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Biomedical subjects

I W Wallace

Publications and source records attributed to I W Wallace.

17 recordsLinked to original sources
PubMed2000

A radiological technique for the assessment of wear in prosthetic knee replacements.

OBJECTIVE: Wear of the polyethylene insert is a well-recognised cause of implant failure in total knee replacements. The purpose of this study was to evaluate a simple, digital fluoroscopic technique for the assessment of wear in knee prostheses. DESIGN: Fluoroscopic images of knee prostheses were produced both of a phantom and in a patient group. Joint space thickness was measured by reference to a known diameter. Measurements were made to assess repeatability of positioning, inter-and intra-observer variance and the effect of angulation. RESULTS: Standard phantom images showed small variation between measurements, high inter-reader correlation (Pearson's correlation coefficient, r=0.98, P<0.001; coefficient of variation=0.53%) and low intra-reader variation (coefficient of variation=0.57%). Inter- and intra-imager variation were low (coefficient of variation=1.05% and 0.88%, respectively). In the patient group, the range of joint space measurements was 1.9-8.9 mm. The coefficient of variation in insert measurements on repeated images was 2.0%. Repeatability of measurements was 0.2 mm with 99% confidence interval. CONCLUSIONS: This technique allows repeatable, precise measurement of insert thickness. The technique may be adapted to any implant where a reliable calibrating distance is present.

Fluoroscopy↗
PubMed1995

Transurethral resection of the prostate in 539 patients at a district general hospital.

This study audited length of hospital stay, mortality and morbidity associated with transurethral resection of the prostate (TURP) in a district general hospital over a 4-year period between 1990 and 1993. Five hundred and thirty-nine TURPs (409 benign and 130 malignant; median age 69 years) were carried out, which represented a twofold increase over the 4-year period. Although the mean duration of stay was 5 days, 92.5% of patients had a hospital stay of less than 7 days. One (0.2%) death occurred in a patient with ischaemic heart disease on the first postoperative day. The commonest cause of morbidity and delayed discharge from hospital was presence of outflow symptoms in nine (1.7%) patients. Transurethral resection of the prostate is a safe procedure in an ever-increasing elderly population with concomitant medical illness, but improved identification of 'at-risk' patients is required in order to further lower the morbidity associated with this procedure.

Aged↗
PubMed1993

Open biliary surgery and the use of routine inpatient audit.

'Morbidity profiles' offer a practicable and effective method of assessing overall surgical performance. In this study they have been used to document the results of elective and emergency open biliary surgery carried out on 246 consecutive patients over a 2-year period. The results demonstrate that such surgery for the treatment of cholelithiasis and its complications is extremely safe. There was one postoperative death (0.4%) and an in-hospital major morbidity rate of 4.6%. Minor morbidity was common, especially in the elderly and following emergency surgery. The data presented here will be of particular interest to the increasing number of surgeons advocating laparoscopic biliary surgery.

Adult↗
PubMed1990

Transurethral resection of the prostate without routine antibiotic prophylaxis: screening for complications.

In a prospective study of 61 patients undergoing transurethral resection of the prostate without antibiotic prophylaxis there were no major postoperative complications in 55 cases (90%). A bacteriological screen involving culture of a preoperative sample of urine, an immediate preoperative urethral swab, prostatic chippings, immediate postoperative blood cultures and catheter-removal sample of urine was carried out to investigate the ability to detect infective complications. The blood cultures had a predictive value of 80% (sensitivity 80%, specificity 93%). However, the result was available in time to influence management in only one of four patients with postoperative septicaemia.

Aged↗
PubMed1975

Urinary aetiocholanolone in patients with early breast cancer from South East Scotland and South Wales.

Urinary aetiocholanolone levels have been measured in 417 women aged between 20 and 70 years. The women were drawn from South East Scotland and South Wales and consisted of patients with either benign or malignant disease of the breast and control patients suffering from no detectable breast disorder. The pattern of aetiocholanolone excretion with respect to age and menopausal status has been defined in each group of patients. No significant differences in urinary levels have been detected between patients with breast disease, whether benign or malignant, and control patients. More detailed examination of the 201 women with early cancer of the breast has also shown that there is no consistent correlation between pre-operative aetiocholanolone levels and factors of prognostic significance detectable at the time of primary treatment-tumour size, grade, round cell infiltration, histological involvement of nodes by tumour and the clinical palpability of lymph nodes. It would seem, therefore, that the prognostic value of pre-operative aetiocholanolone measurements is somewhat limited in patients with early breast cancer. It is noted, however, that low levels of aetiocholanolone are associated with post-menopausal patients, a group in which the prognosis is generally poorer than that in pre-menopausal women.

Adenofibroma↗
PubMed1973

Local immunoglobulin production in breast cancer.

Immunoglobulin levels (IgA, IgG, IgM) have been estimated in protein extracts of 55 malignant and 20 benign tumours of the breast, and in 17 normal tissues from a cancer bearing breast. IgA and IgG were significantly reduced in cancer compared with both benign and normal tissues but IgM, detected in only a third of tumours, was significantly increased. Total immunoglobulin levels and IgG in the malignant tumours correlated with plasma cell infiltration.The menstrual status of the patient had no influence on these findings.

Adenofibroma↗
PubMed1972

Histology in breast cancer prognosis.

Histological sections of the primary tumour and of homolateral axillary lymph nodes from 500 women with operable invasive breast cancer have been examined. The tumours have been graded and the degree of round cell infiltration assessed. These features, together with clinical palpability and pathological involvement of axillary nodes, have been related to survival.It was found that prognosis was worse in patients with a high grade tumour and in those with histological evidence of axillary node spread. Round cell infiltration of the primary tumour did not confer improved survival.The clinical state of the axillary nodes was associated with prognosis in so far that palpable nodes were twice as commonly the seat of metastatic spread as were impalpable nodes.

Axilla↗
PubMed1971

Breast cancer grading.

Histological sections of the primary tumour from 496 women with operable breast cancer have been examined for purposes of histological grading by two observers working independently. Each found a similar distribution of grade through the series, and a virtually identical influence of grade on prognosis. This close agreement occurred despite a 30% disagreement as to grade in individual cases. It is suggested therefore, that this technique while of relevance to analysis of groups of cases is of very limited reliability in individual patient prognosis.

Breast Neoplasms↗