PubMed Health⌕ Search

Biomedical subjects

A Masters

Publications and source records attributed to A Masters.

At least 19 recordsLinked to original sources
PubMed1992

Endoscopic transthoracic sympathectomy for idiopathic upper limb hyperhidrosis.

A 5-year experience of 51 endoscopic transthoracic dorsal sympathectomies for idiopathic palmar hyperhidrosis in 26 patients is presented. Fifty-two percent complained of excessive sweating over their hands, 28% of axillary sweating and 20% over both areas, with a mean duration of 10 years. The second, third and fourth thoracic ganglia and their interconnecting fibres on the affected side were ablated using diathermy cautery. Over a mean follow up time of 26 months, this procedure was successful in curing or improving intractable sweating in 92%. However, axillary sweating was less well controlled than in the palms with 20% of patients describing residual wetness in the axilla. Compensatory sweating (75%) and gustatory sweating (48%) were the commonest side effects; despite this, most patients were satisfied with the functional and cosmetic outcome. Other complications included a temporary Horner's syndrome in one patient, a pneumothorax in the immediate post-operative period in another and a unilateral non-infective reactionary pleural effusion in a third. Two patients developed recurrence of palmar hyperhidrosis within 6 months of surgery. One has been successfully treated by re-operation on the affected side. All patients complained of mild to moderate interscapular chest pain which was easily controlled by non-steroidal anti-inflammatory agents, and resolved within 7-10 days post-operatively. The technique of endoscope transthoracic sympathectomy is effective, relatively simple to perform and usually requires only an overnight stay. It is recommended as the surgical treatment of choice for upper limb hyperhidrosis unresponsive to conservative measures.

Adolescent↗
PubMed1992

Interstitial laser hyperthermia: a new approach for treating liver metastases.

The palliative management of hepatic metastases remains unsatisfactory. There is a need for a simple non invasive technique which can stop or retard the rate of tumour growth. In principle, Interstitial Laser hyperthermia may fulfil such a role. In experimental studies, this technique produced precise in situ necrosis within solid organs which healed safely. In a pilot feasibility study, we treated ten patients with a total of 18 hepatic metastases on 31 occasions using a percutaneous approach to achieve an overall objective response rate of 44%. The treatment proved simple to perform, was well tolerated and produced radiological evidence of necrosis in small metastases (diameter less than or equal to 3 cm). However, further research is required before the technique can be regarded as established. Its future role in most cases will be to control the growth of discrete hepatic metastases unsuitable for resection. In instances where the extent of necrosis can be matched accurately to tumour volume, the potential for cure exists.

Aged↗
PubMed1992

The extensometer--use in spontaneously ventilating awake volunteers.

The extensometer is a new device with potential in the field of respiratory pattern analysis. This paper describes the physical principles upon which the extensometer depends and also assesses its performance as a noninvasive respiratory monitor in respect of its ability to measure tidal volume and to determine obstructive breathing patterns in awake volunteers in the supine position over a limited time period. Further developments of the device are outlined and the current status of torso transducers in anaesthesia and intensive care are discussed.

Abdominal Muscles↗
PubMed1991

Role of interstitial therapy in the treatment of liver cancer.

Conventional palliative management of inoperable focal hepatic tumours remains unsatisfactory. Interstitial techniques such as cryotherapy, alcohol injection, low power laser hyperthermia and interstitial radiotherapy offer alternative approaches. Cryotherapy is an effective and precise technique for inducing tumour necrosis. It can only be performed at laparotomy making it relatively invasive and retreatment impractical. Alcohol is cheap and can be injected percutaneously. However, inhomogeneous distribution produces imprecise and nonreproducible lesions. Low power laser hyperthermia produces precise and reproducible areas of necrosis that are roughly spherical in shape. At present, this technique is most effective for small tumours. Interstitial radiotherapy remains the least evaluated of all the interstitial techniques. Unlike cryotherapy and low power laser hyperthermia, the biological effect of ethanol injection and interstitial radiotherapy cannot be monitored in real time by ultrasound. With the exception of cryotherapy, all methods can be applied percutaneously with low morbidity and mortality. None of these techniques is established, but they may offer the prospect of cure in cases where all areas of tumour can be positively identified and fully treated. However, in most instances the intention is to control the growth of relatively small discrete volumes of tumour within the hepatic parenchyma.

Alcohols↗
PubMed1990

Detection of pS2 messenger RNA in gynecological cancers.

Estrogen-inducible pS2 mRNA was previously detected in human cancer cell lines the growth of which was sensitive to estrogen. In the present study, the expression of the pS2 gene was analyzed in 111 gynecological carcinomas. The pS2 message was detected in greatest abundance in 6 primary carcinomas of the ovary (6 of 29), 4 of these being mucinous cystadenocarcinomas. A secondary carcinoma of the ovary, and another of the omentum (1 of 4), also contained detectable levels of pS2 mRNA. Weak pS2 mRNA signals were occasionally observed in endometrial (2 of 55) and cervical carcinomas (2 of 33) as well. There was a poor correlation between estrogen receptor and pS2 mRNA in ovarian carcinomas.

Biomarkers, Tumor↗
PubMed1990

Sigmoid invasion as a late complication of mucinous cystadenoma of the appendix. Report of a case.

A cystic mass arising from the right iliac fossa was an incidental finding at laparotomy and was treated conservatively after a biopsy had shown no evidence of malignancy. Nine years later the patient presented with shock and colonic bleeding. A large cystic lesion arising from the vermiform appendix and invading the sigmoid colon was found and excised. Histologic examination indicated that the underlying lesion was an inflamed mucinous cystadenoma of the appendix. Frank invasion of viscera by such lesions has not previously been described. Complications of such lesions and their association with other colonic neoplasms are discussed.

Aged↗
PubMed1990

Hypernephroma presenting as a lump in the breast.

The breast is an unusual site for metastatic disease--generally, the breast lesion appears some time after diagnosis of the primary malignancy. An instance of renal cell carcinoma in a 69 year old woman, which presented primarily as a breast lump, is described. This is only the third such case that has been reported in the literature.

Aged↗
PubMed1990

Interstitial laser hyperthermia in tumour therapy.

The clinical applications of non-laser thermal techniques are limited by technical and practical problems. Experimentally, Interstitial Laser Hyperthermia (ILH) is a feasible technique for producing precise, well defined and predictable areas of tissue necrosis which heal safely in normal liver and pancreas. Early clinical experience has shown that ILH is simple to perform and produces well defined areas of thermally mediated necrosis in liver, breast and pancreatic tumours with negligible morbidity and mortality. Further research is necessary to refine the efficacy of what is a promising new treatment modality.

Animals↗
PubMed1989

Long-term recurrence patterns following proximal gastric vagotomy.

Two hundred and forty-two consecutive patients were prospectively followed up following elective proximal gastric vagotomy (PGV) for duodenal, pyloric or prepyloric ulceration. There was no operative mortality and no case of lesser curve necrosis. Five to 15 years follow-up have been completed. One hundred and eighty-three patients were assessable (80% of survivors) and 29 of 33 symptomatic patients attended for endoscopy. Fourteen recurrent ulcers had been diagnosed previously and six new recurrences were diagnosed, giving a total recurrence rate of 11%. Seven of these were transient/innocuous and 13 (7%) were chronic/malevolent recurrences. The majority (70%) of recurrences occurred in the first 5 years of follow-up and only one recurrence occurred later than 10 years' follow-up. More than half (56%) of the operations were performed utilizing Burge intra-operative testing and 44% without Burge testing. No difference in recurrence rates was apparent between these two groups. In seven patients with pyloric or prepyloric ulceration, three (43%) developed a chronic recurrence. PGV is a safe, surgical treatment for duodenal ulceration, offering acceptable recurrence rates and a very low mortality and low incidence of side-effects. The majority of recurrences occur early in the follow-up period. Burge intra-operative testing provides no clear reduction in recurrence rates. PGV should not be used for pyloric or prepyloric ulceration.

Adolescent↗