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Biomedical subjects

R Barry

Publications and source records attributed to R Barry.

At least 37 records · Page 2Linked to original sources
PubMed1993

Duplex Doppler investigation of suspected vascular lesions at the carotid bifurcation.

This prospective study was undertaken to evaluate the role of duplex Doppler (DD) scanning in the diagnosis of masses of suspected vascular origin at the carotid bifurcation. We also assessed the different DD signs of carotid body tumors, especially the difference in resistance index (RI) in the external carotid artery on the side of the tumor. Over a 3-year period (1987-1991) all patients (n = 50) with masses of suspected vascular origin at the angle of the mandible underwent DD investigation. The clinical diagnoses included carotid body tumors and carotid bifurcation area aneurysms. Arteriography was also performed in all patients. DD examination diagnosed carotid body tumors in 11 patients, aneurysms in 5, nonvascular lesions in 11, carotid artery kinks in 10, and a prominent carotid bifurcation in 13 patients. In 23 of 50 patients (46%) no pathology (kinks and prominent vessels) was present. DD imaging proved to be 100% accurate in diagnosing these lesions as determined by arteriography. The DD findings in carotid body tumors demonstrated a "wineglass" bifurcation containing a lesion with echoes as well as pronounced and turbulent multidirectional flow ("hypervascular tumor flow"). Low-resistance flow was present in the external carotid artery in 80% of patients, indicating the blood supply of the tumor. Patients with lumps of suspected vascular origin at the carotid bifurcation should be initially investigated by DD examination, which can accurately exclude the diagnosis of carotid body tumors and carotid aneurysms and clearly eliminate arteriography in these patients.

Aneurysm↗
PubMed1992

Changes in penile skin blood flow following intracavernosal injection of papaverine.

Marked changes in penile skin blood flow following intracavernosal injection of papaverine were observed in 14 subjects. Increased flow was more pronounced in those patients who failed to achieve erection or had poor erection than in those who responded with adequate erection. This observation may explain in part why papaverine fails in subjects responding to prostaglandin E1. It raises the suspicion of a corporal cutaneous shunt, which may influence the choice between the use of an external vacuum device and venous surgery in certain cases of venogenic impotence.

Adult↗
PubMed1992

Experience with a provocative test of calcitonin release as a prospective screening for preclinical medullary thyroid carcinoma in MEN type 2A family members.

We report our experience with a provocative test of calcitonin (CT) release using a combined stimulus of intravenous 10% CaCl2 solution and pentagastrin on 34 normal adults (15 females: age 41 +/- 12.3 years and range 22-65 years; and 19 males: age 43 +/- 9.1 years and range 23-60 years) and in 44 family members of three proven multiple endocrine neoplasia type 2A syndrome (MEN 2A) patients. A commercial radioimmunoassay was used to determine the serum CT levels. Peak CT levels were reached within 2 to 5 minutes after administration of the stimulus in all subjects tested. In the group of normal subjects there was no significant difference in the mean basal CT levels between males (54.8 +/- 21.7 pg/ml) and females (56.5 +/- 34.8 pg/ml), whilst the mean peak response values for males was 146.3 +/- 120.6 pg/ml, which was significantly different from the mean value of females, namely 71.6 +/- 39.0 pg/ml. We did not find significant correlations between the basal CT level, peak CT response, and age. Of the 44 family members tested, 9 showed an exaggerated CT response to the combined stimulus and subsequently had a total thyroidectomy. Histological examination confirmed C-cell hyperplasia (CCH) in one and medullary thyroid carcinoma (MTC) in the other 8. Three of the 9 had high basal plasma CT levels. The 9 patients were retested postoperatively and all showed a flat response to the combined stimulus. Those family members with histological proof of MTC or CCH were screened for genetic linkage to the disease gene for MEN 2A using probe MCK2, and showed correlation in each instance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Early thyroidectomy for medullary thyroid carcinoma in children and young adults with the multiple endocrine neoplasia type 2A (MEN 2A) syndrome.

A South African family, at risk for the multiple endocrine neoplasia type 2A (MEN 2A) syndrome, was identified. The Bloemfontein MEN Study Group was founded, inter alia, to study the effects of early detection of medullary carcinoma of the thyroid (MTC) and treatment by total thyroidectomy in children and young adults with MEN 2A. Genotypes were identified by DNA probe and MTC diagnosed by basal and stimulated calcitonin levels. Between 1986 and 1989, 10 members of the family underwent total thyroidectomy and central lymph node dissection for MTC. There were 6 female and 4 male patients (mean age 22,0 years; range 10 - 35 years). Histological examination of the resected thyroid revealed MTC in all patients; 8 had bilateral disease and 2 unilateral. Lymph nodes were negative for MTC in all patients. None of the patients suffered injury to the recurrent nerve, while 1 experienced transient hypoparathyroidism postoperatively. Replacement therapy is maintaining thyroid hormone levels in all patients. Screening should probably begin at the age of 1 year, and total thyroidectomy should be performed when an elevated calcitonin level is observed.

Adolescent↗
PubMed1991

The development of psychological well-being in late adolescence.

Studies following adolescents from school to work indicate a sharp decrease in psychological symptoms over the 16-17-year period compared to a more gentle decrease subsequently. This could be a genuine developmental phenomenon, related to school leaving, or because anxiety levels are higher at age 16 years due to approaching examinations. The present study examined these hypotheses. GHQ scores for those at school were related to examination candidacy. Eighteen months later such differences had disappeared among those young people now in full-time employment. Similarly, a group who remained in full-time education also showed a significant decline in GHQ scores.

Adaptation, Psychological↗
PubMed1990

Atherosclerosis--multi-organ involvement the rule rather than the exception.

Atherosclerosis is a systemic disorder and significant lesions often occur in organ systems other than the symptomatic area. Three groups of patients, those admitted to hospital with either coronary artery disease, carotid artery stenosis or peripheral vascular disease, were examined for concomitant atherosclerotic lesions. Non-invasive tests, namely duplex scanning of the carotid arteries, arm ergometer exercise testing, and segmental pressure of the limbs, were used during evaluation. A clear association between ischaemic heart disease, carotid artery stenosis and femoropopliteal disease was found. Women appear to be more prone to multi-organ involvement than men; their higher average age on admission to hospital is a possible explanation for this in some cases, but not all.

Adult↗
PubMed1990

Accuracy of B-mode ultrasonography in detecting carotid plaque hemorrhage and ulceration.

A prospective study comparing the accuracy of B-mode ultrasound with evaluation of gross appearance in detecting plaque hemorrhage and ulceration is reported. Ultrasonography was performed on 78 vessels in 66 patients undergoing carotid endarterectomy. Carotid bifurcation atheroma were classified ultrasonographically as smooth, irregular, or ulcerated. Sonolucent areas were considered to be plaque hemorrhage. Analysis of carotid plaques removed at operation included macroscopic and microscopic findings. Duplex Doppler was only 44% sensitive but 78% specific for plaque hemorrhage. If all irregular atheroma were considered ulcerated, the sensitivity of Duplex Doppler was 81% with specificity only 33%. If only lesions with a clearly visualized crater were considered ulcerated, B-mode ultrasound was 85% specific but only 17% sensitive. False B-mode ultrasound diagnoses of ulceration were mainly due to culs-de-sac or pits in fibrotic plaque that looked like ulcers. Ulceration was not noticed on B-mode when there was a two-dimensional problem or calcification with shadowing. False B-mode diagnoses of plaque hemorrhage were due to atheromatous debris, ulcerated plaque hemorrhage, or calcification. Problems still exist in the B-mode ultrasound diagnosis of carotid plaque hemorrhage and ulceration.

Adult↗
PubMed1988

New monoclonal antibodies reactive with defined sequential epitopes in human myelin basic protein.

Three new IgG monoclonal antibodies are described which recognise sequential epitopes of the human myelin basic protein (MBP) molecule in amino acid sequences 36-50, 64-75 and 80-89. Two of the secreting hybridomas were prepared by immunisation of mice with synthetic peptides. This procedure appears to generate antibodies of similar affinities to those made using intact myelin basic protein as the immunogen. It has the advantage that antibodies to preselected regions of the molecule can be made at will and the problem of subsequent epitope localisation is simplified. It is possible with synthetic peptides to generate antibodies of specificities which it would be impossible to achieve by immunisation with intact myelin basic protein. The monoclonal antibodies described here should be useful tools in studies of myelin catabolism in vivo and in vitro. Of particular interest is our Clone 22, making an antibody which reacts equally well with intact human MBP and synthetic peptide sequence 80-89 in liquid phase assays. Antibodies of this rare specificity have been claimed to be able to react with the peptides of myelin basic protein found in the spinal fluid of patients with multiple sclerosis.

Antibodies, Monoclonal↗
PubMed1987

Comparison of duplex Doppler scanning with contrast angiography in carotid artery disease.

The results of ultrasonic pulsed Doppler duplex scanning with spectral analysis were compared with the results of contrast arteriography in 37 patients screened for extracranial carotid artery disease. The kappa value for this comparison was 0.476 +/- 0.149. The overall diagnostic accuracy of duplex scanning was 91% (67/74 vessels) for agreement within one category of true assessment of stenosis. All 5 occluded internal carotid arteries were identified correctly by duplex scanning. Duplex scanning of the internal carotid artery is one of the few noninvasive tests that has the capability of discriminating normal arteries from minimal disease, minimal disease from severe disease, and severe disease from occlusion. Duplex scanning should be used as the initial test in patients with non-hemispheric symptoms and complete stroke. The intra-operative and postoperative routine assessment of the endarterectomised segment has become mandatory. Duplex scanning is invaluable in the management of the patient with an asymptomatic carotid bruit.

Adult↗
PubMed1986

C3 nephritic factor in an individual with recurrent viral infection and lipodystrophy.

A patient with nephritic factor in the serum following an attack of disseminated herpes is described. In the majority of cases, the factor is associated with mesangio-capillary glomerulonephritis, with or without partial lipodystrophy. It has, however, been described in cases of partial lipodystrophy alone, in one patient with recurrent pyogenic infections, and in one healthy individual. It has not previously been described in an individual with disseminated viral infection.

Adult↗