Gt Mcgreal

Mercy University Hospital | Mercy · Department of Surgery

A 72-year-old man presented with a 3-day history of recurrent transient ischaemic attacks comprising slurred speech, left arm weakness and paresthesia. Carotid Doppler revealed total occlusion of the right internal carotid artery (ICA). Computed tomography angiography demonstrated occlusion of the proximal right ICA over a length of 1.5 cm. The ICA...

A 28-year-old woman presented to the emergency department with a 5-day history of a sore throat and a pharyngeal swelling that increased in size. The patient was previously investigated for Marfan's syndrome after episodes of bilateral spontaneous pneumothoraces but did not meet the criteria for diagnosis. Examination revealed a large pulsatile les...

Aims: COX-2 has been shown to be important in angiogenesis and carcinogenesis. We hypothesized that COX-2 expression in breast cancer would correlate with an invasive phenotype.Methods: Forty-one patients with breast cancer had level 3 axillary dissection and bone marrow aspiration (from rib and iliac crest). Nodes were analysed by H and E staining...

The plasminogen activator (PA) system comprises the 2 serine proteases, urokinase PA (uPA) and tissue PA (tPA), the 2 serpin inhibitors, PAI-1 and PAI-2 and the uPA receptor (uPAR; CD87). High levels of uPA, PAI-1, uPA-PAI-1 complex and uPAR in breast cancer tissue are associated with poor prognosis, while high levels of tPA or PAI-2 correlate with...

The Ets family of transcription factors regulate expression of multiple genes involved in tumour progression. The aim of this study was to investigate the expression of Ets-1 in a large panel of human breast cancers and relate its levels to the parameters of tumour progression and metastasis. Using RT-PCR, Ets-1 mRNA was detected in 30 out of 42 (7...

Overwhelming post-splenectomy infection (OPSI) has a 50-70% mortality rate and carries a lifetime risk for the asplenic patient. Specific British guidelines have been developed to reduce its incidence. To determine whether British guidelines were being followed in our own institution and what impact they had on overwhelming post-splenectomy infecti...

Both the expressions of the inducible form of cyclooxygenase-2 and the presence of bone marrow micrometastases are poor prognostic markers in patients with colorectal carcinoma. As cyclooxygenase-2 expression in these tumours is associated with increased metastatic potential in vitro, our objectives were to determine the relationship between cycloo...

Although it is widely accepted that aspirin will increase the risk of intra- and post-operative bleeding, clinical studies have not consistently supported this assumption. We aimed to assess the effect of pre-operative aspirin on blood loss and transfusion requirements in patients undergoing emergency fixation of femoral neck fractures. A prospecti...

The role of prophylactic antibiotics is well established for contaminated wounds, but the use of antiseptic wound wicks is controversial. The aim of this work was to study the potential use of wound wicks to reduce the rate of infection following appendectomy. This prospective randomized controlled clinical trial was conducted at a university hospi...

Conclusion Using the above parameters, these data demonstrate that this population of type 1 diabetics have no evidence of platelet abnormalities. Further, they indicate that anti-platelet therapy is not required in the early stages of type 1 diabetes and that endothelial dysfunction precedes and is a potential mediator of diabetic platelet dysfunc...

Primary hyperparathyroidism affects 1 in 700 individuals in the United States. A single adenoma is responsible in over 85% of cases. Surgery remains the most effective treatment. This study was designed to assess the feasibility of minimally invasive radioguided parathyroidectomy (MIRP) with confirmation of excision by ex vivo radioactivity alone....

The routine use of nasogastric tubes in patients undergoing elective abdominal operation is associated with an increased incidence of postoperative fever, atelectasis, and pneumonia. Previous studies have shown that nasogastric tubes have no significant effect on the incidence of gastroesophageal reflux or on lower esophageal sphincter pressure in...

Large population-based studies have shown a significant association between melanoma and lymphoid neoplasia, particularly non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukaemia (CLL), that is independent of any treatment received for the initial tumour. This study examines the presentation, diagnosis, treatment and progress of three patient...

Investigation of lower extremity pain is compromised by comorbid disorders that may interfere with conventional testing. To compare pedal ergometry with conventional treadmill testing. A prospective study was performed where patients presenting with a diagnosis of intermittent claudication were assessed by both methods of testing. Of 78 patients st...

Thirty three patients with phaeochromocytomas had surgery in St. Vincent's Hospital between 1950 and 1997. 32 patients had hypertension, 32 had palpitations and 30 had excessive sweating. All patients had at least one of these cardinal symptoms. Diagnostic tests changed over this period. In the early cases the phentolamine test was used, later diag...

Axillary clearance, despite its morbidity, retains an essential role in the management of patients with breast cancer. The aim of this prospective study was to document the development of arm swelling and limitation of shoulder movement following complete axillary clearance. One hundred patients who had axillary clearance to level III, for treatmen...

To explore the influence of experience and specialisation on clinical judgement by comparing accuracy in diagnosing anaemia between a consultant general surgeon, a consultant ophthalmologist and their registrars. Conjunctival inspection of 101 patients, subsequent correlation with haemoglobin concentration. Number of correct and incorrect diagnoses...

In a prospective study of 29 patients with clinically node-negative breast cancer, sampling of rib marrow was superior to sampling of iliac-crest marrow for detection of micrometastases. Combination of marrow micrometastatic analysis with sentinel lymph-node mapping may improve accuracy of staging in breast cancer.

We use a braided polyester suture in place of cerclage wire in tension band fixations. The objective of this study was to test the biomechanical properties of this technique. Sixteen cadaveric patellae were fractured and repaired by modified tension band fixation. Eight were fixed using eighteen gauge stainless steel wire as a tension band and eigh...

Studies from model systems suggest that matrix metalloproteinases (MMPs) are causally involved in tumor progression while tissue inhibitors of MMPs (TIMPs) prevent this progression. Here, we show that concentrations of TIMP-1 are significantly higher in breast carcinomas than in fibroadenomas. In primary breast cancers, TIMP-1 concentrations increa...

During a four-year period, 308 patients presented following ingestion of foreign bodies. Ingestion was accidental in 272 cases (88.3%) and deliberate in the remainder. Symptoms at presentation included dysphagia, odynophagia, nausea and vomiting, chest pain and pharyngeal discomfort. Sixty-eight patients were asymptomatic. A policy of expectant man...

Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in con...

This study was performed in response to the literature reporting an abnormally high incidence of false positive Chvostek's sign. These figures range from 5-11% ~2,3>. These data tend to undermine the usefulness of a simple clinical sign upon which rapid therapeutic intervention can sometimes be necessary. Personal observation had previously failed...

A case of histologically confirmed Paget's disease of the breast in a 72 year old man, without underlying breast carcinoma, is reported. This report raises questions about the pathogenesis of this condition and suggests that Paget's disease is an independent, intraepidermal carcinoma rather than a direct extension of intraductal carcinoma of the br...

In an attempt to identify patients at risk of breast cancer, 9E 10 c-myc monoclonal antibody was used to detect the oncogene products in 64 breast tissue biopsies. There were 44 specimens of benign breast disorders: 21 from patients who developed subsequent breast cancer, and 23 from patients who did not. The remainder were malignant tumor biopsies...