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Biomedical subjects

D B Fraser

Publications and source records attributed to D B Fraser.

10 recordsLinked to original sources
PubMed1992

Ultrasonography-directed native renal biopsy: comparison of an automated biopsy device with a needle system.

The authors compared the performance of an automated biopsy device with a large-bore cutting needle system in ultrasonography-guided native renal biopsy. They retrospectively analysed 52 biopsy specimens from 50 adults with diffuse renal parenchymal disease. Twenty-six consecutive biopsy samples had been obtained manually with a 14-gauge needle (Tru-Cut, Travenol Laboratories, Deerfield, Ill.); a second set of 26 samples had been obtained with a biopsy gun (Bard Biopty, Radiplast, Uppsala, Sweden) fitted with a 14-gauge needle of similar design. The systems were compared in terms of the specimens obtained (the adequacy and the quality of tissue, the number of intact glomeruli and the presence of artifacts) and the incidence of biopsy-related complications. Biopsy specimens obtained with the biopsy gun were judged qualitatively as well as quantitatively superior; they contained an average of 17.6 intact glomeruli, whereas only 11.5 intact glomeruli were retrieved with the needle system. Although the incidence of minor complications was lower after biopsy with the automated gun than after use of the needle system (8% and 15% respectively), two major complications were observed after gun biopsy and none after needle biopsy. The results reported here indicate that for native renal biopsy the Biopty gun delivers a higher-quality tissue core with a lower frequency of minor complications, but not of major complications, than the Tru-Cut needle system.

Adult↗
PubMed1989

Pneumatosis coli: is there a relationship with sigmoid colon redundancy?

Pneumatosis coli (PC) is a process characterized by gas-filled cysts in the wall of the large intestine. The barium enema examinations of 14 patients with idiopathic PC were assessed: 93% involved the sigmoid colon, and 84% of patients with sigmoid pneumatosis had sigmoid colon redundancy in comparison to 14% of the control population (p less than 0.001). It is proposed that the sigmoid cysts result in redundancy by affecting the mesentery and colon length. This redundancy may account for the increased risk of sigmoid volvulus in this condition.

Barium Sulfate↗
PubMed1989

Variations in fluoroscopic and spot film techniques during extracorporeal shock wave lithotripsy.

The radiation techniques of different operators who performed extracorporeal shock wave lithotripsy of the kidney were evaluated retrospectively. The study was limited to 9 operators who each performed more than 100 procedures on the Dornier lithotriptor. The average fluoroscopic time and number of video spot films per procedure for all operators were 4.1 minutes and 6.5, respectively. However, the average fluoroscopic time per operator varied from 1.4 to 7.6 minutes and the average number of video spot films per operator varied from 3 to 13. The results illustrate the need for some operators to reduce fluoroscopic time and video spot filming.

Fluoroscopy↗
PubMed1988

Extracorporeal shock-wave lithotripsy in the management of bile duct stones.

Extracorporeal shock-wave lithotripsy (ESWL) was performed in 16 patients with bile duct stones. Dornier HM3 water-bath equipment (Dornier Medical Systems, Marietta, GA) was used in all procedures. All patients had either a T-tube or a nasobiliary, cholecystostomy, or transhepatic biliary drainage tube in place at the time of the lithotripsy. In 12 patients, the indication for ESWL was the failure of or anticipated difficulty with basket extraction of the stones, either via a T-tube tract or by means of endoscopic sphincterotomy. In the other four patients, ESWL was performed immediately after retained stones were found on a postoperative cholangiogram, even though no difficulty was anticipated in removing the stones by means of basket extraction. In 15 (94%) of the 16 patients, the stones were successfully fragmented. The fragments passed spontaneously in nine patients but had to be removed by basket in five patients. In one patient, the fragments could not be extracted by basket. The number of ESWL shocks used in a single session ranged from 525 to 3200. Three patients had two ESWL sessions. No significant complications were observed. ESWL is a successful method for the management of patients with bile duct stones when used in conjunction with other nonsurgical techniques. It was also the only treatment required in 56% of our patients.

Adult↗
PubMed1988

Pain in peripheral arteriography: an assessment of conventional versus ionic and non-ionic low-osmolality contrast agents.

Two low-osmolality contrast agents, ioxaglate meglumine/sodium and iohexol were compared with diatrizoate meglumine/sodium in a controlled double blind study of 126 patients undergoing arteriography for peripheral vascular disease to determine which caused the least pain. Discomfort was assessed by means of a visual analog scale rating pain from 0 to 100. Average values for pain were 39 +/- 27 for diatrizoate, 14 +/- 15 for ioxaglate and 21 +/- 22 for iohexol. We found that both low-osmolality agents caused significantly less pain in peripheral arteriography than the traditional agent. The p values were p less than 0.0005 for ioxaglate and p less than 0.005 for iohexol versus diatrizoate. In addition, ioxaglate was found to cause significantly less pain than iohexol (p less than 0.05) in this patient group.

Adult↗
PubMed1985

Therapeutic embolization of the hepatic artery.

We have performed therapeutic embolization of the hepatic artery and its branches in 15 patients, 14 with metastatic neoplasm and one with postoperative hepatobiliary hemorrhage. In the latter patient, bleeding ceased on embolization of the right hepatic artery and did not recur. The median survival time of the 14 patients who had hepatic embolization was six months. The mean survival time in our three patients with metastatic gastric leiomyosarcoma was 24 months, whereas our five patients with metastases from carcinoma of the colon had a mean survival time of only five months. On the basis of this experience we conclude that hepatic artery embolization is advisable in patients with hormonal effects of metastatic disease and in patients with massive hepatomegaly related to metastases from gastric leiomyosarcomas, and may be indicated in patients with hepatic artery hemorrhage.

Adult↗
PubMed1977

Angiography in gastointestinal bleeding.

Over a four-year period, eight patients with documented gastrointestinal bleeding had angiography as a part of their investigation and treatment at the Department of Radiology, Victoria General Hospital, Halifax, Nova Scotia. A review of these eighty cases has been carried out and angiography has been found to be both safe and reliable in the diagnosis of gastrointestinal bleeding. Cautiously administered intra-arterial pitressin infusion therapy will arrest bleeding in about one-third of cases and in most others will reduce blood loss so that a critically ill patient may be made more fit for subsequent surgery. Patients who have recently received intravenous pitressin should not be given intra-arterial pitressin.

Aged↗
PubMed1977

Arteriography in malignant neoplasms of the bowel.

Eighty patients with gastrointestinal bleeding were investigated by angiography over a four-year period. Nine had malignant neoplasms of the bowel. Inconspicuous neovascularity was the most constant finding, best seen in leiomyosarcoma of the small bowel and adenocarcinoma of the colon. Neovascularity was not seen in a patient with reticulum cell sarcoma of colon detected by extravasation. When other studies including endoscopy and barium examinations have failed to explain acute or chronic bleeding, an appreciable number of intestinal neoplasms may be demonstrated by arteriography.

Adenocarcinoma↗