PubMed Health⌕ Search

Biomedical subjects

R Macfarlane

Publications and source records attributed to R Macfarlane.

53 records · Page 3Linked to original sources
PubMed1989

Surgery for recurrent colorectal carcinoma--is it worthwhile?

A series of 45 patients undergoing a second operation for recurrent colorectal cancer is reported. The majority developed recurrence within 2 years of their initial surgery. Despite regular follow-up, in only 27% of patients submitted to further surgery was the recurrence detected at routine review, and only three of these were asymptomatic at the time of diagnosis. A potentially curative second procedure was undertaken in 47% of cases, with a 2-year survival of 71% and a 5-year survival of 29%. Of those undergoing palliative surgery, this was worthwhile in 64%, providing palliation for more than 6 months. Mean survival following a palliative procedure was 10 months. Palliation was better, and operative mortality lower, when the bulk of the tumour could be removed. In obstructed patients the outcome following palliative resection was better than for palliative bypass procedures. Following resection of metastases there is the prospect of long-term survival, but it is difficult to predict those patients who will do well.

Adult↗
PubMed1989

Tumours of the pineal region.

Tumours arising in the region of the pineal gland provide a considerable challenge in treatment because of their diversity and location. In this article the anatomy and physiology of the pineal gland are considered, together with the pathology of its tumours, their presentation and management.

Antineoplastic Agents↗
PubMed1988

Villous tumours of the large bowel.

A series of 110 patients with villous tumours of the colon and rectum treated by a single surgeon over an 18-year period is reported. Multiple lesions were present in 15 per cent of patients and 24 per cent of cases contained invasive malignancy, of which 83 per cent were Dukes' A. The major lesion was in the rectum in 84 per cent of patients and in the sigmoid colon in 12 per cent. Rectal bleeding and diarrhoea were the most common presenting symptoms; 6 per cent of patients were asymptomatic. Digital assessment proved a more reliable indicator of the presence of malignancy than either random biopsy or barium enema. In all, 70 of 76 (92 per cent) benign rectal lesions and 15 of 22 (68 per cent) malignant rectal lesions were successfully removed by peranal submucous excision or snaring and none of the malignancies so treated has developed a recurrence to date. Benign recurrence has developed in 13 per cent of all patients; the majority appeared within 4 years and were at the same level as the initial lesion. Of the 79 patients with benign tumours 7.6 per cent have subsequently developed large bowel carcinomas, after 2-16 years; all were symptomatic, half were at the same level as the previous benign lesion, and half were suitable for peranal removal.

Adenoma↗
PubMed1988

Symptoms arising from Double-J ureteral stents.

We investigated whether use of the Double-J ureteral stent causes untoward symptoms and complications. Of 20 patients evaluated by questionnaire 18 suffered 1 or more symptoms in the upper (for example loin pain) or lower (for example dysuria and frequency) urinary tract in the absence of infection. Despite the undoubted benefit in many patients, troublesome symptoms are common. We recommend early removal of the stents but we cannot implicate any correctable technical factors.

Abdomen↗
PubMed1987

Traumatic rupture of the diaphragm.

Diaphragmatic disruption is an uncommon consequence of blunt trauma and is easily overlooked unless a high index of suspicion is maintained. The diagnosis is important because of the high incidence of associated organ damage and the complications of a missed injury. This article outlines the clinical features and management of the condition.

Abdominal Injuries↗
PubMed1987

Colovesical fistula.

The experience of 66 cases of colovesical fistula is reported. The most common cause was diverticular disease (71%), the remainder being due to malignancy, Crohn's disease, radiotherapy, appendicitis and trauma. The most sensitive investigation was barium enema, which was abnormal in 98% and actually showed the fistula in 57%. In 32 patients a single stage resection was performed, without mortality or significant morbidity and we would advocate this form of treatment for fistulae which are not complicated by gross sepsis or obstruction.

Colon↗
PubMed1985

Are varicose veins and coronary artery bypass surgery compatible?

In 35 legs being operated on for varicose veins a venogram showed that the part of the long saphenous vein below the knee does not undergo varicose dilatation. In 7 of the 9 examined postoperatively this segment remained patent after the vein above was stripped. Varicose veins resulting from saphenofemoral incompetence can be treated surgically by stripping the long saphenous vein only to the knee and yet still leave a non-varicose segment for future coronary artery bypass grafting.

Coronary Artery Bypass↗
PubMed1985

The management of liver trauma.

Despite advances in the management of liver trauma during the past 40 years, haemorrhage has remained the commonest cause of death. This article outlines the diversity of opinion between the desire to determine the extent of damage and resect devitalised tissue with its attendant risk of exacerbating haemorrhage, and the alternative of a more conservative approach.

Hemorrhage↗
PubMed1985

Popliteal artery entrapment syndrome.

Popliteal artery entrapment syndrome (PAES) is caused by an abnormal anatomical relationship between vessels and muscle within the popliteal fossa. This may result in compression and ultimately thrombosis of the popliteal artery. Awareness of the condition is probably the most important factor in making the diagnosis. This article reviews the clinical features and management of PAES, with observations from personal experience of several cases.

Angiography↗
PubMedDate not supplied

[Development of a multiple PCR method for the identification of Ureaplasma parvum and Ureaplasma urealyticum].

Ureaplasma parvum and Ureaplasma urealyticum, also known as biovar parvum and biovar T960, respectively, could be associated with several disorders in men, women, and mainly, in newborn children with under weight. Several methods have been developed in order to identify the species or biovars of ureaplasmas. We developed a Multiplex-PCR method using the UPS-UPSA and UUS2-UUA2 primers, specific for U. parvum and U. urealyticum, respectively. This Multiplex-PCR method was used to identify cultures of clinical positive samples to Ureaplasma spp. by the "MYCOFAST Evolution-2" Kit. Of 56 positive cultures to Ureaplasma spp. from newborn children, 70% were U. parvum and 30% U. urealyticum; in 76 positive samples in women, 83% corresponded to U. parvum and 17% to U. urealyticum, while in 63 positive samples of men, 76% identified U. parvum and 24% U. urealyticum. The PCR-multiplex method showed specificity for the identification of the biovars or species of ureaplasmas of clinical interest.

Adult↗
PubMedDate not supplied

The natural history of a recurrent central neurocytoma-like tumor.

The central neurocytoma was first recognized as a distinct entity in 1982. The original description was of a low grade, intraventricular neoplasm composed of uniform cells showing neuronal differentiation, and having a very favorable prognosis after surgery. Subsequently rare cases have been described showing malignant histological features but retaining the morphological characteristics that justify inclusion in this category. The behavior of such cases has yet to be determined. We report a case of a longstanding intraventricular tumor showing neuronal differentiation in which repeated recurrences following surgery have revealed evidence of increasing nuclear pleomorphism, mitotic activity and glial differentiation. We suggest that this tumor broadens further the clinical and pathological spectrum of central neurocytoma.

Adult↗