Relationship between carotid intima-media thickness and symptomatic and asymptomatic peripheral arterial disease. The Edinburgh Artery Study.

Background And Purpose: Ultrasonic evaluation of intimamedia thickness (IMT) is one method of assessing the development of early atherosclerosis. This report describes the distribution of IMT within the general population and is one of the first to investigate its association with noninvasively assessed symptomatic and asymptomatic peripheral arterial disease.

Methods: Ultrasonic evaluation of IMT was included in the 5-year follow-up examination of participants of the Edinburgh Artery Study.

Laparoscopic ultrasonography for staging gastroesophageal cancer.

Background: TNM staging of gastroesophageal cancer is improved by the use of laparoscopy for the detection of occult metastases and endoscopic ultrasonography for T and possibly N staging. Laparoscopic ultrasonography may combine the strengths of both of these techniques. The purpose of this study was to compare TNM staging by means of laparoscopic ultrasonography (Lap US), laparoscopy, and conventional computed tomography (CT).

Measurement of spleen size and its relation to hypersplenism and portal hemodynamics in portal hypertension due to hepatic cirrhosis.

Aims: Splenomegaly is common in portal hypertension due to hepatic cirrhosis, but there are little data comparing different methods of spleen measurement. We have compared ultrasound with radionuclide imaging in measuring splenomegaly. The relation of splenomegaly to hypersplenism and portal hemodynamic factors was also studied.

Changing management of pyogenic liver abscess.

The case records of 23 patients who presented over a 5-year period with a diagnosis of pyogenic liver abscess were reviewed. Ascending cholangitis was implicated in nine cases, seven of which were associated with underlying malignancy. Haematogenous spread via the portal route accounted for five cases.

Spiral laminar flow in vivo.

1. Blood flow patterns are poorly understood despite their impact on arterial disease. There have been few measurements in vivo of the three-dimensional blood flow patterns; we present the results of such studies using a new non-invasive in-vivo method of examining biplanar arterial blood flow patterns.

Prospective evaluation of haematological alterations following the transjugular intrahepatic portosystemic stent-shunt (TIPSS).

Background: TIPSS is effective in reducing portal hypertension and provides access to the portal system for direct pressure measurements.

Objective: To assess the incidence and severity of haemolysis and its course following TIPSS, and also to assess changes in spleen size and any relationship to changes in the platelet and white cell count and haemoglobin concentration.

Design: A prospective study.

Surveillance imaging of the operated artery does not alter clinical outcome following carotid endarterectomy.

Clinical outcome was studied in 243 patients undergoing 260 carotid endarterectomies; 166 of these patients underwent serial postoperative surveillance imaging. Including perioperative events, cumulative freedom from ipsilateral stroke was 86 and 82 per cent at 5 and 10 years respectively; the mean incidence of ipsilateral stroke was 1.8 per cent per annum.

Comparison of venous reflux in the affected and non-affected leg in patients with unilateral venous ulceration.

In 54 patients with unilateral leg ulceration of purely venous aetiology the only difference in venous reflux between affected and non-affected legs was with respect to the popliteal and crural veins. Deep and superficial venous reflux is common in legs without the skin changes typical of chronic venous insufficiency. The significance of venous reflux in an ulcerated leg cannot therefore be determined without reference to the contralateral, clinically normal, limb.

Choroidal cells in ovarian cyst fluid: a case report.

Background: The ovary is conspicuous for the wide diversity of histologic tumor types that it contains. Unusual or rare tumors may present diagnostic difficulty on cytologic examination.

Case: A 36-year-old woman presented with an 80-mm cystic lesion in the left ovary.

Development of drug targeting based on recombinant expression of the chicken avidin gene.

The chemistry required for covalent biotinylation of drugs, radiopharmaceuticals and other ligands is highly developed, and a large number of biotinylated reagents can be readily synthesized. In order to investigate whether expression of avidin cDNA in mammalian cells might be useful as part of a drug targeting strategy, we transiently expressed the avidin gene in two human tumor cell lines (the cervical carcinoma cell line, HeLa, and the liver derived line, Hep G2). Avidin protein as detected by either immunohistochemistry or binding of streptavidin-biotin complexes was present and functional following transient expression.

Growth rate of infrarenal aortic aneurysms.

Objective: To delineate the natural history of infrarenal aortic aneurysms with respect to growth rate.

Methods: A referral based series of 233 patients with abdominal aortic aneurysm was serially assessed by abdominal ultrasound.

Results: The mean age was 71 years and the median follow up 26 months (range 6-146).

Case report: computed tomography features of complete splenic infarction, cavitation and spontaneous decompression complicating pancreatitis.

Splenic infarction is a rare complication of pancreatitis. We present the case of a 34-year-old woman, who had undergone previous drainage of a pancreatic pseudocyst, and who represented with left upper quadrant pain. Absence of enhancement of the splenic parenchyma during contrast enhanced computed tomography (CT) allowed confident diagnosis of complete splenic infarction.

The role of duplex and colour Doppler ultrasound in the follow-up evaluation of transjugular intrahepatic portosystemic stent shunt (TIPSS).

Transjugular intrahepatic portosystemic stent shunt (TIPSS) is an effective means of controlling acute variceal haemorrhage. Shunt occlusion or stenosis occurs in up to 30% of patients within 6 months. It is important to detect these patients and intervene to prevent rebleeding.

Fate of the non-operated carotid artery after contralateral endarterectomy.

The long-term fate of the non-operated internal carotid artery (ICA) in 219 patients undergoing contralateral carotid endarterectomy was studied; 151 patients underwent serial postoperative imaging of the vessel. Cumulative freedom from stroke in the non-operated hemisphere was 99, 96 and 86 per cent at 1, 5 and 10 years respectively, giving a mean incidence of stroke of 1 per cent per annum. Only one stroke was preceded by a transient ischaemic attack and no stroke was associated with severe (70 per cent or greater) stenosis of the ICA.

Measurement of ocular blood flow velocity using colour Doppler imaging in low tension glaucoma.

The purpose of this study was to compare the velocity of blood flow and vascular resistance measured by colour Doppler imaging in the ophthalmic and central retinal arteries in 34 eyes of 34 patients (mean age 68.1 years) with low tension glaucoma (LTG) and 17 eyes of 17 age-matched normal controls (mean age 65.2 years).

Duplex ultrasound surveillance of infrainguinal bypass grafts: auditing the process.

The effectiveness of an infrainguinal bypass graft surveillance programme using duplex scanning was assessed over a 2-year period. Of 220 infrainguinal bypass grafts (123 vein and 97 PTFE grafts; 114 to the above knee level, 94 below knee and 12 distal to popliteal artery) in 203 patients, 208 (94.5%) were available for follow-up surveillance.

Tumor cell bystander killing in colonic carcinoma utilizing the Escherichia coli DeoD gene to generate toxic purines.

Inefficiency of gene delivery, together with inadequate bystander killing, represent two major hurdles in the development of a toxin-mediated gene therapy for human malignancy. The product of the Escherischia coli DeoD gene (purine nucleoside phosphorylase, PNP) differs from the mammalian enzyme in its substrate specificity and is capable of catalyzing the conversion of several non-toxic deoxyadenosine analogs to highly toxic adenine analogs. We have found that expression of E.

Effect of 9-benzyl-9-deazaguanine, a potent inhibitor of purine nucleoside phosphorylase, on the cytotoxicity and metabolism of 6-thio-2'-deoxyguanosine.

6-Thio-2'-deoxyguanosine (T-dGuo) has been reported to be both phosphorylated by deoxycytidine kinase and converted to 6-thioguanine by purine nucleoside phosphorylase (PNP). Combination of T-dGuo with an inhibitor of PNP would be expected to generate the 5'-triphosphate of T-dGuo and limit or prevent the formation of 6-thioguanosine triphosphate. Because the incorporation of 6-thioguanine into DNA is believed to be primarily responsible for the antitumor activity of the thiopurines, this treatment might result in enhanced activity against certain tumors, particularly those of T-cell origin.

Recurrent varicose veins: assessment of the saphenofemoral junction.

Thirty-six consecutive unselected patients, who had apparently previously undergone saphenofemoral ligation for primary uncomplicated long saphenous varicosities and who had then re-presented with recurrent thigh varices emanating from the groin, underwent preoperative clinical assessment, hand-held Doppler and duplex ultrasonographic examination and varicography to establish the presence or absence of saphenofemoral incompetence as the cause of recurrence. All patients underwent reexploration of the saphenofemoral junction (SFJ) via a lateral approach. Twenty-six patients had an intact SFJ (type I recurrence) and ten had varices arising from either a thigh perforator, or from abdominal or perineal veins (type II recurrence).

Prevalence of HPV DNA in cervical specimens in women with renal transplants: a comparison with dialysis-dependent patients and patients with renal impairment.

The aim of this study was to assess the prevalence of human papillomavirus (HPV) DNA in women who had received a renal transplant and to compare this with two control groups. Women who had a functioning renal transplant for greater than 6 months (n = 69) were compared with women on maintenance dialysis (n = 89) and women with impaired renal function (creatinine 0.15-0.

Development of an advanced digital image processor for real-time speckle suppression in routine ultrasonic scanning.

This paper describes a digital image processor for ultrasonic speckle suppression that was explicitly designed to satisfy the requirements of detail preservation, adequate smoothing and real-time operation. The first two of these requirements were addressed by selecting a nonlinear adaptive algorithm, which uses a measure of local homogeneity to adjust the amount of smoothing performed at each point of the scan, and employing a large (9 x 9 pixels) filtering window. Real-time operation was achieved by developing a highly concurrent systolic architecture that allowed the efficient mapping of the algorithm into low-cost high-density hardware.

Phosphorylation of the enantiomers of the carbocyclic analog of 2'-deoxyguanosine in cells infected with herpes simplex virus type 1 and in uninfected cells. Lack of enantiomeric selectivity with the viral thymidine kinase.

CdG, the carbocyclic analog of 2'-deoxyguanosine, is active against herpes, hepatitis B, and human cytomegaloviruses. We have studied the interaction of the tritiated enantiomers of CdG with the herpes simplex virus type 1-specific thymidine kinase (HSV-1 TK) and have examined their metabolism in uninfected and HSV-1-infected cells. D- and L-CdG were equally effective competitive inhibitors of the phosphorylation of thymidine (dThd) by the partially purified HSV-1 TK (Ki values were 2.

Purine nucleoside phosphorylase inhibitors: biochemical and pharmacological studies with 9-benzyl-9-deazaguanine and related compounds.

Certain derivatives of 9-deazaguanine that contain arylmethyl, heteroarylmethyl or cycloalkylmethyl groups at the 9-position are potent inhibitors of purine nucleoside phosphorylase (PNP, E.C. 2.