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1.
Heart ; 94(2): 182-5, 2008 Feb.
Article in English | MEDLINE | ID: mdl-17483126

ABSTRACT

OBJECTIVES: We sought to evaluate whether socioeconomic status influences outcome after first-time single aortic or mitral valve replacement. SETTING: National Heart Valve registry. DESIGN AND PATIENTS: Between 1 January 1986 and 31 December 2001, 51 844 consecutive patients who underwent primary aortic or mitral valve replacement were registered on the United Kingdom (UK) Heart Valve Registry. Data included age, gender, valve position, type of valve implant, postcode, follow-up time, date and cause of death. The Carstairs deprivation score (1991 Census data for the UK) was used to stratify cases by level of social deprivation according to postcodes. RESULTS: Both 30-day and 1-year survival/mortality rates were similar across all socioeconomic levels. However, long-term survival rate (up to 15 years) was significantly higher in the least deprived socioeconomic level than in the two most deprived levels. There was an 18% lower survival rate amongst women in the most deprived levels (35.9%, 95% CI: 32.4 to 39.4) versus the least deprived level (43.7%, 95% CI: 38.1 to 49.2, p<0.004). In men, survival in the most deprived levels (39.5%, 95% CI: 36.4 to 42.5) was 7% lower than in the least deprived level (42.7%, 95% CI: 37.7 to 47.7, p<0.005). Biological valve, mitral position, female gender, and low socioeconomic status were all associated with long-term mortality. CONCLUSIONS: A disadvantaged social background has a negative influence on long-term survival after aortic or mitral valve replacement, especially among women.


Subject(s)
Aortic Valve , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation/mortality , Mitral Valve , Social Class , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Bioprosthesis/statistics & numerical data , Female , Heart Valve Diseases/mortality , Heart Valve Prosthesis/statistics & numerical data , Humans , Male , Middle Aged , Poverty , Regression Analysis , Survival Analysis , United Kingdom/epidemiology
2.
Heart ; 90(10): 1172-8, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15367517

ABSTRACT

BACKGROUND: Mechanical valves and bioprostheses are widely used for aortic valve replacement. Though previous randomised studies indicate that there is no important difference in outcome after implantation with either type of valve, knowledge of outcomes after aortic valve replacement is incomplete. OBJECTIVE: To predict age and sex specific outcomes of patients after aortic valve replacement with bileaflet mechanical valves and stented porcine bioprostheses, and to provide evidence based support for the choice of prosthesis. METHODS: Meta-analysis of published results of primary aortic valve replacement with bileaflet mechanical prostheses (nine reports, 4274 patients, and 25,726 patient-years) and stented porcine bioprostheses (13 reports, 9007 patients, and 54,151 patient-years) was used to estimate the annual risks of postoperative valve related events and their outcomes. These estimates were entered into a microsimulation model, which was employed to calculate age and sex specific outcomes after aortic valve replacement. RESULTS: Life expectancy (LE) and event-free life expectancy (EFLE) for a 65 year old man after implantation with a mechanical valve or a bioprosthesis were 10.4 and 10.7 years and 7.7 and 8.4 years, respectively. The lifetime risk of at least one valve related event for a mechanical valve was 48%, and for a bioprosthesis, 44%. For LE and EFLE, the age crossover point between the two valve types was 59 and 60 years, respectively. CONCLUSIONS: Meta-analysis based microsimulation provides insight into the long term outcome after aortic valve replacement and suggests that the currently recommended age threshold for implanting a bioprosthesis could be lowered further.


Subject(s)
Aortic Valve/surgery , Bioprosthesis , Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Aged , Animals , Aortic Valve Insufficiency/surgery , Computer Simulation , Female , Heart Valve Prosthesis Implantation/mortality , Humans , Male , Middle Aged , Stents , Swine , Treatment Outcome
4.
Diabetes Care ; 24(4): 631-6, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11315821

ABSTRACT

OBJECTIVE: To determine the safety and efficacy of the long-acting analog insulin glargine compared with NPH insulin in patients with type 2 diabetes who were previously treated with insulin alone. RESEARCH DESIGN AND METHODS: A total of 518 subjects with type 2 diabetes who were receiving NPH insulin with or without regular insulin for postprandial control were randomized to receive insulin glargine (HOE 901) once daily (n = 259) or NPH insulin once or twice daily in = 259) for 28 weeks in an open-label, multicenter trial. Doses were adjusted to obtain target fasting glucose <6.7 mmol/l. At study end point, the median total daily insulin dose in both treatment groups was 0.75 IU/kg. RESULTS: The treatment groups showed similar improvements in HbA1c from baseline to end point on intent-to-treat analysis. The mean change (means +/- SD) in HbA1c from baseline to end point was similar in the insulin glargine group (-0.41 +/- 0.1%) and the NPH group (-0.59 +/- 0.1%) after patients began with an average baseline HbA1c of approximately 8.5%. The treatments were associated with similar reductions in fasting glucose levels. Overall, mild symptomatic hypoglycemia was similar in insulin glargine subjects (61.4%) and NPH insulin subjects (66.%) However, nocturnal hypoglycemia in the insulin glargine group was reduced by 25% during the treatment period after the dose-titration phase(26.5 vs. 35.5%, P = 0.0136). Subjects in the insulin glargine group experienced less weight gain than those in the NPH group (0.4 vs. 1.4 kg, P < 0.0007). CONCLUSIONS: In patients with type 2 diabetes, once-daily bedtime insulin glargine is as effective as once- or twice-daily NPH in improving and maintaining glycemic control. In addition, insulin glargine deonstrates a lower risk of nocturnal hypoglycemia and less weight gain compared with NPH insulin.


Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin, Isophane/therapeutic use , Insulin/therapeutic use , Blood Glucose/metabolism , Body Mass Index , Circadian Rhythm , Diabetes Mellitus, Type 2/blood , Fasting , Female , Glycated Hemoglobin/analysis , Humans , Hypoglycemia/epidemiology , Hypoglycemia/prevention & control , Insulin/analogs & derivatives , Insulin Glargine , Insulin, Long-Acting , Male , Middle Aged , Postprandial Period , Risk Factors , Time Factors
5.
J Magn Reson Imaging ; 12(2): 363-9, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10931602

ABSTRACT

The purpose of this study was to use ex vivo testing techniques to determine the magnetic resonance imaging (MRI) safety aspects for 32 different heart valve prostheses that had not been evaluated previously in association with the 1.5-T MR environment. Ex vivo testing was performed using previously described techniques for the evaluation of magnetic field interactions (deflection angle and torque), heating [gel-filled phantom and fluoroptic thermometry; 15 minutes of MRI at a specific absorption rate (SAR) of 1.1 W/kg], and artifacts (using gradient echo and T1-weighted spin-echo pulse sequences). Thirteen heart valve prostheses displayed interactions with the magnetic field. However, these magnetic field interactions were considered relatively minor. Heating was < or =0.8 degrees C for these implants. Artifacts varied from mild to severe depending on the amount and type of metal used to make the particular heart valve prosthesis. For these 32 different heart valve prostheses, the relative lack of substantial magnetic field interactions and negligible heating indicate that MR procedures may be conducted safely in individuals with these implants using MR systems with static magnetic fields of 1.5 T or less.


Subject(s)
Heart Valve Prosthesis , Magnetic Resonance Imaging , Artifacts , Hot Temperature , Magnetics , Phantoms, Imaging , Safety , Torque
6.
Circulation ; 99(5): 655-8, 1999 Feb 09.
Article in English | MEDLINE | ID: mdl-9950663

ABSTRACT

BACKGROUND: The United Kingdom Heart Valve Registry (UKHVR) has recently completed collecting information on 52 659 heart valve replacements (in 47 718 patients) performed during the period 1986 to 1995 in the whole of the United Kingdom. Information stored in the UKHVR's computer database was used for this study. Factors affecting the time from first prosthesis to first redo prosthesis were analyzed and provided useful predictive information. The association between prosthesis-induced local pathological processes and redo valve size was investigated. METHODS AND RESULTS: This is a retrospective study of 43 301 patients (from among 47 718 in the database) undergoing single-site replacement of a diseased native mitral or aortic valve over a 10-year period from January 1986 to December 1995 in the United Kingdom. Of these patients, 1051 (2.43%) went on to have a first redo heart valve replacement. Valve survival analysis (Cox regression and Kaplan-Meier curves) was used to study the natural progression to the first redo heart valve replacement. Female sex and having a replacement at the aortic rather than the mitral position were both associated with a longer interval to the first redo operation. Regression analysis showed the size of the redo valve to be influenced by the interoperative time. This effect was more pronounced at the mitral position. CONCLUSIONS: Females and patients having an aortic valve replacement exhibit a longer interval to the first redo operation than do males and patients having mitral valve replacements, respectively. The time from the first replacement to the first redo operation significantly affects the size of the first redo valve.


Subject(s)
Calcinosis/etiology , Cicatrix/etiology , Coronary Thrombosis/etiology , Heart Valve Prosthesis Implantation , Aged , Calcinosis/mortality , Cicatrix/mortality , Coronary Thrombosis/mortality , Female , Humans , Male , Prognosis , Registries , Regression Analysis , Reoperation , Retrospective Studies , Treatment Outcome
7.
J Heart Valve Dis ; 8(6): 697-701, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10616250

ABSTRACT

BACKGROUND AND AIM OF THE STUDY: Approximately 150,000 heart valves are implanted annually world-wide, of which 4% are implanted in the UK. We present a comprehensive profile of the trends in valve replacement (VR) surgery in the UK since 1986 based on data from the UK Heart Valve Registry (UKHVR). METHODOLOGY: The UKHVR is a computerized database collecting prospective data on VR surgery in all UK cardiac units. All patients are tracked by national agencies who register all deaths of UK residents. Thus, the Registry receives a copy of each patient's death certificate and enters the date, place and certified cause(s) of death on the database. RESULTS: Between January 1st 1986 and December 31st 1997, a total of 58,195 patients underwent first-time VR surgery and received 63,649 valves. Mean age at operation in 1986 was 58.7 years (range: 18-87 years) and this rose to 64.7 years (range: 18-94 years) in 1997. In 1986, 12% (n = 578) of patients who underwent VR surgery were aged >70 years compared with 36% (n = 5125) in 1997. There was a 4% decrease in double VR surgery and a 15% reduction in mitral VR between 1986 and 1997. The majority of patients received a mechanical valve; within this group the number of bileaflet valve implants increased significantly since 1986. There has been a reversal in the downward trend in pericardial valves implanted since 1993. Follow up was 96.1% complete, with a total of 342,993 patient-years. Mortality (30-day) fell from 6.9% in 1986 to 3.8% in 1995, but increased to 6.7% in the two years to 1997. Actuarial survival at 1, 5 and 10 years was 89.5%, 78.5% and 61.8%, respectively; confidence intervals of 0.5% reflect the enormity of the database and quality of the data. CONCLUSIONS: UKHVR data can provide comprehensive year-by-year and trend analyses in a database in excess of 63,000 valves. Changes in patient demographics, choice of implanted valve and the pattern of heart valve disease are evident within the UK over the past 11 years.


Subject(s)
Heart Valve Prosthesis Implantation , Heart Valve Prosthesis/statistics & numerical data , Registries/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Bioprosthesis/statistics & numerical data , Heart Valve Prosthesis Implantation/mortality , Heart Valve Prosthesis Implantation/statistics & numerical data , Heart Valve Prosthesis Implantation/trends , Humans , Middle Aged , Prospective Studies , Survival Rate/trends , United Kingdom/epidemiology
8.
Eur J Cardiothorac Surg ; 14(2): 156-64, 1998 Aug.
Article in English | MEDLINE | ID: mdl-9755001

ABSTRACT

OBJECTIVE: To assess the 30-day mortality, long-term survival and freedom from reoperation following surgery for prosthetic endocarditis (PVE). METHOD: A retrospective analysis of data from the UK Heart Valve Registry of 322 patients who had undergone single mechanical/bioprosthetic valve replacement for PVE between 1 January 1986 and 31 December 1996. The mean age was 54.9 +/- 12.8 years and 213 (66.1%) were males. There were 170 aortic and 152 mitral valve implantations. Eighty-five (26%) of the infected valves were bioprosthetic and 237 (74%) were mechanical. Of the new prostheses implanted 53 (17%) were bioprosthetic and 269 (83%) were mechanical. Of those with infected bioprostheses, 50 (15.2%) had mechanical valves at redo surgery, whilst 219 (68.3%) of infected mechanical prostheses were re-replaced by mechanical prostheses. The follow-up was 98% complete with a total of 1084.9 patient years. RESULTS: The 30-day mortality was 63 (19.9%; 95%CI 15.9-24.7%). There were 85 late deaths. One, 5 and 10 year survival rates were 67.1% (61.6-72.0%), 55.0% (49.0-60.7%) and 37.6% (27.9-47.2%), respectively. Age was the only significant determinant of 30-day mortality (P = 0.04). Age (P = 0.001) and explanting of infected bioprosthesis and replacement by mechanical valve (P = 0.04) determined long-term survival (P = 0.001). The incidence of re-reoperation was 9.9%. Freedom from reoperation for PVE was 88.4, 87.3 and 87.3% at 1, 5 and 10 years, respectively. Explanting of bioprosthesis and replacement by mechanical valve (P < 0.001) and reoperation within 60 days of native valve replacement (P = 0.02) were determinants of reoperation for PVE. Freedom from death or reoperation was 61.1, 50.6 and 34.2% at 1, 5 and 10 years, respectively. Age (P = 0.003), explanting of bioprosthesis and replacement by mechanical valve (P = 0.002) and the period between prosthetic re-replacement (P = 0.04) determined freedom from death or reoperation. CONCLUSION: Operation for PVE carries a high 30-day mortality and reduced long-term survival. There is no evidence that type of prosthesis used for re-reoperation determines survival or freedom from re-reoperation.


Subject(s)
Bioprosthesis/adverse effects , Endocarditis/mortality , Endocarditis/surgery , Heart Valve Prosthesis Implantation/mortality , Heart Valve Prosthesis/adverse effects , Prosthesis-Related Infections/mortality , Prosthesis-Related Infections/surgery , Female , Humans , Male , Middle Aged , Registries/statistics & numerical data , Reoperation/statistics & numerical data , Survival Analysis , Survival Rate , Time Factors , United Kingdom/epidemiology
9.
Ann Thorac Surg ; 66(6): 1940-7, 1998 Dec.
Article in English | MEDLINE | ID: mdl-9930473

ABSTRACT

BACKGROUND: Little is known of time-related outcome and comparative performance of biological and mechanical prostheses following tricuspid valve replacement (TVR). METHODS: A retrospective UK Heart Valve Registry study (Jan 1, 1986 to June 30, 1997) identified 425 patients who underwent TVR. Two-hundred twenty-five (52.9%) received biological and 200 (47.1%) received mechanical valves. One-hundred sixty (38%), 158, and 76 had isolated, double, and triple valve replacements, respectively. The follow-up was 96% complete with a total of 1,585 patient-years. RESULTS: Thirty-day mortality for TVR was 17.3% (73 deaths). One-, 5-, and 10-year survival rates were 72.2%, 59.9%, and 42.9%, respectively. Year of operation (p = 0.04), age (p = 0.04), and number of valves implanted (p = 0.0 3) predicted overall mortality. Age (p<0.001) and year of operation (p = 0.002) predicted overall survival. Thirty-day mortality for biological and mechanical prostheses was 18.8% and 15.6%, respectively. One-, 5-, and 10-year survival rates were 70.5%, 61.5%, and 47.7% for biological and 74.0%, 57.9%, and 33.9% for mechanical prostheses, respectively. Freedom from reoperation at 1 and 10 years was 98.7% and 97.4%. Freedom from death or reoperation was 71.2% at 1 year and 41.9% at 10 years. None of the above outcomes was significantly different between the type of valve prostheses. CONCLUSIONS: TVR carries a high 30-day mortality and a poor longer term survival. No superiority could be identified for biological or mechanical prostheses in the tricuspid position for either survival or reoperation.


Subject(s)
Bioprosthesis , Heart Valve Prosthesis , Tricuspid Valve/surgery , Bioprosthesis/statistics & numerical data , Female , Follow-Up Studies , Heart Valve Prosthesis/statistics & numerical data , Heart Valve Prosthesis Implantation/statistics & numerical data , Humans , Male , Middle Aged , Proportional Hazards Models , Registries/statistics & numerical data , Reoperation/statistics & numerical data , Retrospective Studies , Survival Rate , Time Factors , Treatment Outcome , United Kingdom/epidemiology
10.
Memory ; 6(6): 665-87, 1998 Nov.
Article in English | MEDLINE | ID: mdl-10320869

ABSTRACT

We investigated the recovery from memory of a primary task after an interruption. If the primary task lacked associative support among its task components, recovery was more difficult following an interruption that overlapped either completely or partially in the amount of information shared with the primary task (an interruption-similarity effect). In addition, memory for completed actions was superior to memory for impending unfinished actions. However, if the primary task had associative support among its task components, there was no adverse effect of interruption similarity, and completed and unfinished actions were recalled equally well. We explore possible explanations and implications of these results.


Subject(s)
Attention , Memory , Humans , Mental Recall , Time Factors
11.
Circulation ; 96(10): 3403-8, 1997 Nov 18.
Article in English | MEDLINE | ID: mdl-9396434

ABSTRACT

BACKGROUND: Aging of the population and advances in preoperative and postoperative care are reflected in an increasing number of patients > or = 80 years of age undergoing aortic valve replacement (AVR) in the United Kingdom. The present study presents data on postoperative 30-day mortality, actuarial survival, and cause of death based on a large collective patient population. METHODS AND RESULTS: Data were extracted from the UK Heart Valve Registry. From January 1986 to December 1995, 1100 patients > or = 80 years of age underwent AVR and were reported to the registry. Six hundred eleven patients (55.5%) were women. The mean follow-up time was 38.9 months. The 30-day mortality was 6.6%. Of the 73 early deaths, 42 were due to cardiac reasons. The actuarial survival was 89%, 79.3%, 68.7%, and 45.8% at 1, 3, 5, and 8 years, respectively. After the first 30 postoperative days, 144 of the 205 deaths were due to noncardiac reasons. Malignancy, stroke, and pneumonia were the most common causes of late death. Bioprosthetic valves were implanted in 969 patients (88%) and mechanical valves in 131 (12%) patients. There was no difference in early mortality and actuarial survival between the two groups (P>.05). CONCLUSIONS: The above results suggest that under the selection criteria for AVR currently applied in the United Kingdom, patients > or = 80 years of age show a satisfactory early postoperative outcome and moderate medium-term survival benefit.


Subject(s)
Aging/physiology , Aortic Valve/surgery , Heart Valve Prosthesis Implantation , Aged , Aged, 80 and over , Cause of Death , Female , Heart Valve Prosthesis Implantation/mortality , Humans , Male , Registries , Reoperation , Survival Analysis , Time Factors
12.
J Exp Psychol Learn Mem Cogn ; 23(5): 1261-74, 1997 Sep.
Article in English | MEDLINE | ID: mdl-9293634

ABSTRACT

It has been argued that temporal and spatial position information are represented similarly, but prior research comparing their time course of retrieval with item information has not supported this conclusion. The time course of retrieval was compared for spatial position and item information in 3 response signal experiments, and differences were found in the time course of retrieval that paralleled those found previously for temporal position and item information (B.M. McElree & B.A. Dosher, 1993). The finding was unaffected by restrictions on the degree of relational support, postretrieval decision difficulty, and the elimination of a strategy favoring item recognition. The authors conclude by discussing whether the data indicate that a recall process was contributing to recognition performance.


Subject(s)
Attention , Mental Recall , Orientation , Pattern Recognition, Visual , Verbal Learning , Adult , Female , Humans , Male , Reaction Time , Reading
13.
Eur J Cardiothorac Surg ; 11(5): 922-8, 1997 May.
Article in English | MEDLINE | ID: mdl-9196310

ABSTRACT

OBJECTIVE: Over the last decade there has been an increasing number of patients aged 80 years and over undergoing heart valve replacement. However, literature on the outcome of mitral valve replacement (MVR) in this age group is still limited. METHODS: We conducted the present study by analysing data extracted from the UK Heart Valve Registry. From January 1986 to December 1994, 86 patients underwent isolated MVR and 10 underwent combined MVR with aortic valve replacement (AVR) and were reported to the Registry. RESULTS: The 30 day mortality was 10.4% (9/86) in the MVR group and 10% (1/10) in the MVR and AVR group. The actuarial survival was 79.8, 64.1 and 40.7% at 1, 3 and 5 years, respectively, in the MVR group. Of the 10 early (30 day) deaths, 8 were due to cardiac reasons and 19 of the 28 late deaths were due to non-cardiac reasons. A total of 55 (57.2%) patients received a bioprosthetic valve implant and 41 (42.8%) patients received a mechanical valve implant. There was no difference in survival between the two groups. CONCLUSIONS: The above results suggest that MVR in octogenarians produces a satisfactory early postoperative outcome and moderate medium-term benefit. There is no difference in survival between patients receiving bioprosthetic and patients receiving mechanical valve implants.


Subject(s)
Cause of Death , Heart Valve Prosthesis/mortality , Mitral Valve/surgery , Actuarial Analysis , Aged , Aged, 80 and over , Aortic Valve/surgery , Bioprosthesis/mortality , Female , Humans , Male , Patient Selection , Prosthesis Design , Registries , Survival Rate , Time Factors , United Kingdom/epidemiology
14.
Memory ; 3(2): 201-19, 1995 Jun.
Article in English | MEDLINE | ID: mdl-7796305

ABSTRACT

A simulation of an air traffic control task was the setting for an investigation of the functions of external cues in prospective memory. External cues can support the triggering of an action or memory for the content of the action. We focused on memory for the content, and manipulated the temporal characteristics of the external cue to disentangle two possible functions the cue can support: (1) an external cue visible during a retention interval could support rehearsal of the to-be-performed action; (2) an external cue visible at the end of a retention interval could support retrieval of the to-be-performed action. Two experiments were conducted that converge on the same conclusion: the primary function of an external cue is to support retrieval. Implications for the design of a computer interface to present prospective cues are discussed.


Subject(s)
Association Learning , Cues , Mental Recall , Analysis of Variance , Aviation , Humans , Practice, Psychological , Retention, Psychology , Time Factors
15.
Arch Neurol ; 50(1): 20-3, 1993 Jan.
Article in English | MEDLINE | ID: mdl-8418796

ABSTRACT

We describe six young patients with insidiously progressive, painless weakness in the distribution of a single major lower extremity nerve. No cause could be found despite extensive evaluation, including surgical exploration. At the time of diagnosis, all patients had weakness and three patients had sensory loss. In all cases, electromyography revealed a chronic axonal mononeuropathy without conduction block or focal conduction slowing. Magnetic resonance, computed tomographic, and ultrasound imaging studies did not identify a region of nerve swelling, mass, or compression. At surgical exploration, the nerve appeared atrophic in two patients, indurated in one patient, and normal in two patients. Biopsy specimens obtained from two abnormal nerves revealed either wallerian degeneration or endoneurial fibrosis. The clinical features of these patients comprise an unusual clinical entity with no known cause or treatment.


Subject(s)
Nervous System Diseases/diagnosis , Action Potentials , Adolescent , Adult , Child , Electromyography , Female , Femoral Nerve/physiopathology , Humans , Leg/innervation , Male , Nervous System Diseases/physiopathology , Peroneal Nerve/physiopathology , Sciatic Nerve/physiopathology , Tibial Nerve/physiopathology
16.
Oral Surg Oral Med Oral Pathol ; 65(1): 81-4, 1988 Jan.
Article in English | MEDLINE | ID: mdl-3422400

ABSTRACT

The lesion reported in this article destroyed much of the right side of the mandible in a 14-year-old boy. Clinically, it resembled Burkitt's lymphoma and was initially treated as such. After correct microscopic diagnosis, the mass regressed with the use of intravenous amphotericin B and surgical reduction. The histologic comparison with giant-cell granuloma is considered.


Subject(s)
Granuloma, Giant Cell/diagnosis , Histoplasmosis/diagnosis , Mandibular Diseases/diagnosis , Mandibular Neoplasms/diagnosis , Adolescent , Burkitt Lymphoma/diagnosis , Burkitt Lymphoma/pathology , Diagnosis, Differential , Granuloma, Giant Cell/pathology , Histoplasmosis/pathology , Humans , Male , Mandibular Diseases/pathology , Mandibular Neoplasms/pathology
17.
Int J Oral Maxillofac Surg ; 16(2): 205-13, 1987 Apr.
Article in English | MEDLINE | ID: mdl-3110321

ABSTRACT

15 primary and one metastatic osteosarcoma of the jaw bones in Nigerians are described. The age range was typical of this tumour; most cases were in the mandible. Clinical and radiographic features were often diagnostic but the microscopic appearances were varied and problematical. No metastases were detected and effective surgical treatment depended upon the degree of spread in soft tissue. Inoperable tumours had infiltrated the pharyngeal and tonsillar area. Some resected cases survived for one year or more.


Subject(s)
Mandibular Neoplasms/pathology , Maxillary Neoplasms/pathology , Osteosarcoma/pathology , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Nigeria
19.
Int J Oral Maxillofac Surg ; 16(1): 119-24, 1987 Feb.
Article in English | MEDLINE | ID: mdl-3104490

ABSTRACT

2 cases of this rare tumour in Nigerian subjects is described. Clinical features indicated relatively slow but painful growth, aggravated in 1 case by dental extractions. Radical resection was followed by 6-year survival without recurrence or overt metastasis. Microscopic differential diagnosis is discussed.


Subject(s)
Chondrosarcoma/pathology , Mandibular Neoplasms/pathology , Adult , Diagnosis, Differential , Female , Humans , Male
20.
Am J Obstet Gynecol ; 156(1): 79-85, 1987 Jan.
Article in English | MEDLINE | ID: mdl-3541625

ABSTRACT

A guide presented in this article provides the sonographer with a list of fetal malformations that have been described in association with specific drugs or chemicals and that can be visualized by current ultrasonographic techniques.


Subject(s)
Abnormalities, Drug-Induced/diagnosis , Fetal Diseases/diagnosis , Prenatal Diagnosis , Ultrasonography , Female , Humans , Pregnancy
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