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H C Irving

Publications and source records attributed to H C Irving.

53 records · Page 3Linked to original sources
PubMed1989

A prospective study of the incidence and significance of fetal choroid plexus cysts.

Cysts of the choroid plexus of the lateral ventricle can be detected in the fetus during routine scanning at 16-18 weeks' gestation with an approximate incident of one in every 120 pregnancies. It is likely that in a high percentage of cases cysts are bilateral and that their recent discovery is mainly due to improvements in imaging technology. Although the great majority of cases resolve and do not result in any morbidity, five cases of trisomy 18 and one case of trisomy 21 associated with fetal choroid plexus cysts have been reported. In this prospective study, choroid plexus cysts were detected in 42 fetuses, resulting in 40 normal infants and 2 cases of trisomy 18. It is concluded that there may be a relationship between fetal choroid plexus cysts and trisomy 18. In order to obtain a more precise and accurate result, a multi-centre prospective study is being organized.

Brain Diseases↗
PubMed1988

Multicystic dysplastic kidney: is nephrectomy still appropriate?

We analyzed 25 cases of multicystic kidney to assess the impact of prenatal diagnosis on the management of this condition. The incidence of unilateral multicystic kidney was 1 in 4,300 live births. Of the 23 children with unilateral multicystic kidneys only 3 (13 per cent) had a readily palpable lesion. These findings suggest that multicystic kidney is a more common renal anomaly than was previously recognized and that the majority of cases remained undiagnosed before the advent of prenatal diagnosis. Ultrasound re-evaluation in 11 children suggests that the natural history of multicystic kidneys is towards spontaneous involution. Two kidneys were not identifiable by followup ultrasound. Hypertension and malignancy complicating multicystic kidney are reported infrequently. The literature on hypertension does not generally support the view that multicystic kidney poses a significant risk of hypertension in later childhood or adult life. We believe that the routine removal of multicystic kidneys in infancy is no longer appropriate.

Evaluation Studies as Topic↗
PubMed1987

Transabdominal chorion villus biopsy: 100 consecutive cases.

A series of 100 transabdominal chorionic villus biopsies were carried out for maternal age (34 patients), fetal sexing (15), previous aneuploidy (21), biochemical analysis (5), gene-probe analysis (17), and oligohydramnios or fetal anomaly (6). 18 patients were over 14 weeks pregnant at the time of sampling. Tissue samples were obtained from 98 patients, including one set of twins. All 99 tissue samples proved adequate for laboratory diagnosis. Chromosome mosaicism was encountered in 4 cases (among direct preparation karyotypes in 1 case, between direct and cultured cells in 2 cases, and between chorion cells [both direct and cultured] and the fetus in 1 case). No patient miscarried but 1 had a stillbirth and 1, who had undergone transcervical biopsy before referral to our hospital, started to bleed before termination of pregnancy because of a diagnosis of cystic fibrosis. These data suggest that the transabdominal method of chorion biopsy will fulfil its theoretical and early promise.

Chorionic Villi↗
PubMed1987

Percutaneous nephrostomy in paediatrics.

Percutaneous nephrostomy has been performed on 18 kidneys in 16 children with an age range of 1 day old to 14 years. The indications and techniques for percutaneous nephrostomy are described, the results are documented, and the effects of the procedure on the management of these patients are discussed. It is shown that percutaneous nephrostomy in paediatrics is a safe and reliable method for draining renal collecting systems in order to relieve obstruction, to assess renal function and to drain pyonephroses.

Child↗
PubMed1987

Monitoring of renal allografts by Doppler ultrasound.

Cyclosporin (CyA) associated renal dysfunction may be due to an arteriolopathy which reduces graft perfusion. We have prospectively monitored 27 renal allograft recipients, within 30 days of transplantation, by continuous wave Doppler ultrasound. Changes in the frequency shift waveform should indicate alterations in renal blood flow. Objective analysis was made in 112 waveforms by determining the ratio of the area under the frequency shift/time curve of the first half and the second half of the cardiac cycle (AUC 1/2 ratio). The AUC of the first half of the cycle indicates systolic blood flow plus the first part of diastolic flow, whereas the AUC of the second half indicates the remainder of diastolic flow. The AUC 1/2 ratio during ATN was not significantly different from that during stable renal function. However the ratio was significantly higher during acute rejection episodes and CyA nephrotoxicity. Although a statistical difference was demonstrated between acute rejection and CyA nephrotoxicity, the AUC 1/2 ratio alone does not differentiate these 2 conditions. These preliminary findings suggest CyA nephrotoxicity does reduce renal allograft blood flow and that this non-invasive technique may have a useful role to play in monitoring of patients immunosuppressed with CyA.

Cyclosporins↗
PubMed1985

Pre-natal diagnosis: how useful is it?

Dilatation of the fetal urinary tract can now be detected by ultrasound imaging in pregnancy. Forty-six cases of pre-natally diagnosed dilatation were analysed to assess the contribution of this information to subsequent urological management. Positive pre-natal scans proved accurate. Dilatation was confirmed by neonatal ultrasound imaging or by autopsy in 24 of 25 consecutive inborn neonates and two aborted fetuses. Forty-four live births were studied. Twelve neonates had physical signs at birth which rendered the pre-natal diagnosis unnecessary. In 32 neonates (73%) the urinary tract anomaly was identified solely as a result of pre-natal imaging and would otherwise have remained undetected. However, in seven neonates the information was of doubtful value (mild unilateral dilatation), in 16 it was of probable value (confirmed unilateral PUJ obstruction, multicystic kidney, etc.) and in only nine neonates (20%) was it of definite value (treatable conditions affecting both kidneys or a solitary kidney, e.g. urethral valves, PUJ obstruction in a solitary kidney, etc.). Pre-natally detected bilateral dilatation (18 infants) carried a poor prognosis--33% mortality and 56% incidence of coexistent abnormalities. No infants in our series had undergone intra-uterine drainage, but the numbers of survivors and their renal function was comparable to the published results for fetal intervention.

Dilatation, Pathologic↗
PubMed1984

Ultrasonography of the pancreas, liver, and biliary system in cystic fibrosis.

Abdominal ultrasound imaging was performed in 50 children. Thirty nine were proved to have cystic fibrosis while 11 had respiratory infections and thus acted as controls. The pancreas was abnormal in 75% of cystic fibrosis patients aged under 5 years and in 95% over 5 years. In cystic fibrosis patients over 5 years old who had malabsorption, the pancreas was abnormal in 100%. Abnormalities of the liver parenchyma were found in 23%, of the gallbladder in 24%, and splenomegaly in 8% of the cystic fibrosis patients.

Adolescent↗
PubMed1982

Massive gastrointestinal bleeding in Crohn's disease: successful control by intra-arterial vasopressin infusion.

A case of massive lower gastrointestinal bleeding from Crohn's disease is reported. This is an uncommon complication of the disease and the literature is reviewed. Successful control of gastrointestinal bleeding by intra-arterial vasopressin infusion has not previously been reported in Crohn's disease. We suggest that this technique may be used in an attempt to avoid surgery.

Adult↗
PubMed1980

Tuberculous mediastinal lymphadenopathy in Bradford.

During the calendar year 1978, 18 patients who commenced treatment for pulmonary tuberculosis in the Bradford Chest Clinic were found to have enlarged mediastinal lymph glands. Sixteen of these 18 patients were adults who thus presented radiographic patterns which have been classically regarded are representing primary tuberculous infection and are usually seen in children but only rarely in adults. All 16 adult patients were immigrants of either Indian or Pakistani origin. Tuberculosis is therefore a common cause of mediastinal lymphadenopathy in the immigrant population and in view of the successful response to therapy it should be considered ahead of the more usual diagnoses of lymphoma, sarcoidosis or metastatic carcinoma.

Adult↗