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Biomedical subjects

S R Wild

Publications and source records attributed to S R Wild.

46 records · Page 3Linked to original sources
PubMed1980

Grey-scale ultrasonography and percutaneous transhepatic cholangiography in biliary tract disease.

Fifty-one patients with suspected obstructive jaundice and 14 without jaundice in whom disease of the biliary tract was suspected but infusion cholangiography had been unhelpful were examined by grey-scale ultrasonography and percutaneous transhepatic cholangiography and the findings analysed retrospectively. Grey-scale ultrasonography distinguished between obstructive and hepatocellular jaundice in 35 out of 46 patients (76%) and indicated the site of the obstruction in 27 (58%) and the cause of the obstruction in 13 (28%). Percutaneous transhepatic cholangiography distinguished between obstructive and hepatocellular jaundice in 42 of the patients (91%) and indicated the site of the obstruction in 42 (91%) and the cause in 29 (63%). In the 14 patients without jaundice percutaneous transhepatic cholangiography showed bile-duct stones in one an ampullary stenosis in three. It is concluded that grey-scale ultrasonography and percutaneous transhepatic cholangiography are complementary examinations and that ultrasonography should always be undertaken first as it is a non-invasive procedure that may provide the surgeon with all the diagnostic information he requires. Percutaneous transhepatic cholangiography should be performed when grey-scale ultrasonography has shown dilated bile ducts but failed to provide adequate diagnostic information. Cholangiography is also required when preoperative percutaneous drainage of the bile duct is contemplated. In those patients in whom grey-scale ultrasonography shows non-dilated ducts endoscopic retrograde cholangiopancreatography is probably the contract examination of choice.

Biliary Tract Diseases↗
PubMed1980

Bipedal lymphography in the management of bladder cancer.

Bipedal lymphography was performed in 91 patients with transitional cell carcinoma of the bladder. Equivocal reports were submitted in 18 (19.8%) examinations. In this series 18 (19.8%) of the patients died within one year of first treatment by radical radiotherapy. The prognosis was poorer in patients with more locally advanced tumours, in whom there was a higher proportion of abnormal lymphograms. An abnormal lymphogram was also related to a poorer prognosis than if the lymphogram was normal. This difference was greater when associated with a poorly differentiated cancer. The implications for management are discussed.

Carcinoma, Transitional Cell↗
PubMed1980

The detection of pyelonephritic scarring in children by radioisotope imaging.

Radioisotope scintigraphy of the kidney and intravenous urography have been compared in 79 children with bacteriologically proven urinary tract infections, followed up over a period of between one and four years. Both techniques were in agreement as to the presence or absence of an abnormality, and the extent of any abnormality present, in 93.5% of the kidneys studied. There was a discrepancy in ten kidneys. Excretion urography has a sensitivity of 0.86 and a specificity of 0.92 in the detection of pyelonephritic scarring in children. Radioisotope scintigraphy has a sensitivity of 0.96 and a specificity of 0.98. It is therefore concluded that radioisotope scintigraphy is the preferred technique.

Atrophy↗
PubMedDate not supplied

An integrated haematuria clinic.

The prognosis of bladder cancer is worsened by delay in its management. To reduce such delay we have organised a clinic where intravenous urography and cystoscopy, using a flexible cystoscope, are carried out at the patient's first visit. In a two-year period 321 patients attended this clinic. The results of investigation in 305 patients are reported. A total of 6% of patients with microscopic haematuria (n = 52) and 15% of patients with macroscopic haematuria (n = 253) had transitional cell carcinomata. This difference was not significant (P = 0.08, chi-squared). The delay between referral and trans-urethral resection of tumour for patients with bladder tumours was reduced from a mean of 60 days to a mean of 33 days by the institution of the clinic (P < 0.01, Mann-Whitney). We recommend that all patients referred to a urological service with haematuria, whether macroscopic or microscopic, should be investigated. The integration of that investigation in a single day decreases delays in diagnosis and management.

Adolescent↗