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Biomedical subjects

E W Fletcher

Publications and source records attributed to E W Fletcher.

At least 37 records · Page 2Linked to original sources
PubMed1984

Significance of idiopathic deep venous thrombosis.

The risk of developing an overt malignancy after an isolated deep venous thrombosis (DVT) is poorly documented. We therefore reviewed a series of patients in whom a solitary idiopathic DVT had been proven by venography at least 12 months earlier. No patient had developed a malignancy at follow-up. However, decreased fibrinolytic activity was observed in five out of the six patients aged less than 45 years. Patients with an idiopathic DVT should not be subjected to an exhaustive search for malignancy.

Adult↗
PubMed1984

Embolisation of host kidneys for the control of hypertension after renal transplantation: radiological aspects.

In this study 12 patients with drug-resistant hypertension after renal transplantation had their own kidneys ablated by therapeutic embolisation. The technical aspects of the procedure are described in detail. An improvement in blood-pressure control was achieved in eight of the 12 patients. These results are similar to those which have been reported after bilateral nephrectomy. It is concluded that embolisation of the host kidneys is a simple, effective and less hazardous alternative to surgery in the treatment of severe hypertension after renal transplantation.

Adult↗
PubMed1983

Direction of flow in superficial veins as a guide to venous disorders in lower limbs.

Clinical methods and directional Doppler velocimetry applied to superficial veins have been used to study 527 patients with venous disorders in the lower limbs. Phlebography assisted by the image intensifier has been carried out in 80 of these patients. All examinations have been done with the patient upright, exercising, and without use of any artefact, such as a tourniquet. By these combined means Doppler flow patterns in the superficial veins of five groups of patients have been identified: (1) a highly distinctive downward flow in the upright exercising patient (retrograde circuit) in simple incompetence of the superficial veins (82.1%); (2) a characteristic pattern of upward flow accentuated by exercise, indicating collateral function past deep veins impaired by previous thrombosis (postphlebitic syndrome) (5.7%); (3) a surge back and forth on exercise in patients with valveless deep veins, probably of cogenital origin (8%); (4) sustained upward flow, accentuated by exercise, in veins acting as collaterals to occluded iliac veins (1.5%); (5) a variety of flow patterns in congenital states, including Klippel-Trenaunay syndrome (2.7%). Approximately one half of patients with venous stasis were in the first group and therefore probably had curable conditions; the remainder had the deep vein problems. The incidental role of the "perforator" is discussed and attention drawn to the significance of the retrograde circuit based upon the foot. The directional Doppler flowmeter provides an important screening test that positively identifies simple superficial vein incompetence, suitable for treatment, or gives clear warning of unsatisfactory deep veins that should be investigated further.

Blood Flow Velocity↗
PubMed1982

Urinary stones in subjects with a permanent ileostomy.

The prevalence of urinary stones in a group of subjects living with a permanent ileostomy has been determined by intravenous urography. Thirty-nine of the ileostomists had previously suffered from ulcerative colitis, while the remaining 12 suffered from Crohn's disease. Four of the ileostomists who had had ulcerative colitis had urinary stones (10.3 per cent). These four subjects were all male, so that among the 23 male ileostomists who had had ulcerative colitis 17.4 per cent had urinary stones. No urinary stones were found in the ileostomists with Crohn's disease. Various factors thought to be associated with a liability to urolithiasis have been examined in the ileostomists and also in a control group of 39 healthy subjects matched for age and sex with the ileostomists who had had ulcerative colitis. The ileostomists commonly showed a reduced urinary volume, a low urinary sodium and magnesium content and low urinary pH. The ileostomists were much more prone to be hyperuricaemic than the controls, and hyperuricaemia was strongly associated with the presence of urinary stones.

Colitis, Ulcerative↗
PubMed1982

Intravenous urography as a routine examination in epididymitis-a re-evaluation.

One hundred and twenty-seven intravenous urograms of patients with acute epididymitis were evaluated during a period of 9 years. The majority of these patients had normal urograms. A tuberculous renal lesion was found in only one case. Twenty-seven patients had prostatic enlargement and 10 of these were under 50 years of age. Other abnormalities which were found were not related to epididymitis. It is suggested that intravenous urography is indicated in patients with acute epididymitis only when there is evidence of previous tuberculosis or when laboratory findings arouse suspicion of genitourinary tuberculosis.

Adolescent↗
PubMed1981

Chiba needle in renal puncture guided by real-time ultrasound.

A technique for renal cyst and renal pelvic puncture is presented using the Chiba needle guided by real-time ultrasound. Our experience in 10 cases is recorded. The advantages of real-time ultrasound guidance are described, and the value of the technique is illustrated. There were no complications in this small series.

Adolescent↗
PubMed1980

Observer variation in assessing renal scarring.

To examine the extent of variation between experienced observers in recognizing renal scarring, 60 intravenous urograms from schoolgirls with bacteriuria were presented separately to three radiologists with a major interest in the radiology of the urinary tract. Observers were asked to state whether scarring was "absent", "doubtful" or "present" at each of three sites in each kidney: the poles and the midportion. The proportion of overall agreement, i.e. the proportion of coincident opinions, was 86% to 89%. Results were also analysed by using the kappa statistic, which corrects for agreement due to chance. Kappa values ranged from 0.67 to 0.73. These values indicate higher levels of inter-observer agreement than those recorded for many other radiological examinations and are much greater than those noted by others for inter-observer variation in the recognition of renal scarring in urograms in adults. The likely explanations for these high levels of agreement are discussed. Observers disagreed about the extent of scarring in one-third of cases. Studies of the prevalence of scarring should take account of observer variation and should be based on judgments by more than one experienced observer.

Adolescent↗
PubMed1980

A comparison between the ankle systolic pressure and mercury strain gauge plethysmography in the assessment of patients with arterial disease of the lower limbs.

Mercury strain gauge plethysmography and ankle systolic pressure measurements have been used in the assessment of patients with arterial disease affecting the lower limbs. Plethysmography can differentiate those patients with arterial disease from normal subjects, but it is not possible to determine the site of arterial disease as judged angiographically. It is possible to differentiate patients with rest pain from those patients experiencing intermittent claudication by means of the time to peak flow and time to half peak flow. Because of the significant positive correlation between the changes in peak flow and pressure index produced by reconstructive arterial surgery, the plethysmograph has not been shown to have any advantage over ankle systolic pressure measurements in assessing the results of surgery for peripheral arterial disease affecting the lower limb.

Adult↗
PubMed1979

Lymphocele after renal transplantation.

Lymphoceles occurred in 25 of 115 patients after renal transplantation in the Oxford Unit. Signs of obstruction or pressure were produced in 16 of these 25 patients (15%), while nine were detected on a routine ultrasound scan. The 16 symptomatic lymphoceles were treated successfully by aspiration or surgical fenestration into the peritoneal cavity . Of the possible causes examined, diathermy and division of iliac lymphatics seemed to be the most likely reason for this high incidence. Since a technique of ligating or clipping the iliac lymphatics has been adopted, no lymphoceles have occurred in the subsequent 70 transplants.

Humans↗
PubMed1978

Is fetal radiography really necessary?

A survey of fetal radiographs taken in a teaching maternity hospital during one year showed that less than 10% of fetuses were radiographed. This figure could be reduced further if ultrasound were more widely available.

England↗
PubMed1978

Small bowel melaena: 2 cases diagnosed by angiography.

Two cases of small bowel tumour presenting with melaena are reported. Selective visceral arteriography was found to be invaluable in the management of these cases. The first case presented with intermittent bleeding causing anaemia. Conventional barium studies of the small and large bowel revealed no abnormality. Superior mesenteric angiography revealed a mass lesion in the jejunum, with features characteristic of a leiomyoma. The second case presented with massive gastrointestinal bleeding. Selective visceral angiography was performed initially and revealed a large, mainly avascular, mass lesion in the ileum. Pathological examination showed a leiomyoma which had undergone cystic degeneration. The value of selective angiography in patients with suspected small bowel bleeding is discussed..

Adult↗
PubMed1976

Oliguria in the incubating neonate. Emergency aortography and urography in neonates using mobile X-ray equipment.

Neonates in incubators underwent umbilical aortography, excretory urography and suprapubic cysto-urethrography using a mobile X-ray machine in the Premature Baby Unit to define the cause of their oliguria. The techniques were easy to perform without endangering the infants by moving them. The radiological findings in the four neonates investigated contributed significantly to the management of their illnesses.

Anuria↗