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Biomedical subjects

F Lomas

Publications and source records attributed to F Lomas.

14 recordsLinked to original sources

Sonography in the diagnosis of carpal tunnel syndrome.

OBJECTIVE: The few papers published on the use of sonography in carpal tunnel syndrome suggest it may be a useful diagnostic test. This study aims to prospectively evaluate the use of sonographic measurements of the median nerve in the diagnosis of carpal tunnel syndrome. SUBJECTS AND METHODS: Patients with documented carpal tunnel syndrome and a group of asymptomatic control subjects were enrolled and underwent high-resolution sonography of the carpal tunnel. A small-footprint linear array transducer was used to scan and measure the median nerve cross-sectional area and the maximum transverse and anteroposterior diameters. Data from the patient group and the control group were compared to establish optimal diagnostic criteria for carpal tunnel syndrome. RESULTS: Sixty-eight carpal tunnel syndrome patients (50 women, 18 men) with 102 affected nerves and 68 nerves in 36 asymptomatic controls (23 women, 13 men) were examined. Qualitative assessment alone was found to be unreliable. All measurements showed significant differences between patients and controls. The most predictive measurement was swelling of the median nerve, which was significantly greater in carpal tunnel syndrome patients compared with controls (mean, 0.13 cm2 versus 0.07 cm2). Thus, quantitative assessment of the median nerve provides an accurate diagnostic test (sensitivity, 82%; specificity, 97%), with an area larger than 0.09 cm2 being highly predictive of carpal tunnel syndrome. CONCLUSION: We confirm that median nerve cross-sectional area measurement correlates well with the presence of carpal tunnel syndrome and is both sensitive and specific for the diagnosis.

Carpal Tunnel Syndrome↗

The ultrasonic diagnosis of urachal anomalies.

Seven cases of urachal anomalies are presented. The spectrum of the disorder and the criteria for ultrasound diagnosis are described. Six of seven cases were correctly diagnosed pre-operatively with diagnostic ultrasound, but one case with no cystic component was missed. The appearance of a fixed, midline, cystic, extraperitoneal swelling between the umbilicus and the bladder should suggest the diagnosis.

Adolescent↗

The role of gallium-67 scanning in febrile patients.

The source of sepsis in febrile patients can be a difficult diagnostic problem. Gallium-67 has been utilized as a diagnostic tool in the evaluation of these patients. A retrospective review was done of 47 patients who presented with pyrexia of unknown origin (27 patients), postoperative fever (11 patients), septicaemia (4 patients) and miscellaneous sepsis (5 patients). Whole body imaging with Gallium-67 gave an overall sensitivity and specificity of 86 and 77%, respectively, which compares favourably with previous studies. The sensitivity and specificity was similar in all patient subgroups. Gallium-67 allowed for more effective and directed use of organ-specific imaging modalities, such as computed tomography, ultrasound and guided intervention, in localizing and defining the source of sepsis. Where more than one possible source of fever was present. Gallium-67 scanning correctly identified the activity of the different foci. Gallium-67 scanning should be used early in the evaluation of patients presenting with fever of uncertain origin.

Fever of Unknown Origin↗

Technetium-99m autologous phagocyte scanning: a new imaging technique for inflammatory bowel disease.

A method to determine the extent of active inflammatory bowel disease using selective labelling of autologous neutrophils and monocytes by phagocytosis of a technetium-99m (99mTc) stannous oxide colloid is described. Unlike leucocyte scanning techniques using Indium-III (IIIIn), the 99mTc colloid scan uses a cheap, readily available isotope, which specifically labels phagocytes. Scan results in 20 patients with inflammatory bowel disease were compared with barium examinations and colonoscopic appearances. There was close agreement in 15 of 20 patients as to the extent of mucosal disease. In four cases the scan showed more extensive disease than was suggested by barium examination. The scan showed terminal ileal Crohn's disease in three patients in whom the barium studies of the ileum had been reported as normal. In four patients with inactive disease and normal barium examinations no activity was seen on the scans. The 99mTc phagocyte scan is a sensitive, reliable means of determining the extent of active inflammatory bowel disease and can be used to quantify disease activity.

Adolescent↗

Radiochemistry and biostability of autologous leucocytes labelled with 99mTc-stannous colloid in whole blood.

Autologous leucocytes were labelled in whole blood by phagocytic uptake of 99mTc-stannous colloid. This colloid has a mean particle size of 1.5 micron and labels leucocytes with 81% efficiency. Individual cell uptakes were: granulocytes 42%, monocytes 39%. Isotonic sodium citrate added after the labelling procedure did solubilise excess colloid but was not necessary for adequate removal of excess colloid. Labelled leucocytes were shown in vitro to be viable and maintain normal bactericidal and chemotactic capacity. Biodistribution, clearance rates and dosimetry are presented. These results indicate that autologous leucocytes can be efficiently labelled with 99mTc-stannous colloid with good residual cell function.

Animals↗

Prenatal ultrasound in the diagnosis and management of fetal exomphalos. Case reports.

A patient is presented in whom ultrasonic examination at 39 weeks detected fetal exomphalos with an intact sac and no associated gross abnormalities. These findings served as major indications for the safe delivery by Caesarean section of a baby that survived and had successful corrective surgery when 6 months old. The infant might well not have survived vaginal delivery.

Cesarean Section↗

Lipoprotein composition in hypothyroidism.

Sixteen patients with hypothyroidism have had their lipid status assessed before and during replacement therapy. More than 60% had hypercholesterolaemia and more than 60% had hypertriglyceridaemia. Significant reductions in plasma cholesterol, but not in plasma triglyceride, were seen during replacement therapy. A high cholesterol: triglyceride ratio was observed in VLDL and this relationship tended back to normal during treatment. This raises the possibility that in hypothyroidism, as in Type III hyperlipoproteinaemia, an abnormality in VLDL conversion to LDL is present.

Adolescent↗