Biomedical subjects
Publications and source records attributed to D N Bremner.
Situs inversus viscerum is a rare condition that can present difficulties in management of abdominal pathology. We report a patient with situs inversus totalis who underwent an uncomplicated laparoscopic cholecystectomy.
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Fifty-six patients treated surgically for cryptorchidism between 1950 and 1975 were assessed for fertility. Their age at the birth of their first child was used as the parameter. A direct comparison with the normal population of different regions was available from the General Register Office of Scotland, obviating the need to use female statistics for comparison. The results showed that only very late surgical treatment of unilateral cryptorchidism affected fertility.
A prospective randomised study of subcutaneous heparin compared with no heparin was performed in 60 patients undergoing transurethral resection of the prostate. Operative blood loss in the irrigation fluid was measured using a haemoglobinometer. Blood loss correlated with the amount of prostate resected and the duration of the procedure. Subcutaneous heparin had no significant effect on the measured blood loss in transurethral resection of the prostate and can be used as a safe means of prophylaxis against thrombo-embolic complications.
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Fifty-one patients undergoing abdominoperineal resection of the rectum for carcinoma were studied with regard to bladder function after surgery. Fifty-nine per cent had motor denervation of the bladder due to tumour or operative damage to the pelvic parasympathetic nerves and this produced symptoms of incomplete bladder emptying requiring treatment in 90% of this group. The factors affecting the incidence of nerve damage were discussed. The long-term effect of parasympathetic nerve damage was investigated and the management is discussed.
A case of congenital absence of the appendix occurring in a child with severe thalidomide deformities is described. The literature on agenesis of the appendix is reviewed. The frequency and significance of internal abnormalities in thalidomide children are discussed.
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The value and errors of one method of operative cholangiography were assessed prospectively with the aim of reducing further the incidence of unnecessary explorations of the common bile duct and the occurrence of residual stones. Operative cholangiograms were obtained using a cystic duct cannula in 174 cases, the technical failure rate being 2%. All cases were followed up using intravenous cholangiography where necessary. Of 129 judged normal by the operator, 2 were found to have common bile duct stones-false negative rate 1%. Of 45 judged abnormal by the operator, 10 had negative explorations- false positive rate 6%. Anomalies were discovered in 12% of patients. It is concluded that meticulous technique and accurate interpretation are essential for the best results. The high incidence of anatomical variations present is of interest and this alone emphasises the necessity of carrying out the investigation and the need of experienced interpretation.
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Explore the source record for details and available documents.