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Biomedical subjects

C J Kelley

Publications and source records attributed to C J Kelley.

At least 19 recordsLinked to original sources
PubMed2005

Fat necrosis of the breast--a review.

Fat necrosis of the breast is a benign condition that most frequently affects peri-menopausal women. It can mimic breast cancer clinically or radiologically. In other cases it can obscure malignant lesions. The core of this review is derived from a MEDLINE database literature search from 1966-2004. Further references were from lateral search. In this paper, we review the pathogenesis and pathology clinical and radiological features of fat necrosis of the breast. The implication of fat necrosis in the management of patients with breast lump is also discussed. Fat necrosis of breast is a complex process. Therefore, a systematic review of this condition will enable surgeons, radiologists and oncologists working in the field of breast disease to understand it better and improve its management.

Biopsy, Fine-Needle↗
PubMed1992

The role of instructional set on alcoholic performance.

This study was conducted to determine whether alcoholic and control subjects respond differently to manipulations that either enhance personal involvement (PI) or reduce negative affect (R, relaxation) on tests of neuropsychological function. In Phase 1, 48 male alcoholics and 36 male control subjects completed neuropsychological tasks under standard instructional sets. In Phase 2, subjects completed equivalent forms of these tests under one of three randomly assigned conditions; the PI condition in which subjects were encouraged to identify specific ways of improving their performance, the R condition in which subjects participated in a short relaxation exercise designed to reduce anxiety, or a No Treatment (NT) condition in which no attempt to manipulate the subjects' involvement or affect was made. Alcoholics were inferior to controls in both Phase 1 and Phase 2 [Fs (1,82) > 5.03, ps < 0.03]. The experimental manipulation differentially affected measures of negative affect and effort in the predicted direction. There were no group x condition interactions. Alcoholic and control subjects responded comparably to the experimental manipulations. This investigation, in combination with others using related manipulations, reinforces the hypothesis that alcohol-related cognitives dysfunction reflects an underlying deficit in brain states.

Adult↗
PubMed1990

A deficit of bladder cancer in an Asian community in the UK.

Over a 10-year period, the incidence of bladder cancer in the local Asian community living within the Ealing hospital catchment area was compared with that in the indigenous population and that in England and Wales. A significantly reduced incidence was seen in the Asian community, using both comparisons.

Asian People↗
PubMed1989

Study of the effectiveness of bupivicaine infiltration of the ilioinguinal nerve at the time of hernia repair for post-operative pain relief.

The effect on post-operative pain relief and analgesic requirements of direct ilioinguinal nerve block using 0.5% bupivicaine (Marcain) at the time of hernia repair was studied. Sixty patients were randomly allocated into two groups, A and B, both being well matched for age, numbers and sex. Those in whom nerve block was used (Group A) required significantly less intramuscular opiates and strong oral analgesics (co-dydramol) than those who did not receive bupivicaine (Group B) during the first 24 hours post-operatively.

Analgesics↗
PubMed1986

Liver atrophy complicating benign bile duct strictures. Surgical and interventional radiologic approaches.

The hepatic atrophy and hypertrophy complex has been described in a selected group of nine patients with benign bile duct stricture. The clinical features common to this group were a high biliary stricture and a long-standing history of cholangitis and intermittent jaundice. A history of multiple surgical procedures and associated vascular damage or portal hypertension is strongly suggestive of the atrophy and hypertrophy complex. The radiologic criteria for the diagnosis of this condition are presented. Computerized tomography and HIDA scintigraphy were valuable as noninvasive means to diagnose lobar liver atrophy. The atrophy and hypertrophy complex described herein poses significant therapeutic problems and demands approaches other than those normally applicable for high biliary strictures. A combined surgical and radiologic approach with additional interventional radiologic procedures may be appropriate in patients in whom hilar anastomosis is difficult or impossible.

Adult↗
PubMed1985

Per-operative cholangiography and post-cholecystectomy biliary strictures.

A series of 78 patients with post-cholecystectomy biliary strictures have been examined. The majority (71%) did not have per-operative cholangiography at the time of initial cholecystectomy. Of the remainder, inadequate views were obtained in two patients and incomplete information was associated with subsequent common bile duct damage. In addition the study was performed after the common bile duct had been transected in a further two cases. The use of per-operative cholangiography in patients undergoing cholecystectomy is advocated, and the advantages and disadvantages of such an approach examined.

Adult↗
PubMed1985

Colonoscopy related endotoxemia.

A pilot study of 20 patients who underwent colonoscopy was performed to investigate the occurrence of endotoxemia related to the procedure and its clinical significance. With the use of the limulus lysate method of assay, endotoxemia was demonstrated in 25 per cent of the patients during colonoscopy and 65 per cent afterwards, but was not associated with either concomitant bacteremia or any ill effects. The appearance of endotoxin in significant concentration in the presence of normal liver function and with no overt focus of infection, suggests that substantial absorption of bacterial products which originate in the intestine occur, but under normal circumstances cause no demonstrable deleterious effects.

Adolescent↗
PubMed1984

Hepaticojejunostomy in benign and malignant high bile duct stricture: approaches to the left hepatic ducts.

Biliary-enteric anastomosis for relief of biliary obstruction caused by benign or malignant disease at the confluence of the bile ducts can be difficult. An approach by dissection at the confluence has to be performed directly into an area of scarring or at the site of a neoplastic lesion; exposure of an adequate duct for anastomosis is often difficult and may appear impossible. This paper describes an alternative approach to the hepatic ducts by dissection of the left hepatic ductal system. The method has been used with success in thirty-six patients.

Bile Duct Neoplasms↗
PubMed1984

Benign bile duct stricture following cholecystectomy: critical factors in management.

Seventy-eight patients with benign bile duct stricture following cholecystectomy were referred for further management over an 8-year period. The majority (58 per cent) had multiple operations before referral. On presentation 90 per cent of patients had abnormal liver function tests, 19.5 per cent a depressed serum albumin, 49 per cent a history of previous major infection, and 14 per cent associated liver disease and portal hypertension. Seventy-two patients (92 per cent) were operated upon: 63 by stricture repair alone, 4 by stricture repair and portal systemic anastomosis, and one by splenorenal anastomosis alone. Of the patients treated by stricture repair alone and no other procedure 90 per cent have a good result with a mean follow-up of 3.3 years, and an operative (30-day) mortality of 3.2 per cent. There were no postoperative deaths in 61 patients in whom stricture repair alone was performed by direct suture techniques, but in the presence of portal hypertension and liver disease the mortality was 27 per cent. Factors influencing a satisfactory stricture repair were the number of previous operations, site of stricture and type of repair. Factors influencing mortality were the number of previous operations, a history of major infection, the site of stricture, pre-operative serum albumin concentration, and the presence of liver disease and portal hypertension.

Adult↗
PubMed1983

Non-surgical management of post-cholecystectomy haemobilia.

Therapeutic embolization of the hepatic artery was performed in two patients actively bleeding from aneurysms resulting from previous surgical damage to the artery at cholecystectomy. The advantages of embolization over surgical ligation of the hepatic artery are discussed.

Adult↗