was successful in 2 cases but failed in 1, who went on to have the abscess drained surgically. We suggest that PAD can be a useful initial treatment to improve the patient's condition prior to definitive surgical resection.

Abscess↗
PubMed1985

The barium enema appearances in solitary rectal ulcer syndrome.

Solitary rectal ulcer syndrome is a benign condition of unknown aetiology, usually found in young adults. The main clinical complaint is of rectal bleeding, often with change in bowel habit. The radiological findings in 17 patients with histologically proven solitary rectal ulcer syndrome, seen at the General Infirmary at Leeds over an 8-year period, are presented. Ulceration, polypoid lesion, stricture, granularity or a normal rectal mucosa may all be found on barium enema. The histological findings and pathogenesis of the condition are discussed.

Adolescent↗