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Biomedical subjects

J E Shevland

Publications and source records attributed to J E Shevland.

13 recordsLinked to original sources
PubMed1993

Ultrasonography of the pancreas in patients with multiple endocrine neoplasia type I.

Fifty-seven patients with the multiple endocrine neoplasia type I (MEN-1) syndrome underwent sonographic examinations, and focal pancreatic lesions were demonstrated in 18 (33%). Size ranged from 5 to 65 mm in diameter, and multiple lesions were seen in five patients. Eight patients with pancreatic lesions less than 20 mm have been followed over a period of 1 to 6 years. Of these eight patients, only one had a lesion that increased in size. Ultrasonography was able to detect asymptomatic pancreatic tumors in a higher proportion of MEN-1 patients than previously. Sonography is a useful method of detecting islet cell tumors greater than 5 mm in diameter and is able to follow up these lesions to assess increase in lesion size and number.

Adenoma, Islet Cell↗
PubMed1985

Value of hepatic computerized tomographic scanning during amiodarone therapy.

Amiodarone therapy is difficult to monitor because of the poor correlation between plasma amiodarone levels and clinical efficacy or toxicity. Monitoring tissue levels may give a better measure of effectiveness, but tissue levels cannot be easily measured. The iodine-containing amiodarone and its major metabolite, desethylamiodarone (DA), are highly tissue-bound, and it has been shown that computerized tomographic (CT) scanning of the abdomen will detect drug deposition in the liver. Ten patients receiving chronic amiodarone therapy were studied by abdominal CT scanning. Liver CT density was increased in 6; 68 to 94 CT units (normal 50 to 65) and liver/spleen relative CT density increased in 5; 1.4 to 2.0 (normal 1.0 to 1.3). Estimates of liver drug levels (based on a calibration curve with inorganic iodide) gave values of up to 3 g of amiodarone and DA per kilogram weight of liver. Absolute and relative liver CT density correlated significantly with plasma levels of DA (r = 0.65, p less than 0.05), but not with amiodarone (r = 0.55, p less than 0.1). No significant correlation was found with QTc intervals. This indirect estimate of liver deposition of amiodarone and DA may prove useful in guiding antiarrhythmic therapy.

Aged↗
PubMed1985

Echocardiographic features of a mediastinal pancreatic pseudocyst.

Cross sectional echocardiography detected a mediastinal pancreatic pseudocyst which caused extracardiac compression in a 49 year old man. Computed tomography confirmed the presence of a cystic lesion lying behind the heart and extending from the pancreas to above the carina. Surgical decompression resulted in resolution of the clinical and echocardiographic findings.

Echocardiography↗
PubMed1985

Superior vena caval obstruction: an analysis of seventy-six cases, with comments on the safety of venography.

Seventy-six cases of superior vena caval obstruction (SVCO) were documented in the period 1970-1980. There were 53 males and 23 females, with a mean age of 61.7 years. The underlying causes were:- Lung cancer, 64/76, 84.2%; Metastatic disease, 4/76, 5.3%; Lymphoma, 4/76, 5.3%; Benign aetiology, 2/76, 2.6%; Undiagnosed, 2/76, 2.6%; 97.4% of the cases were due to malignancy. Of 61 patients on whom follow-up is available, only one is alive. Eighty-two percent of this group died within one year following the onset of SVCO. Autopsies were performed on 17 patients. Nine of these (52.9%) showed invasion of the superior vena cava, 6 (35.3%) showed compression without invasion, and 2 (11.8%) showed neither compression nor invasion following Radiotherapy. Venography was performed on all patients with only one minor complication being recorded.

Carcinoma, Small Cell↗
PubMed1983

Lobar collapse in the surgical intensive care unit.

The chest X rays of 200 consecutive patients in the surgical Intensive Care Unit were reviewed. Eighteen cases of lobar collapse were diagnosed in 17 patients (8.5%) with a high degree of certainty. Most cases involved the left lower lobe (12/18, 66%), but collapse of the right lower lobe (4/18, 22%) and the right upper lobe (2/18, 11%) was also noted. Although theories have been postulated to account for the high incidence of left lower lobe collapse following cardiac surgery, the predominance of left lower lobe collapse generally amongst ICU patients is not fully explained.

Child↗
PubMed1981

Accuracy of computed tomographic scanning in assessment of the mediastinum in bronchial carcinoma.

We believe that malignant involvement of mediastinum is a contraindication to attempted resection of bronchial carcinoma. It was hoped that computed tomographic (CT) scanning might improve our ability to assess the mediastinum prior to thoracotomy. The accuracy of CT scanning, performed with modern techniques, in assessment of the mediastinum of 22 patients with bronchial carcinoma has therefore been determined. In all the patients CT scan impressions have been correlated with the histologic findings at thoracotomy or mediastinoscopy. In detection of malignant involvement of the mediastinum, the CT scan had a sensitivity of 80% and a specificity of 76%. There was only one false negative CT scan report, and in this case the mediastinum was involved at a site which could not have been inspected at anterior cervical mediastinoscopy. We conclude that a negative CT scan makes mediastinoscopy an unnecessary screening procedure in determining resectability. Since there was a significant number of false positive CT scans, we feel that such a report necessitates tissue confirmation before the decision to withhold thoracotomy is made. The CT scan may help to determine the best test to achieve this tissue confirmation.

Bronchial Neoplasms↗