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Biomedical subjects

W Lees

Publications and source records attributed to W Lees.

15 recordsLinked to original sources
PubMed1992

Technical considerations in 113 percutaneous cholecystolithotomies.

Percutaneous cholecystolithotomy (PCCL) was considered appropriate on the basis of clinical and ultrasound criteria in 220 of 283 patients referred with symptomatic cholecystolithiasis. Contraindications to PCCL were a small, shrunken, thick-walled gallbladder or an intrahepatic gallbladder. PCCL was performed in 113 patients (80 women, 33 men; mean age, 56 years). Local anesthesia was used in 10 patients; general anesthesia, in 103 patients. The average procedure time was 1 hour. Complete stone clearance was achieved in 100 patients. PCCL was successful in 107 patients; in 77 of these, it was completed in a single stage. Six technical failures occurred, and seven patients had persistent cystic duct stones. Acute, nonfatal complications occurred in 15 patients and were managed conservatively. In 12 of 13 patients with stones impacted in the Hartmann pouch, patency of the cystic duct was restored. It is concluded that PCCL is a safe, effective procedure for clearing the gallbladder of calculi regardless of their size, composition, or number. It preserves the gallbladder, enables possible restoration of contractility, and can be performed without general anesthesia.

Cholangiography↗
PubMed1987

Role of immunoblotting in the diagnosis of culture negative and enterococcal endocarditis.

Serum samples from patients with endocarditis and septicaemia due to Enterococcus faecalis, Enterococcus faecium, Streptococcus bovis, and Streptococcus sanguis were immunoblotted against antigenic extracts from all four species. In E faecalis endocarditis there was a strong IgM response to E faecalis antigenic bands of 112, 88-90, and 45-47 Kd and a strong IgG response to 88-90 and 45-47 Kd bands. In E faecium endocarditis there was a pronounced IgG response to an E faecium band of 82-90 Kd. For S bovis endocarditis, there was a strong IgG response to several components of S bovis including bands of 66, 58, 52 and 4 Kd. For S sanguis, there was a strong IgG response to bands of 80-82, 76, 60 and 45 Kd. These patterns of antibody production were absent in patients with uncomplicated septicaemia and in controls. The delineation of these patterns enabled confirmation of the final diagnosis in seven patients initially suspected of having culture negative endocarditis.

Antibodies, Bacterial↗
PubMed1978

Comparative clinical impact of endoscopic pancreatography, grey-scale ultrasonography, and computed tomography (EMI scanning) in pancreatic disease: preliminary report.

Grey-scale ultrasound scanning (US), computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) were performed in a series of 50 patients with known or suspected pancreatic disease. The impact of the individual tests were assessed in the relevant clinical context. With a maximum of 100, the overall clinical impact score of ERCP (75) exceeded that of CT(63) and US (36). In patients with obscure pain, and in those with relapsing pancreatitis, a combination of US and ERCP provides good clinical guidance. Computed tomography scanning can currently be reserved for documentation of patients with a major mass lesion. None of the techniques can detect early pancreatic cancer, except of the papilla of Vater, where ERCP is diagnostic. Recommendations for future diagnostic strategies may alter as grey-scale ultrasonography and computed tomography develop, and, in any case, depend on many factors including local expertise, availability, and cost.

Adolescent↗
PubMed1976

A comparison of wedge and segmental resection of the lung.

In the past few years there has been increasing use of limited resection for pulmonary carcinoma, especially in patients with restricted cardiorespiratory function. Because there is frequently a choice as to the type of limited resection, it was considered worth while to review the safety and efficiency of the two principal types. In total, 212 wedge resections and 281 segmental resections are reported. Despite certain theoretical advantages to segmentectomy, wedge resection carried a lower complication rate. Seventy-one per cent of wedge resections were free of complications compared to 54% of segmental resections. Minor complications were defined as apical air space and apical haematoma. The incidence of minor complications was similar for each group, 22% for wedge resections and 27% for segmentectomies. However, there was a significantly higher major complication rate in the segmental resection group (19%) compared to the wedge group (7%). This is understandable, considering the amount of raw lung surface exposed after segmental resection. It appears that where it is surgically feasible, wedge resection should be practised.

Hemoptysis↗