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Biomedical subjects

M Purcell

Publications and source records attributed to M Purcell.

49 records · Page 3Linked to original sources
PubMed1984

Diagnostic imaging in mediastinal thyroid tumor.

Various diagnostic imagings in nine patients with mediastinal goiters were presented. The clinical manifestations of these patients were various, from totally asymptomatic to severe dyspnea. Six of the nine patients underwent surgical intervention, three were follicular adenomas and three were nodular goiters. A chest radiograph (positive in seven out of nine patients) provided the most valuable initial localization of a goiter mass to the anterior, middle, or posterior compartment. Esophagograms (performed in four patients) showed compression of esophagus by the mediastinal mass. I-131 scintigraphy (performed in seven patients) was capable of detection of functional (in three patients) vs nonfunctional status of thyroid status (in four patients). Angiography (performed in five patients), characterized by anatomic continuity with cervical thyroid gland, calcifications, well-defined border of masses and/or contrast enhancement, offered important roles to direct a diagnosis of intrathoracic goiter. The computed tomography becomes increasingly important because all mediastinal goiters are not radioiodine avid.

Adenoma↗
PubMed1976

Unusual encephalitic illnesses in a child with acute leukaemia in remission: possible role of measles virus and Toxoplasma gondii.

We report a girl who developed an encephalitic illness with visual loss after two years treatment for acute lymphoblastic leukaemia. The visual loss was found to be due to bilateral macular degeneration. She later developed radiological evidence of intracranial calcification and temporal lobe epilepsy. A second episode of encephalitis occurred when she had been off all antileukaemic treatment for three years and this left her with a right hemiparesis. Investigation suggested involvement with both measles virus and Toxoplasma gondii as a cause for these illnesses.

Child↗
PubMed1976

Response in the newborn to raised upper airway resistance.

The effect of raising the airways resistance of 56 normal newborn babies by blocking alternate nostrils was studied by means of oesophageal intubation and the trunk plethysmograph. Increased resistance was associated with reduced respiratory rate and ventilation. A comparison was made of the response in different sleep states. In rapid eye movement (REM) sleep respiratory tidal volume decreased on blocking, there was no increase in the work of breathing and the fall in minute volume was greater than in non-REM sleep where tidal volume and minute work increased on blocking. These responses may be relevant to the sudden unexpected death syndrome in infancy, and to the management of normal newborns.

Airway Resistance↗
PubMedDate not supplied

Staff communication with people with intellectual disabilities: the impact of a work-based training programme.

Previous studies have identified changes that front-line service staff could usefully make to enhance their communications and those of their clients who have intellectual disabilities. These were incorporated into a training programme delivered in the workplace that involved a self-selected group of 24 experienced staff working either in small-scale residential settings and day centres. Analysis of video-recordings made before and after training showed that although most clients had become more active communicators (particularly when they were engaged in shared activities with staff), significant changes in staff behaviours as a whole were not observed. However increased responsiveness from staff did correlate significantly with increases in the client's communication acts. In addition, qualitative reports from staff and tutors pinpointed specific changes that staff had made. The difficulties of evaluating changes in staff-client communications are discussed and four features for training staff in communication are identified as essential; namely, it should be work-based, client focused, mentor-guided, and effective strategies documented and shared.

Adult↗
PubMedDate not supplied

Diabetic Charcot joint mimicking acute osteomyelitis in radiography and three-phase radionuclide bone imaging study.

Three phase radionuclide bone imaging procedures are used to differentiate cellulitis and osteomyelitis. Acute cellulitis is shown only as increased radioactivity in the blood flow and blood pool images; a persistent area of high activity in a delayed image is usually diagnosed as acute osteomyelitis. We present a patient with Charcot's joint secondary to diabetes mellitus whose three-phase bone imaging as well as radiographic studies revealed a consistent picture of acute osteomyelitis. In the appropriate clinical setting, Charcot's joint, along with several other etiologies (including bone tumors, leukemia, trauma, recent surgery, Paget's disease, and malunion of fracture), should be included in the differential diagnosis.

Arthropathy, Neurogenic↗
PubMedDate not supplied

99m-Tc HMDP bone scintigraphic findings of gouty arthropathy of both hands: extending soft tissue uptake adjacent to the joints.

The 99mTc hydroxy methylene diphosphonate scintigraphic findings of both hands are correlated to the radiographic findings in a patient with a 30-year history of gouty arthropathy. Scintigraphic differentiation of the type of arthritis on the basis of uptake pattern is difficult. However, the findings of rheumatoid arthritis are confined to the joints and usually the involvement is symmetrical. With gout there is a tendency toward asymmetrical, bilateral, multifocal joint involvement with areas of intense abnormal uptake; because of the associated soft tissue swelling, the intense uptake usually extends beyond the involved joints.

Arthritis↗
PubMedDate not supplied

Massive splenic metastases with localization of a skeletal imaging agent.

A 70 year old man with squamous cell carcinoma of the lung underwent Tc-99m sulfur colloid liver-spleen scintigraphy and abdominal CT studies; both studies showed multiple large lesions in the massively enlarged spleen, with a cystic appearance being noted on the CT examination. Two consecutive Tc-99m HMDP bone scintigrams demonstrated mild, diffuse radioactivity in the region of the spleen, indicating extraosseous localization of the bone imaging agent in the spleen and suggesting solid tumor masses rather than cysts. At autopsy, the huge spleen weighing 2,200 gm contained multiple, large, metastatic masses. Some of the masses were undergoing necrosis/liquification which would explain the cystic appearance on CT. While bone scintigraphy plays an important role in the detection of skeletal metastatic lesions, extraosseous localization of the imaging agent can provide additional diagnostic information.

Aged↗