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Biomedical subjects

M F O'Brien

Publications and source records attributed to M F O'Brien.

At least 91 records · Page 5Linked to original sources

Red cell survival after Heterograft valve surgery.

Intravascular haemolysis was studied in 24 patients three to nine months after calf or pig valve heterografts had been inserted for severe valvular heart disease. No patient had haemolytic anaemia. In five of the 24 patients there was subclinical haemolysis, and in these five the haemolysis appeared to be related to residual aortic regurgitation or to the presence of other foreign material such as a Dacron aortic graft. The extent of postoperative haemolysis in these five patients was comparable to that observed preoperatively in patients with valvular heart disease.The results support the belief that, in contrast to artificial valve prostheses, heterograft valves behave similarly to human valves as regards haemolysis.

Adult↗

One-stage Fowler-Stephens orchidopexy for impalpable undescended testis.

BACKGROUND: The Fowler-Stephens orchidopexy (FSO) is a well-described treatment for high maldescended testes where the limiting factor for successful placement in the scrotum is short testicular vessels. The operation involves division of these vessels. The testicular blood supply is then dependent on collaterals from the vasal artery. AIMS: To assess the long-term outcome of patients who underwent this procedure in our institution. METHODS: The medical records of 20 patients who underwent 22 FSO from 1978 to 1999 by one urologist (HB) were reviewed. Outcome was assessed in terms of testicular position and size. RESULTS: Age at operation ranged from 2 to 14 years (mean 5.8 years). All patients had a one-stage FSO and in two of them the procedure was bilateral. In five patients, FSO was preceded by a diagnostic laparoscopy. Mean follow up was 22 months (range 0-121 months). Overall, results were considered good in 18 of 22 testes (82%). CONCLUSION: Our results for the one-stage FSO are comparable with other procedures for the management of high maldescended testis.

Adolescent↗

Should patients with a pre-operative prostate-specific antigen greater than 15 ng/ml be offered radical prostatectomy?

BACKGROUND: Patients with prostate cancer with a pre-operative prostate-specific antigen (PSA) >15 ng/ml who undergo radical retropubic prostatectomy (RRP) generally do not have a good outcome, yet may have organ-confined cancer and should be offered the option of surgery. AIM: To assess the outcome of patients who underwent RRP with a pre-operative PSA >15 ng/ml. METHODS: Thirty-four patients, mean pre-operative PSA: 25.46 ng/ml (15.03-76.6) and mean Gleason score: 6.4 (5-9) were assessed. RESULTS: Two groups were identified. Group I: 41% (14/34) have no biochemical recurrence to mean follow up of 58 months (30-106). Mean PSA: 18.8 ng/ml (15.03-25.84). Mean Gleason score: 6.1 (5-7). Clinical stage: T1c in 80%. No patient had seminal vesicle or lymph node involvement. Group II: 59% (20/34) have biochemical recurrence or died (3) from their disease to mean follow up of 66 months (36-98). Mean PSA: 28.9 ng/ml (15.28-76.6). Mean Gleason score: 6.7 (5-9). Clinical stage: T1c in 25%. Eleven patients had seminal vesicle (8) involvement or positive lymph nodes (3) or both (2). CONCLUSION: RRP seems feasible in patients whose pre-operative PSA is between 15 and 25 ng/ml with stage T1c, Gleason score < or = 7 and negative lymph node frozen section.

Adenocarcinoma↗

Mesenteric cysts--a series of six cases with a review of the literature.

BACKGROUND: Symptomatic mesenteric cysts account for only 1 in 100,000 acute adult and 1 in 20,000 acute paediatric admissions. Acute symptoms are related to compression of intra-abdominal organs or stretching of the mesentery by rapid expansion. An abdominal mass, mobile in transverse but not longitudinal plane, is often the only physical finding. METHOD: We outline the presentation, management and histological findings of 6 cases that presented to this hospital from 1987-1997. RESULTS: There were 5 adults aged 32-79 yr and an 8 yr old boy. The child presented acutely with a painful tender abdominal mass. Of the adults, 1 presented acutely, 2 with chronic symptoms and 2 were incidental findings. Mesenteric cysts were successfully resected in all cases. CONCLUSION: Surgical intervention is recommended and resection of adjacent bowel may be necessary for complete excision. Successful minimal access surgery via the laparoscope has been reported and may become more widely applicable.

Adult↗