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Biomedical subjects

S Etheredge

Publications and source records attributed to S Etheredge.

4 recordsLinked to original sources

Colour-coded duplex ultrasonography in selection of patients for transluminal angioplasty.

Transluminal angioplasty can be used to relieve symptomatic lower extremity arterial disease with minimal morbidity. This prospective study compares the accuracy of colour-coded duplex ultrasonography with intra-arterial digital subtraction angiography in selection of femoro-popliteal lesions for angioplasty. Isolated, short (< 6 cm) and haemodynamically significant stenosis (> 50% reduction in diameter) were considered for angioplasty. Colour-duplex selection and exclusion was in agreement with angiography in 68 out of 86 lower limbs (79%). The sensitivity, specificity, positive and negative predictive value of colour duplex compared with angiography yielded values of 60.9, 87.5, 60.9 and 85.7%, respectively. The discrepancy between colour duplex and digital subtraction angiography can be partly explained by the tendency of duplex to underestimate the severity and length of disease. It is concluded that colour-coded duplex can be used as a screening tool for lower extremity arterial disease to select appropriate lesions for endovascular procedures. The accuracy of duplex in the present study was not perfect and the decision for further intervention should be based on clinical grounds.

Angiography, Digital Subtraction↗

Mechanisms of renal excretion of cisdichlorodiamine platinum.

Eighteen diuretic rabbits were given cisdichlorodiamine platinum (CDDP) and the clearance of plasma water platinum was determined with a simultaneous inulin clearance. The rabbits were then given probenecid (50 mg/kg) or choline (50 mg/kg) and the clearance of free platinum was calculated. CDDP has a high clearance, exceeding glomerular filtration rate. The drug appears to be secreted by the anionic transport system in the proximal tubule, as the clearance of free platinum is markedly decreased by the administration of probenecid.

Animals↗

Long-term survival after cadaveric renal transplantation.

In a series of 404 consecutive first cadaver kidney transplants performed since 1967 the actuarial five- and 10-year survival of patients were 61% and 47% respectively and of grafts 46% and 36%. In more than four-fifths of the patients surviving these intervals the original cadaveric grafts were functioning at these times, and most of the remainder were sustained by subsequent grafts. Although graft survival has remained static since 1967, patient survival improved. Results for 43 consecutive second cadaver transplants were similar after five years to those of first grafts. These results promote the acceptability of cadaveric transplantation as a long-term treatment for chronic renal failure.

Adolescent↗

Thoracic outlet syndrome.

Eleven patients with vascular sequelae of thoracic outlet syndrome were operated on at the University of California, SanFrancisco, during the past 17 years. Five patients presented with episodes of ischemia of the arm and hand secondary to microemboli released from subclavian arterial lesions produced by chronic compression at the thoracic outlet. Treatment consisted of arterial reconstruction, removal of the compressive structure, and cervical sympathectomy to relieve or lessen distal ischemia. Four of the five patients had good or excellent results; one patient required amputation of the forearm. The results were inversely proportional to the extent of distal arterial embolic occlusions present at the time of surgical treatment. Six patients presented with symptoms of chronic venous hypertension. Four of the six had subclavian venous thrombosis and were treated by transaxillary resection of the first rib to decompress the collateral veins within the costoclavicular space. All four were symptomatically improved. Two patients had venous hypertension due to extrinsic compression of the subclavian vein. One patient became asymptomatic and the other was markedly improved after resection for external compression. In this small series transaxillary resection of the first rib has resulted in symptomatic improvement in chronic venous hypertension of the arm.

Adolescent↗