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Biomedical subjects

S C Rankin

Publications and source records attributed to S C Rankin.

At least 19 recordsLinked to original sources
PubMed2001

Noninvasive imaging of living related kidney donors: evaluation with CT angiography and gadolinium-enhanced MR angiography.

OBJECTIVE: This study was performed to determine whether noninvasive imaging with CT angiography and MR angiography in the preoperative investigation of living, related kidney donors provides sufficient information for the surgeon. MATERIALS AND METHODS: Eighty consecutive potential living kidney donors were investigated. Fifty patients underwent CT angiography and 30 underwent MR angiography before donor nephrectomy. CT was performed using 3-mm collimation with a pitch of 1.6 after the injection of 150 mL of nonionic contrast medium. The axial data, multiplanar reconstructions, and maximum intensity projections were reviewed. MR angiography was performed on a 1-T magnet using a contrast-enhanced three-dimensional gradient echo technique. Maximum intensity projections and axial reformations were reviewed. Imaging findings were compared with the surgical results in 54 patients. RESULTS: CT angiography and MR angiography were 100% sensitive in identifying the main renal arteries and renal veins. CT angiography visualized 37 of the 40 arteries identified at surgery, for a detection rate of 93%. MR angiography visualized 18 of the 20 arteries identified at surgery, a detection rate of 90%. CONCLUSION: CT angiography and MR angiography are suitable for the noninvasive investigation of living kidney donors and provide all the information required by the surgeon. Both methods may miss small accessory renal arteries. MR angiography does not use potentially toxic contrast material or radiation and is the preferred investigation, with CT angiography reserved for patients unable to tolerate MR imaging.

Adult↗
PubMed2000

Detection and characterisation of integrons in Salmonella enterica serotype enteritidis.

Integrons have been widely described among the Enterobacteriaceae including strains of multi-resistant Salmonella enterica serotype Typhimurium DT104; however, information with respect to the presence of integrons among S. enterica serotype Enteritidis strains is limited. Multi-resistant isolates of Enteritidis were screened for the presence of integrons using a PCR protocol. One integron was detected in all isolates that were resistant to sulfonamide and streptomycin. Characterisation of these isolates indicated an integron which ranged in size between 1000 and 2000 bp and which harboured a gene cassette encoding the ant(3")-Ia gene specifying streptomycin and spectinomycin resistance. Further studies revealed the integrons to be located on large conjugative plasmids. This appears to be the first report of plasmid-borne integrons in Enteritidis.

Anti-Bacterial Agents↗
PubMed2000

One year's clinical experience with unenhanced spiral computed tomography for the assessment of acute loin pain suggestive of renal colic.

OBJECTIVE: To assess the use of unenhanced spiral computed tomography (CT) as the primary investigation of choice for suspected acute renal colic in clinical urological practice. Patients and Methods Between 1 August 1997 and 31 July 1998, all patients attending a hospital accident and emergency department with acute loin pain suggestive of renal colic underwent a physical examination, urine analysis, plain abdominal radiography (if clinically indicated) and unenhanced spiral CT. The effective radiation dose and financial cost of unenhanced spiral CT and standard three-film emergency intravenous urography (IVU) were calculated. RESULTS: In all, 116 patients were assessed, 63 of whom had calculi and related secondary phenomena of obstruction identified on unenhanced spiral CT. There were two false-positive and one false-negative result. An alternative urinary tract diagnosis was made in four patients, including two with renal cell carcinoma and one ureteric transitional cell carcinoma. Causes other than in the urinary tract were diagnosed in three patients, i.e. two with ovarian cyst and one with sigmoid diverticulitis. The effective radiation dose of unenhanced spiral CT was 4.7 mSv and that for three-film IVU was 1.5 mSv. The costs of both IVU and unenhanced spiral CT were identical. CONCLUSIONS: Unenhanced spiral CT allows a rapid, contrast-medium-free, anatomically accurate diagnosis of urinary tract calculi and in the present series had a sensitivity of 98% and a specificity of 97%. CT provided an alternative diagnosis in 6% of patients. These advantages must be weighed against the threefold greater radiation dose of unenhanced spiral CT than with three-film IVU, and in practice the requirement for a radiologist to interpret routine axial scans.

Adult↗
PubMed2000

Renovascular disease.

The gold standard for the diagnosis of renal artery stenosis is angiography, with response to treatment the proof of its significance. Non-invasive methods of investigation are required and are now available including functional imaging, ultrasound, CT and MR angiography and the merits and limitations of these tests are discussed.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2000

MRI of the breast.

MRI of the breast is rapidly evolving as a sensitive technique for the detection and staging of breast cancer. It has considerable benefits but is time consuming and expensive. The benefits and limitations of this technique are presented.

Breast Neoplasms↗
PubMed2000

Hepatic angiosarcoma: findings on multiphasic contrast-enhanced helical CT do not mimic hepatic hemangioma.

OBJECTIVE: The objective of our study was to identify multiphasic contrast-enhanced helical CT findings of angiosarcoma of the liver to determine whether this tumor could be confused with hemangioma of the liver. CONCLUSION: Angiosarcoma of the liver is a multifocal tumor with a variety of findings on multiphasic contrast-enhanced helical CT. None of the findings would usually be confused with the typical findings of hepatic hemangioma.

Adolescent↗
PubMed1999

CT angiography.

The advent of spiral (helical, volume) CT has revolutionised the performance of body CT and allowed the development of CT angiography (CTA). CT angiography is a non-invasive method of visualising the vascular system and in some instances can replace conventional angiography. In spiral CT a volume of data is obtained rapidly with no respiratory misregistration at peak vascular opacification following the peripheral injection of contrast. Appropriate timing will ensure that either the venous or arterial tree is visualised and from the volume of data multiple overlapping slices can be obtained to generate 2D and 3D images with no increase in radiation to the patient. CT angiography may be performed as a dedicated study or be undertaken retrospectively using post-processing of data from a conventional diagnostic spiral scan to provide additional information about the vascular tree. When undertaken as a dedicated study CTA is quicker, less invasive and less costly than a conventional angiogram with a decrease in the radiation dose to the patient; however, the spatial resolution is limited with vessels less than 2 mm not visualised and there is no contrast saving.

Angiography↗
PubMed1999

Unenhanced helical CT for renal colic--is the radiation dose justifiable?

AIM: The purpose of this study was to define and compare the radiation doses to patients undergoing computed tomography (CT) or intravenous urography (IVU) for the investigation of renal colic. METHODS: The IVU dose was calculated from dose area product measurements for 27 abdominal films (AXR) and a review of 30 IVUs performed to investigate renal colic. The effective dose to a patient undergoing CT was calculated using anthropomorphic model data. Fifty patients underwent CT for the investigation of renal colic over a 6-week period. RESULTS: CT following our protocol confers an average effective dose of 4.7 mSv. An IVU to investigate renal colic used 2.5 AXRs. A 3 film IVU gives an average dose of 1.5 mSv. Forty-two CT examinations were abnormal and the findings are described in the text. CONCLUSION: Although unenhanced CT confers diagnostic advantages and avoids the risks of intravenous contrast medium, this should be considered against the increased radiation dose to the patient which in our institution is over three times that of an IVU.

Colic↗
PubMed1999

Assessment of strain relatedness among Salmonella serotypes Salinatis, Duisburg, and Sandiego by biotyping, ribotyping, IS200 fingerprinting, and pulsed-field gel electrophoresis.

Salinatis (antigenic formula, 4,12:d:eh:enz15) is a rare Salmonella serotype currently designated a triphasic variant of the diphasic serotype Duisburg (1,4,12,27:d:enz15) (underlining indicates that the O antigen is determined by phage lysogenization). Salinatis could also be related to serotype Sandiego (4,[5],12:eh:enz15), from which it might have been derived by loss of H-d flagellin genes. Nineteen Salmonella strains of serotypes Salinatis, Duisburg, and Sandiego were examined by biotyping, PvuII and SmaI ribotyping, IS200 fingerprinting, and pulsed-field gel electrophoretic profiling. Results from these methods, used alone or together, indicate that serotype Salinatis is more likely to be related to serotype Sandiego than to serotype Duisburg. For future lists of serotype names, it is recommended that Salinatis be considered a variant of Sandiego.

Animals↗
PubMed1999

Evaluation of head examinations produced with a mobile CT unit.

Recent years have seen the development of mobile CT units, designed for use in operating theatres, intensive care units and accident and emergency departments. One such unit is the Tomoscan M (Philips, Utrecht, The Netherlands). It operates with a maximum tube voltage of 130 kV, and a maximum tube current of only 50 mA. This study tested whether acceptable quality CT images of the brain could be produced on the mobile unit with these parameters. 44 consecutive normal head examinations performed on the mobile scanner were compared with 35 examinations from two conventional CT units. Two independent readers scored the examinations for noise and artefact. CT dose index (CTDI) values for the three CT units were obtained in free air as an estimate of patient dose. Differences in artefact score between CT units were generally small, but noise scores were worse when using the Tomoscan M with a 2 s slice time. The lowest CTDI values were obtained with the Somatom DRH (Siemens, Erlangen, Germany) unit and the highest with the SR 7000 (Philips, Utrecht, The Netherlands), with values from Tomoscan M, in all except one case, falling between these values for the protocols used in the study. The measured scattered radiation doses from the Tomoscan M are presented.

Adolescent↗
PubMed1998

A comparison of air, CO2 and an air/CO2 mixture as insufflation agents for double contrast barium enema.

Using CO2 for DCBE is recommended as it may decrease pain afterwards but recent studies suggest it produces inferior distension. This prospective double blind study was designed to evaluate the use of an air/CO2 mixture. We randomised 105 patients to receive air, CO2 or a 50/50 mixture as the insufflation agent in DCBE. Gases were administered from prefilled bags. Those requiring additional insufflations before over couch films were recorded. Post procedure symptoms were evaluated by questionnaire. Distension and mucosal coating were assessed independently. There was no difference in mucosal coating. Those given CO2 had significantly less immediate and delayed pain compared to air and less delayed pain compared to the 50/50 mixture. Distension with air was graded better than with the other two agents but the difference did not reach statistical significance. However 50 % of patients receiving CO2 and 40 % of those receiving the mixture required additional insufflation before over couch films as distension was considered suboptimal, compared to 17 % of those given air, which was statistically significant. Our results indicate that using CO2 causes less pain than using air or the mixture although top up insufflations are often required to maintain adequate quality distension.

Adult↗
PubMed1998

Computed tomography and positron emission tomography in the pre-operative staging of oesophageal carcinoma.

UNLABELLED: Because patients with carcinoma of the oesophagus usually present with advanced disease and surgery has a high mortality with cure in less than 10% of patients, pre-operative staging to select appropriate patients is necessary. Computed tomography (CT) plays an important role in staging but has well recognized limitations. Positron emission tomography (PET) which provides physiological information may therefore be a better alternative. OBJECTIVE: To compare the findings of CT and positron emission tomography (PET) with 2-[18fluorine]-fluoro-2-deoxy-D-glucose (FDG) in the pre-operative staging of oesophageal carcinoma. MATERIALS AND METHODS: Twenty-five patients with biopsy proven oesophageal cancer had pre-operative staging using CT and FDG-PET. The studies were read independently and full histological confirmation was obtained in 19 patients. Four parameters were studied: the primary tumour, peri-oesophageal lymph nodes, liver metastases and left gastric lymph nodes. RESULTS: PET visualized all primary tumours; CT missed one. CT identified 4/8 patients with involved peri-oesophageal nodes and PET 3/8. CT identified 5/9 patients with left gastric adenopathy and PET 1/9. PET visualized a liver metastasis missed on CT and appeared to be better in assessing residual tumour. PET did identify distant metastases not seen on CT in seven patients. CONCLUSIONS: The two techniques are both effective in showing the primary tumour and about equally sensitive in the demonstration of peri-oesophageal nodes. PET is probably more sensitive than CT for the detection of distant metastases.

Esophageal Neoplasms↗
PubMed1998

Multiple lower limb non-ossifying fibromas in siblings with neurofibromatosis.

Non-ossifying fibromas are common benign lesions of tubular long bones. There is recognized association of these bony lesions with neurofibromatosis type 1 although the presence of non-ossifying fibromas in familial members with the condition has not previously been reported. We report two siblings with neurofibromatosis and radiological evidence of multiple lower limb non-ossifying fibromas. Both patients presented with pain in the knees and a pathological fracture was observed in one case. Patients with multiple non-ossifying fibromas should be examined carefully for other evidence of neurofibromatosis.

Adolescent↗
PubMed1998

Spiral CT: vascular applications.

Recent technical advances in CT have renewed interest in the development of CT angiography (CTA). CT angiography is a minimally invasive method of visualising the vascular system and is becoming an alternative to conventional arteriography in some situations. Spiral technology allows a volume of data to be obtained on a single breath-hold with no respiratory misregistration. Fast machines with second or subsecond acquisition times mean the images are obtained while there are high circulating levels of contrast medium giving peak vascular opacification from a peripheral intravenous injection. Accurate timing will ensure either the arterial or venous phase is imaged. Multiple overlapping axial images can be obtained from the data set with no increase in radiation dose to the patient and from these scans computer generated multiplanar and 3D images are obtained which can be viewed from numerous angles. CT angiography can be performed more quickly, less invasively and at reduced cost compared to conventional angiography.

Angiography↗
PubMed1997

Antimicrobial resistance of Salmonella enterica typhimurium DT104 isolates and investigation of strains with transferable apramycin resistance.

An examination of salmonella isolates collected by the Scottish Agricultural College Veterinary Services Division from April 1994 to May 1995 was conducted to determine the extent to which Salmonella enterica serotype Typhimurium phage type 104 (DT104) occurred and to investigate the antimicrobial resistance patterns of isolates. Typhimurium DT104 was the predominant salmonella and was isolated from nine species of animal. All isolates of this phage type possessed resistance to at least one antimicrobial and 98% of the isolates were resistant to multiple antimicrobials with R-type ACTSp the predominant resistance pattern. Various other resistance patterns were identified and transferable resistance to the veterinary aminoglycoside antimicrobial apramycin was demonstrated in three strains. A retrospective study for gentamicin resistance in isolates from the Scottish Salmonella Reference Laboratory collection revealed a human isolate of Typhimurium DT104 resistant to gentamicin but sensitive to apramycin and a bovine isolate with apramycin and gentamicin resistance.

Animals↗