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Biomedical subjects

C D Auld

Publications and source records attributed to C D Auld.

At least 19 recordsLinked to original sources
PubMed1998

Laparoscopic cholangiography: a prospective study.

BACKGROUND: The place of cholangiography has been controversial in the conventional and now in the laparoscopic setting. The aim of this study was to evaluate laparoscopic cholangiography and compare use of a portable C-arm image intensifier with conventional radiography. METHODS: One hundred and ninety-seven consecutive patients undergoing laparoscopic cholecystectomy were randomized before operation to cholangiography by either C-arm image intensifier or conventional radiography. Data were collected on a pro forma completed immediately after the operation. RESULTS: Cholangiography was successful in 93.0 per cent of patients. Cholangiography with an image intensifier was significantly faster. In 19 patients the ductal system was obscured by a cannula; in 17 of these cases a metal cannula was used. In 31.6 per cent of patients the clip on the cystic duct was within 1 cm or less of the common bile duct (CBD). CONCLUSION: Laparoscopic cholangiography is a safe procedure. Use of an image intensifier should be the preferred method of obtaining images. Metal cannulas are more likely to obscure the ductal system. The proximity of the clip on the cystic duct to the CBD highlights the potential for injury caused by electrocautery or erroneous clip application.

Adolescent↗
PubMed1997

Audit of colorectal cancer surgery by non-specialist surgeons.

BACKGROUND: Some authorities recommend that colorectal cancer should be treated in specialist units but evidence that non-specialist units demonstrate comparatively poor results may be lacking. METHODS: Between 1987 and 1991, 267 patients were operated on by four general surgeons, none of whom was a specialist in colorectal surgery. Procedure-related complications, postoperative mortality and disease-related survival rates were analysed. RESULTS: There were four cases of intraperitoneal sepsis (1 per cent) and five of 189 patients (3 per cent) had clinical anastomotic dehiscence; there was no case of wound dehiscence. The postoperative mortality rate after elective and emergency surgery was 2 and 13 per cent respectively. The 5-year disease-related survival rate for curative and palliative surgery was 67 and 9 per cent respectively. There were no significant differences between the surgeons. CONCLUSION: Disease-related variables such as early-stage disease and fewer patients presenting as emergencies may have a greater favourable influence on ultimate survival than surgeon-related variables.

Aged↗
PubMed1992

Needle core biopsy of the breast with a spring-loaded device.

Over a 2-year period, 151 outpatients with a palpable breast lump requiring needle core biopsy were randomized to a Tru-Cut 14-G (T14), Bioptycut 14-G (B14) or Bioptycut 18-G (B18) needle. Use of a Biopty gun resulted in less pain than a Tru-Cut needle. An inadequate sample was obtained after two needle passes in 11 of 49 (T14), none of 51 (B14) and two of 51 (B18) patients (chi 2 = 14.6, 2 d.f., P = 0.0007). Tissue samples were assessed by a single pathologist for tissue volume and overall diagnostic value; the B14 group scored better than the B18 and T14 for both of these parameters (P < 0.003). The sensitivities were 68 (T14), 88 (B14) and 96 (B18) per cent (overall chi 2 = 7.3, 2 d.f., P = 0.026). The Biopty gun with a 14-G needle results in a higher sampling success rate, greater diagnostic sensitivity and a better specimen quality than the Tru-Cut, and is much easier to use.

Adult↗
PubMed1992

Splenic abscess: is conservation applicable?

A rare occurrence of salmonella abscess in a congenital cyst of the spleen is presented. Although splenectomy was curative, the role of splenic salvage is discussed. Percutaneous drainage is curative in about 70% of cases and may be the treatment of choice in solitary thick-walled abscesses. It should be remembered, however, that residual or regenerated splenic tissue is no absolute guarantee against sepsis. The treatment of splenic abscess should be individualised.

Abscess↗
PubMed1990

Abdominal trauma.

Explore the source record for details and available documents.

Abdominal Injuries↗
PubMed1989

Penetrating abdominal stab wounds: a plea for a more conservative policy.

This is a retrospective study of 107 penetrating abdominal stab wounds which have been reviewed on the basis of the clinical indications for surgery. Eighty-four patients underwent laparotomy. The unnecessary laparotomy rate was 35 per cent and the mortality 2.4 per cent. Important complications developed in 44 per cent of those undergoing surgery. Evaluation of clinical variables is presented and it is suggested that in the absence of shock, generalized peritonitis or evisceration, careful initial assessment, monitoring and regular re-examination would be a satisfactory method of treatment for many cases. This would result in a decrease in unnecessary laparotomies and associated excess morbidity.

Abdominal Injuries↗
PubMed1989

Hepatobiliary complications in chronic pancreatitis.

Thirty nine patients undergoing surgery for chronic pancreatitis were investigated for evidence of hepatobiliary disease. In addition to pre-operative assessment by liver function tests, ultrasound, ERCP (in 33) and percutaneous transhepatic cholangiography (in five), all had peroperative liver biopsy. Common bile duct stenosis was diagnosed in 16 (62%) of the 26 patients with successful cholangiography. Features of extrahepatic biliary obstruction were found on biopsy in 11 patients, three of whom showed features of secondary sclerosing cholangitis. No patients had secondary biliary cirrhosis. Three had parenchymal liver disease (cirrhosis, resolving hepatitis and alcoholic hepatitis respectively) and two others had features suggestive of previous alcohol-induced injury. Five (83%) of the patients with clinical jaundice had biopsy features of extrahepatic biliary obstruction, as did eight (67%) with alkaline phosphatase above twice normal and seven (44%) with radiological common bile duct stenosis. Neither alkaline phosphatase rise, nor common bile duct stenosis alone or in combination, were a reliable indication of the need for biliary enteric bypass surgery. Pre-operative liver biopsy may be a valuable adjunct in the assessment of such patients.

Adult↗
PubMed1985

The control of male stress incontinence by implantable prostheses.

Twenty-six patients were treated by implantable prostheses in a 10-year period, 22 by primary Kaufman III and four by primary Rosen. Sixteen of 22 patients having the Kaufman III procedure were cured or markedly improved over a follow-up period of 6 months to 10 years. The Rosen prosthesis, whilst simple to install and making the patient continent, eventually produced urethral fistulae in all cases. The Kaufman III prosthesis appears to be the procedure of choice in uncomplicated male stress incontinence.

Adult↗
PubMed1984

Histopathological review of transitional cell carcinoma of the upper urinary tract.

A histopathological review of 30 patients with transitional cell carcinoma (TCC) of the upper urinary tract showed that 21 patients had dysplastic epithelium adjacent to the tumour, irrespective of the degree of invasion; 20 patients had multifocal disease with some degree of dysplasia or carcinoma elsewhere. It is concluded that radical surgery should be performed whenever possible, even in the superficial low grade tumour.

Adult↗
PubMed1980

Cooling responses in shivering and non-shivering dogs during induced hypothermia.

1. Hypothermia to a temperature of 30 degrees C was induced in both shivering and non-shivering groups of dogs. 2. There was a sustained increase in oxygen consumption in the dogs allowed to shiver and this was up to 300% greater than the oxygen consumption in the relaxed dogs. 3. The increased tissue requirement for oxygen was met both by increased cardiac output and increased oxygen extraction from haemoglobin. 4. Oxygen utilization remained adequate in hypothermia, as shown by the absence of hypoxic acidosis. 5. Heart rate fell during cooling and stroke volume increased to meet the increased oxygen demands associated with shivering during the induction of hypothermia.

Animals↗
PubMed1979

Accidental hypothermia and rewarming in dogs.

1. Twenty lightly anaesthetized dogs were cooled to 29 degrees C by cold-water immersion. Ventilation was spontaneous and the animals were allowed to shiver freely. Metabolic heat production and respiratory heat exchange were measured during rewarming. 2. The animals were divided into four groups each of five dogs and each group was rewarmed by a different technique. The control group was allowed to rewarm spontaneously; a second group was given warm (45-50 degrees C) fully humidified air to breathe in addition; a third group was rewarmed in a hot-water bath (42-44 degrees C) and the remaining group was given in muscle relaxant to abolish shivering and rewarmed by warm inspired air only. 3. The group rewarmed in hot water achieved normal core temperature most rapidly but there was no difference in the rewarming rates of the group rewarmed spontaneously and of the group given warm air to breathe in addition. 4. The group given a muscle relaxant and rewarmed with warm inspired air required 12 h to achieve the same core temperature as the shivering groups achieved in 2 h. Compared with the heat produced by shivering the amount of heat which it was possible to transfer across the respiratory tract was so small that it did not materially influence the rate of rewarming.

Animals↗