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Biomedical subjects

L N Murthy

Publications and source records attributed to L N Murthy.

8 recordsLinked to original sources
PubMed1999

Intravenous urography in urinary tract surveillance in carcinoma of the bladder.

AIMS: The need for intravenous urography (IVU) in upper tract surveillance for primary transitional cell carcinoma (TCC) of the bladder is contentious. We reviewed our intensive screening policy in the follow-up of these patients to ascertain if such a policy is required and if specific groups could be identified to rationalise this protocol. METHODS: Review of the clinical and radiological data on 174 patients with a diagnosis of primary TCC of the bladder attending a teaching hospital urology department. RESULTS: Eight upper tract 'lesions' were identified: six TCC and two false-positive examinations using IVU. No link was demonstrable between upper tract recurrence and tumour stage, grade or multiplicity at diagnosis. All had recurrent bladder tumour but four of the six upper tract tumours occurred at 72 months or later. Twenty-nine patients over the study period developed either a dilated pelvi-calyceal system or a non-functioning kidney detected on IVU. CONCLUSIONS: Upper tract TCC can present late and patients with early bladder recurrence and those who do not show a reduction in bladder tumour number at follow-up cystoscopy are most at risk. IVU can probably be safely abandoned in those without local recurrence at 24 months. IVU is sensitive but not specific for upper tract tumour but also yields other relevant clinical information concerning the renal tract. Screening for upper tract metachronous disease should therefore be confined to those with recurrent transitional cell carcinoma of the bladder.

Adult↗
PubMed1995

The use of duplex ultrasound in the assessment of arterial supply to the penis in vasculogenic impotence.

Impotence may be caused by arterial disease affecting the vessels supplying the corpora cavernosa. Color duplex ultrasound was used to measure the peak systolic velocity and systolic rise time in the deep penile arteries in 22 impotent men following papaverine stimulation. The results were compared with the findings of selective internal pudendal pharmaco-arteriography. A further comparison was made using color duplex ultrasound with 37 impotent men who all responded well to papaverine. A systolic rise time of 110 msec. or more was found to be the best discriminant of disease in the arteries supplying the corpora giving a positive predictive value of 0.92. A long systolic rise time in a papaverine responder may indicate that the arterial supply is borderline or that the arterial flow is maximal and that the problem lies on the sinusoidal-venous side. It appears that in the absence of a pathological condition there is a large surplus arterial supply.

Adult↗
PubMed1993

Evaluation of "Gastromiro" for bowel opacification during computed tomography: comparison with diatrizoate and barium sulphate.

A new oral formulation of iopamidol, "Gastromiro", was evaluated as a bowel contrast agent during abdominal computed tomography (CT). Comparison was made with the well established agents sodium/meglumine diatrizoate ("Urografin 370") and dilute barium sulphate ("E-Z CAT") in a randomized, blind study of 150 consecutive patients undergoing abdominal and/or pelvic CT. Parameters assessed included quality of bowel opacification, artefact generation, contrast-medium palatibility, side effects and cost. No significant difference was found between the three contrast media in stomach- or small-bowel opacification. E-Z CAT was superior at opacifying the caecum/ascending colon. No compelling reason to choose a particular agent was found in the other assessed parameters, but cost is a significant factor.

Administration, Oral↗
PubMed1991

Plasma osmolality, iodine concentration and urographic images following high and low osmolar contrast media.

Three contrast media (sodium iothalamate, iopamidol and sodium/methylglucamine ioxaglate) in a dose of 240 mg iodine per kilogram of body weight were compared in clinical urography. The ionic monomer sodium iothalamate was the only medium to significantly elevate the plasma osmolality though it returned to normal values within 4 min. All three media exhibited first order linear kinetics. When corrected for the effects of diuresis, sodium iothalamate was shown to give the highest urinary iodine concentrations. On visual scoring sodium iothalamate produced better nephrograms and overall urograms than either of the low osmolar agents.

Contrast Media↗
PubMed1990

Percutaneous transluminal angioplasty of the innominate, subclavian, and axillary arteries.

Percutaneous balloon angioplasty offers an alternative to surgery for the alleviation of symptoms in upper limb arterial disease. This report documents 28 per-femoral dilatation procedures in 27 patients for 33 subclavian, two innominate, and two axillary lesions. Thirty-four stenoses and three occlusions were treated, with multiple dilatations in five patients. Indications for treatment were: arm ischaemia (15 patients); neurological (steal syndrome) symptoms (8); and combined ischaemia plus steal (5). Angioplasty was technically successful in 27 procedures with symptomatic relief in 25 cases up to a mean follow-up of 24 months (median 20 months, range 2-90 months). One patient had successful repeat angioplasty for recurrent ischaemic symptoms after 30 months. Angioplasty improved pulse deficits in all but two patients and reduced arm blood pressure differential to less than 30 mmHg in all but three patients. There were three complications: a femoral artery occlusion and a groin haematoma required surgical intervention and another patient suffered an extension of a contralateral stroke. Percutaneous balloon angioplasty has proved safe and effective. We recommend angioplasty as the first line treatment for ischaemic or neurological symptoms in upper limb vascular disease.

Angioplasty, Balloon↗
PubMed1984

Extrarenal arteriovenous fistula. An unusual complication of percutaneous renal transplant biopsy.

A percutaneous allograft biopsy in a renal transplant recipient with declining function was followed by haemorrhage from the external iliac artery requiring repair of the puncture site. A common iliac arteriogram performed subsequently showed an external iliac arteriovenous fistula. In retrospect, an isotope scan performed at 48 h post-transplant, showed the upper pole of the graft overlying the iliac vessels. To avoid such complications we recommend a careful assessment of the anatomical relationships of the transplant kidney to major blood vessels prior to biopsy.

Adult↗