Computed tomography infusion choledochography in the management of Caroli's syndrome.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
H A Harley
Publications and source records attributed to H A Harley.
Results of a randomized trial of end-to-side portacaval shunt and distal splenorenal shunt in alcoholic liver disease and variceal bleeding.
Since 1976, we have compared the end-to-side portacaval shunt (PCS) with the distal splenorenal shunt (DSRS) in patients with alcoholic liver disease and recurrent variceal bleeding. Fifty-four patients were randomly assigned to receive either shunt procedure. There were 27 patients in each group and both groups were highly comparable in clinical and laboratory characteristics. Median follow-up was 31 mo in each group. Postoperative complications and operative mortality (7% after PCS, 12% after DSRS) were comparable. Spontaneous portasystemic encephalopathy developed in 32% of the patients at risk after PCS and in 39% after DSRS. Rebleeding from varices occurred in 4% of the patients after PCS and in 27% after DSRS. Cumulative survival was not significantly different between groups (5-yr survival: 31% after PCS, 43% after DSRS). We have failed to demonstrate superiority of DSRS in our patients with alcoholic liver disease with respect to postoperative encephalopathy or survival, and have experienced an unusually high rate of variceal rebleeding after DSRS.
Adult↗
Sternoclavicular joint infection with group B streptococcus.
Explore the source record for details and available documents.
Arthritis, Infectious↗
Profound hypocalcaemia associated with oestrogen treatment of carcinoma of the prostate.
A case of profound hypocalcaemia which occurred in a patient with osteoblastic metastatic carcinoma of the prostate after treatment with oestrogens is reported. Although there may have been other contributory factors, it was felt that the administration of oestrogens was the most important causative element. Treatment with high doses of oestrogens in patients with osteoblastic metastatic carcinoma of the prostate should be accompanied by frequent measurements of plasma calcium levels.
Adenocarcinoma↗
Traumatic gastric ulceration.
A case of acute gastric ulceration is described which resulted from direct blunt trauma to the stomach. This produced significant haemorrhage ten days after the injury which was successfully managed by conservative means.
Adolescent↗
Gastrointestinal endoscopy: some perspectives.
Remarkable technological advances of fibreoptic endoscopy in the past two decades have produced important improvements in diagnosis and treatment of gastrointestinal and hepatobiliary disorders. These advances must be kept in perspective; continuing, critical assessment of their contribution to the management of patients is desirable. Endoscopy can have adverse effects on the total performance of departments of gastroenterology, on gastroenterology as a discipline, and even on the status of the medical profession in the community. Gastroenterologists need to show proficiency of performance and integrity of practice. Control may be achieved by certification delineation of privileges, peer review, public accountability, and realistic financial returns for procedures. Records of a department of gastroenterology indicate that some control may be achieved by insistence on a consultation before decision on endoscopy. This may be a desirable alternative to endoscopy on demand. Undue emphasis on technology runs some risk of destroying the proper practice of consultant medicine.
Endoscopy↗
A simple screening strategy for diagnosing the porphyrias.
Explore the source record for details and available documents.
Adult↗