Biomedical subjects
Publications and source records attributed to P O Mack.
Isolated splenic abscess is an uncommon condition. Seven cases seen between 1980 and 1990 are reviewed. The clinical presentation is non-specific and diagnosis is usually delayed. Computerized tomography allowed for accurate diagnosis in all cases. Pseudomonas species as a causative organism is reported to be rare, but were present in three of the present cases. Antibiotic therapy alone is insufficient and splenectomy remains the treatment of choice.
Gall-bladder conservation therapy has been evolving during the past decade. Popular techniques of conservative therapy are extracorporeal shock wave lithotripsy (ESWL) and medical dissolution therapy. The limitations of these procedures have prompted a search for alternative techniques, particularly in relation to percutaneous stone extraction. The cases of four patients with symptomatic gallstones who underwent percutaneous cholecystolithotomy under laparoscopic guidance are reported. The gall-bladder was punctured with a long needle and the tract dilated so that a nephroscope could be introduced. Three cases required stone fragmentation by an ultrasonic lithotripter before removal. Postoperative recovery was uneventful in all cases.
Retroperitoneal neurilemmomas are the rarest of all retroperitoneal tumours. A rare case of a very large benign retroperitoneal neurilemmoma is presented. Pre-operative diagnosis of these tumours is difficult and the majority are asymptomatic. They are usually detected as an abdominal mass on routine examination as in this case. Despite severe displacement and distortion of the inferior vena cava in this patient, there were no clinical abnormalities detected. The predominantly cystic nature of the tumour was well demonstrated by ultrasound and CT scan examination but the true nature of the tumour could not be diagnosed. It is very rare for these tumours to be malignant and recurrence after surgical excision is rare.
A simple laboratory method of investigating the metabolism of malignant tissues has been devised for liver cancer. The apparatus consists of a standard glass scintillation vial with an inner glass well suspended within it from a rubber lined cap. 14C-labelled glucose metabolised by the tumour tissue in the inner well into 14CO2 will be trapped by alkali in the outer vial, and the radioactivity quantified by liquid scintillation counting. The counts obtained will give a measure of the rate of tissue glucose oxidation. Application of this method to an animal liver tumour model has shown that the tumour tissue has a glucose oxidation rate of 2.8 times that of the host liver. The method is simple and versatile, can be adapted to various types of tissues, and may have potential clinical applications.