PubMed Health⌕ Search

Biomedical subjects

I K Fry

Publications and source records attributed to I K Fry.

At least 19 recordsLinked to original sources
PubMed1988

Detection of alcohol-induced fatty liver by computerized tomography.

Computerized tomographic (CT) scanning of the liver was undertaken in 17 occasional and 19 heavy drinkers undergoing health screening. The median attenuation value of the liver (CT number) in occasional drinkers with normal liver function tests was 54.4 compared with 25.9 in the heavy drinkers (P less than 0.001). Fourteen of the heavy drinkers had a CT number below the lowest value observed in occasional drinkers with normal liver function, indicating reduced liver density due to fatty change. Serum gamma-glutamyl transpeptidase was normal in 36% of these individuals. A rise in CT number was observed in 4 out of 5 heavy drinkers who underwent a second scan after decreasing their alcohol consumption. These findings suggest that CT scanning provides a noninvasive and convenient method of screening for a fatty liver, which occurred to a variable degree in over 70% of the men who admitted to regularly taking 8 or more alcoholic drinks per day.

Fatty Liver, Alcoholic↗
PubMed1984

The role of computed tomography in the detection of intrathoracic lymphoma.

Computed tomographic scanning of the chest in 100 patients with newly diagnosed malignant lymphoma detected mediastinal lymphadenopathy (39%) and parenchymal deposits (15%) with a significantly greater sensitivity and specificity than conventional radiological techniques. This principally affected the staging and treatment of patients with limited stage disease. The stage was changed in 10/61 patients (16%) with Stages I-III prior to CT scan and treatment was altered in 11/29 (38%) patients for whom radiation was the treatment of choice. Complete remissions as defined by CT scan have been more durable than those defined by CXR alone.

Adult↗
PubMed1984

Can ultrasound and computed tomography replace high-dose urography in patients with impaired renal function?

Ninety-one patients with unexplained impaired renal function were investigated by high-dose urography, ultrasound and computed tomography (CT) without contrast. The aim was to evaluate the role of ultrasound and CT in renal failure, in particular their ability to define renal length and to show collecting system dilatation. In the majority of patients, renal length could be measured accurately by ultrasound. Measurements were less that those at urography because of the absence of magnification. Renal measurement by CT was not a sufficiently accurate indicator of renal length to be of clinical use. Both ultrasound and CT were sensitive detectors of collecting system dilatation: neither technique missed any case diagnosed by urography. However, in the presence of staghorn calculi or multiple cysts, neither ultrasound nor CT could exclude collecting system dilatation. CT was the only technique which demonstrated retroperitoneal nodes or fibrosis causing obstruction. It is proposed that the first investigation when renal function is impaired should be ultrasound, with plain films and renal tomograms to show calculi. CT should be reserved for those patients in whom ultrasound is not diagnostic or in whom ultrasound shows collecting system dilatation but does not demonstrate the cause. Using this scheme, ultrasound, plain radiography and CT would have demonstrated collecting system dilatation and, where appropriate, shown the cause of obstruction in 84 per cent of patients in this series. Only 16 per cent of patients would have required either high-dose urography or retrograde ureterograms.

Adolescent↗
PubMed1983

The appearances on computed tomography after abdominoperineal resection for carcinoma of the rectum: a comparison between the normal appearances and those of recurrence.

Computed tomography is well recognised as a means of showing recurrent tumour in patients who have undergone abdominoperineal resection for carcinoma of the rectum. The appearance of recurrent tumour has to be distinguished from that of normal postoperative fibrous tissue. To define the normal postoperative appearances CT was carried out on 15 patients at various intervals up to 18 months after the operation. All the patients were clinically free of recurrence at the time of the scan and for at least six months afterwards. The appearances were compared with those in 19 patients who had local recurrence at the time of scanning. The normal appearances are outlined, pitfalls in diagnosis are described and points of differentiation between the normal appearance and recurrent tumour are discussed.

Female↗
PubMed1982

Value of computed tomography of the abdomen and chest in investigation of Cushing's syndrome.

Computed tomography (CT) scans were performed on 37 patients with biochemically proved Cushing's syndrome to evaluate the role of CT in the investigation of this condition. CT rapidly and correctly identified all 15 adrenocortical tumours, distinguishing five carcinomas from the 10 adenomas. In ACTH-dependent Cushing's syndrome appreciable bilateral adrenal enlargement was common in patients with an ectopic source (6 of 10 cases), while those with a pituitary source usually had normal sized adrenals (9 of 10). Two patients with a history of over seven years had bilateral adrenal nodules. CT was more accurate in locating a primary ectopic source of ACTH (5 of 12 cases) than any other technique and was particularly valuable in detecting small (less than 1.5 cm) peripheral lung carcinoid tumours which may be undetectable by conventional x-ray techniques. Its speed, accuracy, and simplicity make CT the technique of choice both to show the adrenal anatomy and to locate a suspected ectopic ACTH-secreting tumour in patients with proved Cushing's syndrome.

ACTH Syndrome, Ectopic↗
PubMed1981

Computed tomography in patients with an abdominal mass: effective and efficient? A controlled trial.

In 28 of 53 patients with a palpable abdominal mass computed tomography (CT) was used as the initial imaging technique, and conventional imaging was used in the remaining 25 patients. The diagnosis was established more quickly in the CT group, and the period of inpatient investigation was shorter. The cost of imaging investigations was higher for the CT group, but this difference was small when compared with the difference in cost of inpatient stay. CT seems accurate in the investigation of a palpable abdominal mass and particularly useful in excluding a pathological cause. The need for the latter is emphasised by the fact that no lesion could be found in 23 of the 53 patients.

Abdominal Neoplasms↗
PubMed1981

Computed tomography (CT) of abdominal aortic aneurysms: determination of longitudinal extent.

The aim of this study was to evaluate computed tomography (CT) in the assessment of abdominal aortic aneurysms with particular reference to their longitudinal extent. Twenty-nine patients were examined by CT, 21 of whom came to surgery. Sixteen of these 21 patients were also examined by ultrasound. At CT the relation of the aneurysm to the renal arteries proximally and the bifurcation distally was noted, along with the definition of the aortic outline. At subsequent surgery the longitudinal relations of the aneurysm and evidence of localized stretching of or leakage from the sac were assessed by an observer without knowledge of the CT scan report. Correct extent of the aneurysm in relation to the renal arteries was predicted by CT in 20 out of 21 patients who underwent surgery. CT assessment with respect to the bifurcation was correct in 16. The CT findings proved correct in one patient with localized stretching of one part of the aneurysm and in one patient where leakage was occurring. CT scanning was found to be superior to ultrasound in our preoperative assessment of the superior extent of abdominal aortic aneurysms. CT is considered to be the investigation of first choice when evaluation an abdominal aortic aneurysm.

Aorta, Abdominal↗
PubMed1981

The use of the right decubitus position in computed tomography of the liver and pancreas.

Sixty patients underwent computed tomography (CT) with a 20 s scanner of the upper abdomen in the supine and right decubitus positions. The images of the liver were compared. The scores for the hepatic image were better when the patient was in the right decubitus position. The scores for the image of the pancreatic head were about the same in the two positions but improvement occurred in the right decubitus position in nearly half the patients. Scores for the other parts of the pancreas and for the pancreas as a whole were usually worse when in the right decubitus position although improvement did sometimes occur. Scanning in the right decubitus position has been demonstrated to be of value in reducing artefact shadows in the hepatic image and may on occasions improve the quality of the pancreatic image. Accordingly scanning in the right decubitus position is a useful aid when supine views have given poor results or when the presence of a lesion is equivocal.

Humans↗
PubMed1981

Renal function after high dose urography in patients with renal failure.

A retrospective study of 40 patients with moderate to severe renal failure who had high dose urography showed that none developed oliguric acute renal failure after the urogram. In 37 patients there was no worsening in renal function attributable to the urogram. This group included five patients in whom renal function was already deteriorating at the time of the urogram. In three patients a transient rise in serum creatinine without oliguria occurred in the week following urography. Differences between the British and North American experience are discussed.

Acute Kidney Injury↗
PubMed1981

The effect of DDAVP on intravenous urography.

The possible role of an antidiuretic hormone analogue, DDAVP (1 deamino-8-D-arginine vasopressin), in intravenous urography has been studied. The minimum effective dose of intravenous DDAVP in normal hydrated subjects was shown to be 2 ng/kg. During intravenous urography in fluid restricted subjects, a dose of 1 microgram DDAVP was necessary to reduce significantly the urine flow rate after contrast medium injection. Although the mean pyelographic score after DDAVP was increased, the differences observed were not statistically significant. The possible reasons for this finding are discussed.

Arginine Vasopressin↗
PubMed1981

Pre-operative computed tomography of carcinoma of the rectum.

Fifty-two patients with carcinoma of the rectum under-went computed tomography (CT) in the immediate preoperative period. CT was used in order to assess extrarectal tumour spread. The resected specimen was staged by the pathologist who subdivided spread in continuity beyond the bowel wall into slight, moderate or extensive. In 21 out of 23 patients with no or slight extrarectal local spread CT showed normal perirectal fat. Extrarectal spread was demonstrated by CT in eight of the nine patients found to have extensive local spread. This was seen to be circumferential in the only two patients with inoperable tumors. CT identified discrete nodal enlargement in seven of the 18 patients with histologically involved lymph nodes. CT may help the less experienced surgeon, especially when he is not confident of his findings at digital examination. CT allows assessment of high rectal tumours which cannot be examined digitally. It may play a role where a tumour with extensive local spread is clinically suspected and confirmation is needed before preoperative radiotherapy is given.

Humans↗
PubMed1980

Computerised tomographic (CT) abdominal scanning in Hodgkin's disease.

Thirty-nine patients with Hodgkin's disease (HD) with little or no clinical evidence of abdominal disease were investigated by abdominal CT scanning. The results were compared with those of bipedal lymphography and laparotomy and splenectomy. In the assessment of para-aortic lymph nodes, CT scanning and lymphography were of equal efficacy in determining the presence or absence of disease (87 and 79% respectively). Although CT scan could occasionally demonstrate disease in nodes in areas other than the retroperitoneum, its value was limited by its inability to detect involvement of nodes which were not significantly enlarged. CT assessment of splenic HD was unreliable, focal deposits being detected in only one of the 11 spleens involved. In this selected group of patients, CT scan had little advantage over lymphography in the description of disease extent. However, CT scan would appear to be the investigation of choice in patients with suspected abdominal relapse because of the more frequent presence of disease in sites not seen on lymphography. When treatment decisions are dependent on accurate knowledge of distribution of disease, CT scanning cannot yet effectively replace staging laparotomy and splenectomy as the means of achieving this information.

Hodgkin Disease↗
PubMed1980

Computed tomography as an adjunct to bimanual examination for staging bladder tumours.

Computed tomography (CT scanning) has been undertaken in 51 patients with bladder tumours, 15 of whom subsequently had pathological examination of the bladder to confirm the extent of tumor spread. Concordance between the CT and pathological staging (80%) was as good as that between clinical and pathological staging (73%). Most of the inaccuracies of clinical staging were underestimations of the extent of muscle invasion, whilst the inaccuracy of CT involved overstaging. The principal areas where CT might improve the accuracy of clinical staging are in patients with invasive tumours who after transurethral resection have no mass palpable on bimanual examination, and in patients following radiotherapy who might be candidates for salvage cystectomy but in whom assessment of the spread of tumour is difficult because of post-irradiation fibrosis. Data from a much larger series are required to ascertain whether the additional information provided by CT will produce any improvement in patient management.

Female↗