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Biomedical subjects

J E Boultbee

Publications and source records attributed to J E Boultbee.

14 recordsLinked to original sources
PubMed1992

Doppler assessment of the uterine circulation and the clinical behaviour of gestational trophoblastic tumours requiring chemotherapy.

The haemodynamics of the uterine arteries and myometrium were assessed using Doppler ultrasound in forty consecutive patients requiring treatment for invasive mole and choriocarcinoma. The investigations were performed prior to the commencement of chemotherapy and the subjects followed prospectively. The Doppler waveforms from the uterine arteries were analysed using the pulsatility index. It was found that patients with a pulsatility index of 1.1 or less were significantly more likely to develop drug resistance than those with a higher value (P < 0.04). There was no significant association between the pulsatility index and metastatic disease or uterine bleeding. Five out of eight patients who developed drug resistance could have avoided initial inadequate treatment if the Doppler findings were included in the scoring system for selecting chemotherapy for these tumours. It can be concluded that assessment of the uterine arteries using the pulsatility index prior to the treatment of patients with invasive mole and choriocarcinoma is of help in predicting those who will develop drug resistance.

Arteries↗
PubMed1990

Noninvasive monitoring of renal blood flow characteristics during acute renal failure in man.

Duplex Doppler ultrasound (DDU) was used to study the blood flow characteristics of the renal interlobar artery in 20 subjects with acute renal failure (ARF), 14 subjects with transient impairment of renal function and 23 control subjects with normal function. Renovascular resistance was assessed by pulsatility index (PI) and change in flow velocity by change in mean frequency shift (delta f). The 99% confidence intervals for PI in the three groups were 3.32-5.46, 1.58-2.34 and 0.99-1.33 respectively. Values for delta f were 0.2-0.38, 0.5-0.62 and 0.7-1.02 kHz respectively. Ten ARF patients recovered function, 99% confidence intervals for PI just prior to recovery were 0.9-1.48 and for delta f 0.52-1.02 kHz. There was increased renovascular resistance and reduced intrarenal blood flow velocity at the onset of ARF. These changes persisted during ARF; recovery of function occurred after they returned to normal. Similar, but less marked, changes were found in patients with a transient impairment of function.

Acute Kidney Injury↗
PubMed1990

Preliminary Doppler studies on the uterine artery and myometrium in trophoblastic tumours requiring chemotherapy.

The uterine circulation in 38 patients with invasive mole or choriocarcinoma were investigated using Doppler ultrasound. Twenty-six non-pregnant and 23 pregnant volunteers were assessed in a similar fashion to act as control groups. The pulsatility indices were significantly lower in the patients with trophoblastic disease when compared with the non-pregnant and pregnant groups (Student's t-test; P less than 0.001 and P less than 0.02 respectively). The uterine circulation in persistent trophoblastic diseases shows a characteristic Doppler profile suggesting the presence of large low resistance blood vessels. This may be useful in the initial assessment of these tumours before cytotoxic chemotherapy.

Adult↗
PubMed1990

Ultrasonic morphology of the uterus and ovaries after treatment of invasive mole and gestational choriocarcinoma.

Ultrasound imaging of the uterus and ovaries was performed on 41 patients after completion of apparently successful cytotoxic chemotherapy for invasive mole and choriocarcinoma. Uterine volume was calculated and the echopattern of the uterus and ovaries assessed. Forty-nine per cent of subjects had an abnormal uterine appearance and 20% had ovarian theca-lutein cysts. Two patients relapsed on follow-up but no predictive ultrasonic features could be established on uterine or ovarian morphology after chemotherapy.

Antineoplastic Agents↗
PubMed1989

Practical use of duplex Doppler analysis of the renal vasculature in critically ill patients.

Duplex doppler examination of blood flow in renal interlobar arteries was analysed in twelve critically ill patients before and during low-dose dopamine infusion (2 micrograms/kg/min). Renal vasodilatation and increased blood flow were observed with dopamine, confirming results with indirect or invasive techniques. The doppler ultrasound technique is entirely non-invasive, is simple and quick to carry out, provides instant results, and will allow tailoring of inotropic support in critically ill patients to provide optimum renal blood flow.

Blood Flow Velocity↗
PubMed1989

Doppler time velocity waveform studies of the uterine artery and uterus.

This study describes a reliable and reproducible method of obtaining Doppler frequency shift waveforms from the uterine artery based on observations in 26 non-pregnant women. The waveforms were detected easily but direct display of the vessel was inconsistent. The values of the pulsatility index calculated from the waveforms had a mean of 3.25 (SD 0.83). The standard error of the mean was 0.16 and based on this, the 95% reference range was 1.21 to 5.29. The stage of the menstrual cycle did not affect the pulsatility index nor was there any significant difference between subjects who were nulliparous and those who had had previous pregnancies. These results show that Doppler ultrasound can be applied to the non-pregnant uterus and the data presented may be used as a baseline for the study of uterine pathology.

Adult↗
PubMed1979

Experiences with grey scale ultrasonography in hepatic amoebiasis.

Ultrasound examination was conducted in 151 proven cases of amoebic liver abscess. In the majority of patients the lesion was solitary but 25% of patients had multiple lesions; 17% of all the abscesses were in the left lobe of the liver. Most abscesses had no, or very few internal echoes and these were either of the same density as the normal liver (15%) or less dense (84%). In all cases there were relatively fewer echoes in the lesion. Abscesses in critical areas were accurately located especially in relation to the pericardium. Other liver lesions such as hepatoma which may enter into the clinical diagnosis can be recognised. Ultrasound has particular value in accurate localisation of the lesion for aspiration, demonstration of unsuspected multiple abscesses and size estimation in serial studies of the patient under treatment. The diagnostic errors were mainly due to initial inexperience and demonstrated some of the diagnostic pitfalls. It is concluded that the introduction of this technique has proved to be of considerable value in the diagnosis and management of amoebic liver abscess in our area, where the disease is still a major clinical entity. If diagnosed early and treated adequately the condition has an excellent prognosis.

Biopsy, Needle↗
PubMed1979

Grey scale ultrasound appearances in hepatocellular carcinoma.

Thirty patients with histologically proven hepatocellular carcinoma were examined ultrasonically. All except two of these cases were reported ultrasonically as having a solid mass. Forty-three per cent of these lesions appeared multiple and 90% had irregular walls or boundaries. Stretching or distortion of the inferior margin of the liver is considered significant and 53% of cases demonstrated this feature. Just over two-thirds (67%) of the lesions were echogenic and under one-third (27%) were mixed lesions with echogenic and transonic areas. These transonic areas are considered to be due to the necrosis within the tumour. Most patients presented late and died within three months. Ninety per cent had clinical hepatomegaly or an epigastric mass. So far the main benefits of ultrasonography have been the recognition or exclusion of treatable disease such as liver abscess, cysts and congestive conditions of the liver, which may also present with unexplained hepatomegaly or epigastric masses. The possibility of a recognisable echo pattern for hepatocellular carcinoma emerged from this study. By conducting selective ultrasonic surveys in endemic areas and by employing the ultrasonic criteria described early diagnosis may be possible. Aspects of management and research may be assisted.

Adult↗