Mohamed Ziyad Abubacker - Academia.edu (original) (raw)
Papers by Mohamed Ziyad Abubacker
Nuclear Medicine Communications, 2006
reported in the literature. Further, although the overall sensitivity is not good it does fare we... more reported in the literature. Further, although the overall sensitivity is not good it does fare well in the investigation of post-operative patients.
Gut, 2009
A 67-year-old man presented with worsening shortness of breath on exertion and peripheral oedema ... more A 67-year-old man presented with worsening shortness of breath on exertion and peripheral oedema of 3 months duration. He had evidence of heart failure including raised jugular venous pressure, gallop rhythm and bilateral pedal oedema. …
Clinical Radiology, 2006
To evaluate the diagnostic performance of an interactive, adaptively averaged (AA) two-dimensiona... more To evaluate the diagnostic performance of an interactive, adaptively averaged (AA) two-dimensional (2D) magnetic resonance cholangiography (MRC) technique in patients with suspected biliary disease by comparison to the standard MRC technique. MATERIALS AND METHODS: The AA 2D MRC method registers the images after acquisition, allowing summation of multiple images to improve the signal:noise ratio (SNR) and thereby potentially improve the visualization of bile ducts. One hundred and twenty-eight patients underwent both 2D conventional and AA magnetic resonance cholangiopancreatography (MRCP). Twenty-seven patients were excluded from the analysis as AA images could not be properly obtained due to technical failures. All examinations were performed using a 1.5 T whole-body MR system and a four-channel torso phased array coil. Images of 101 patients were adaptively averaged using an in-house developed program written in IDL. Two readers qualitatively evaluated the studies in consensus, blinded to acquisition details and without knowledge of clinical information. RESULTS: The AA technique was significantly better than the conventional 2D MRC for the visualization of the second-order branch intrahepatic ducts (p < 00001). Overall, there was no significant difference in the diagnostic confidence between two techniques (p ¼ 0.12). However, the AA technique showed a trend towards more confident diagnosis of biliary strictures (p ¼ 0.055), likely due to better diagnostic confidence in identifying second order branch intrahepatic duct strictures (p ¼ 0.054). CONCLUSION: Excluding those patients those patients in whom either satisfactory respiratory gating or a suitable kernel placement was not achieved, AA 2D MRC demonstrated a significant improvement in visualization of intrahepatic duct branches compared to standard MRC.
British Journal of Medical and Surgical Urology, 2011
Objective: To determine the diagnostic accuracy of ultra-low dose contrast-enhanced CT (ULDCECT) ... more Objective: To determine the diagnostic accuracy of ultra-low dose contrast-enhanced CT (ULDCECT) and its ability to measure differential renal function (DRF) in patients presenting clinically with acute ureteric colic by comparison to IVU (using an equivalent radiation exposure) and DMSA, respectively. Patients and methods: Fifty-three patients presenting clinically with acute ureteric colic underwent IVU, ULDCECT and DMSA on the same day of their hospital admission. Diagnostic accuracy of ULDCECT and IVU was compared to interventional findings and clinical outcome. Estimation of DRF by ULDCECT was derived through measurement of enhancing renal volumes and DMSA. Results: ULDCECT had superior sensitivity (97%) and specificity (100%) in the identification of renal tract stone disease compared to IVU (84 and 95% respectively), with comparable radiation exposure (1.7 mSv versus 1.4 mSv). Furthermore, ULDCECT revealed non-urological pathology in eight patients (15%), including perforated...
Journal of Endovascular Therapy, 2003
To report the embolization of a renal artery aneurysm using Onyx, a radiopaque nonadhesive liquid... more To report the embolization of a renal artery aneurysm using Onyx, a radiopaque nonadhesive liquid embolic agent. Case Report: A 28-year-old woman with hypertension and fibromuscular dysplasia presented with a 20-mm renal artery aneurysm. In order to avoid any migration of embolic material into the parent vessel, a compliant balloon was inflated to exclude the aneurysm from the blood flow while injecting the liquid embolic agent. Complete aneurysm exclusion was achieved immediately, with no angiographic or duplex evidence of distal embolization or intra-aneurysmal flow. The Doppler ultrasound at 6 months confirmed aneurysm exclusion. Conclusions: The ease of use and nature of this material makes Onyx an effective and safe option in the treatment of wide-necked renal aneurysms.
British Journal of Radiology, 2006
Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effe... more Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effects at organ level are not well understood, especially the effect on liver fat storage. Such studies require serial hepatic fat measurements, for which liver biopsy is impractical. In 10 healthy volunteers we demonstrate the use of rapid (total 2 min acquisition time, 10 min magnet room time), non-invasive, quantitative MRI to serially measure hepatic fat changes induced by following a low carbohydrate diet for 10 days. A significant (p&amp;lt;0.01) reduction in hepatic fat after 3 days of dieting was observed in 5 subjects. All subjects demonstrated significant (p&amp;lt;0.01) reductions in hepatic fat by day 10. A strong correlation (kappa = 0.81) existed between the initial fat content and the percentage fat content reduction in the first 3 days of the diet. All subjects lost weight (average 1.7 kg at day 3 and 3.0 kg at day 10), but this was not correlated with hepatic fat loss after 3 days or 10 days of dieting. The results presented illustrate the potential value of MR hepatic fat quantification in longitudinal studies of hepatic fat content.
Endocrinology, Diabetes & Metabolism Case Reports
Summary An insulinoma is a rare tumour with an incidence of four cases per million per year in ad... more Summary An insulinoma is a rare tumour with an incidence of four cases per million per year in adults. The incidence in children is not established. There is limited literature available in children with insulinoma, and only one case is reported in association with Down’s syndrome in adults. Insulinoma diagnosis is frequently missed in adults as well as in children. The Whipple triad is the most striking feature although it has limited application in young children. Hypoglycaemia with elevated insulin, C-peptide and absent ketones is highly suggestive of hyperinsulinism. We present a case of 10-year-old boy with Down’s syndrome with recurrent insulinoma. He was initially misdiagnosed as having an adrenal insufficiency and developed cushingoid features and obesity secondary to hydrocortisone treatment and excessive sugar intake. The tumour was successfully localised in the head of the pancreas with an MRI and octreotide scan on first presentation. Medical treatment with diazoxide and...
CardioVascular and Interventional Radiology, 2004
We report our experience with a combined approach of endovascular biopsy followed by immediate st... more We report our experience with a combined approach of endovascular biopsy followed by immediate stenting in the management of superior vena cava (SVC) syndrome secondary to obstructing mediastinal masses. A diagnosis of malignancy was obtained in six of eight (75%) biopsies and symptomatic relief was accomplished in all patients. We have found this to be a rapid, safe and effective management strategy that we now consider for all patients presenting with de novo SVC syndrome.
Biosciences Biotechnology Research Asia, 2011
Biosciences Biotechnology Research Asia, 2012
Radiology, 2004
To evaluate one-stage antegrade ureteral stent placement without postprocedural nephrostomy tube.... more To evaluate one-stage antegrade ureteral stent placement without postprocedural nephrostomy tube. Tubeless ureteral stent insertion was attempted in 41 (30 men, 11 women; eight, benign obstruction; nine outpatients) of 97 adults (56 excluded). Patients were clinically stable with known ureteral obstruction and had been referred for antegrade ureteral stent insertion. Exclusion criteria were infection, coagulopathy, or emergency cases. After renal access was achieved, ureteral stents were inserted. If drainage was satisfactory and there was no marked procedural bleeding, all access was removed without leaving a nephrostomy tube behind. Technical and clinical success rates and complications were assessed with review of radiologic and clinical notes. If one-stage stent insertion was unsuccessful, a nephrostomy tube was inserted and two-stage stent placement was performed. All 56 patients excluded from this study underwent two-stage stent placement. Major complication rate was assessed (Fisher test). One-stage stent insertion was technically successful in 36 (88%) patients; two with an identifiable risk factor (recent bladder operation, retrograde ureteral instrumentation) developed septicemia that required repeat nephrostomy tube insertion and 2-8 extra days of hospitalization. Clinical success rate was 83% (34 of 41). No major bleeding occurred. In 13 (36%) of 36 patients, hematuria lasted longer than 24 hours but resolved without further intervention or blood transfusion. In those who underwent two-stage stent placement (n = 61), technical success rate was 100%, but clinical success rate was 98%; one patient developed septicemia, and no major hemorrhage occurred. Difference in major complication rate between groups was not significant (6% [two of 36] vs 2% [one of 61]; P =.55). One-stage tubeless antegrade ureteral stent insertion in selected cases showed 88% technical success rate and 83% clinical success rate, with no major hemorrhage.
European Journal of Pediatric Surgery, 2003
Hyperlactaemia has been shown to predict mortality in preterm babies undergoing intensive care. T... more Hyperlactaemia has been shown to predict mortality in preterm babies undergoing intensive care. The value of such measurement has not been evaluated in babies undergoing laparotomy for necrotising enterocolitis (NEC). The aim of this study was to determine whether peri-operative blood lactate measurements (L) can be used to predict outcome in preterm babies with necrotising enterocolitis. Clinical and laboratory data in 24 babies who underwent laparotomy for NEC over 3 years were collected. The data were analysed to correlate blood lactate level with the clinical outcome. There were no statistically significant differences between babies who died and those who survived in terms of gestation, birth weight, condition at birth, etc. There was no difference in pre-operative acid-base status parameters between the groups. Median (range) of pre- and post-operative blood lactate measurements (L) are shown: Pre-op Lactate: 0.9 (0.3 to 2.4) n = 15 (Survivors); 2.7 (0.5 to 10.9) n = 5, p = 0.05 (Non-survivors). Post-op Lactate: 1.2 (0.5 to 6) n = 19 (Survivors); 4.7 (0.2 to 19.5) n = 5, p = 0.06 (Non-survivors). Babies with pre-operative hyperlactaemia ([L] > 1.6 mmol/L) were more likely to die. (Odd's Ratio 22, Confidence Interval 1.54 to 314.3, p = 0.04). Pre-operative L was not higher in babies who subsequently had bowel resection compared to those who had no bowel resection ([L] = 0.88 mmol/L [0.3 to 10.9] vs. 1.6 mmol/L [0.6 to 2.7], [p = 0.2]). Post-operative L was generally higher than pre-operative L but was a less useful predictor of death. This study suggests that elevation of L in the pre-operative period carries a poor prognosis in babies with NEC. As L was not significantly different between babies who had necrotic bowel and those who had a healthy bowel, we postulate that it reflects inadequate global tissue oxygen delivery rather than local disease process. Pre-operative optimisation of oxygen delivery has been shown to reduce mortality in high-risk adult surgical patients. Babies with NEC may also benefit from further peri-operative resuscitation.
European Journal of Pediatric Surgery, 2006
Abdominoscrotal hydrocele (ASH) is an uncommon entity. It consists of large inguinoscrotal swelli... more Abdominoscrotal hydrocele (ASH) is an uncommon entity. It consists of large inguinoscrotal swelling which is dumbbell shaped, and in theory, communicates with its intra-abdominal component. Although various theories have been proposed, the aetiology is still unclear. To date, the only reported management is by surgical excision. Spontaneous resolution has not been documented in the literature. We present a case of proven abdominoscrotal hydrocele successfully managed by conservative approach.
Child's Nervous System, 2001
Spontaneous resolution of acute hydrocephalus without aspiration of cerebral fluid is rare. In a ... more Spontaneous resolution of acute hydrocephalus without aspiration of cerebral fluid is rare. In a neonate born at full term this has only been reported once before. We report on one further case that was caused by intraventricular haemorrhage (IVH). The probable mechanism is resolution of the acute haemorrhage in the region of the aqueduct, resulting in resolution of the hydrocephalus itself. The importance of considering conservative management of acute hydrocephalus in the clinically stable neonate is emphasised.
CardioVascular and Interventional Radiology, 2004
We report our experience with a combined approach of endovascular biopsy followed by immediate st... more We report our experience with a combined approach of endovascular biopsy followed by immediate stenting in the management of superior vena cava (SVC) syndrome secondary to obstructing mediastinal masses. A diagnosis of malignancy was obtained in six of eight (75%) biopsies and symptomatic relief was accomplished in all patients. We have found this to be a rapid, safe and effective management strategy that we now consider for all patients presenting with de novo SVC syndrome.
British Journal of Radiology, 2006
Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effe... more Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effects at organ level are not well understood, especially the effect on liver fat storage. Such studies require serial hepatic fat measurements, for which liver biopsy is impractical. In 10 healthy volunteers we demonstrate the use of rapid (total 2 min acquisition time, 10 min magnet room time), non-invasive, quantitative MRI to serially measure hepatic fat changes induced by following a low carbohydrate diet for 10 days. A significant (p,0.01) reduction in hepatic fat after 3 days of dieting was observed in 5 subjects. All subjects demonstrated significant (p,0.01) reductions in hepatic fat by day 10. A strong correlation (k50.81) existed between the initial fat content and the percentage fat content reduction in the first 3 days of the diet. All subjects lost weight (average 1.7 kg at day 3 and 3.0 kg at day 10), but this was not correlated with hepatic fat loss after 3 days or 10 days of dieting. The results presented illustrate the potential value of MR hepatic fat quantification in longitudinal studies of hepatic fat content.
Nuclear Medicine Communications, 2006
reported in the literature. Further, although the overall sensitivity is not good it does fare we... more reported in the literature. Further, although the overall sensitivity is not good it does fare well in the investigation of post-operative patients.
Gut, 2009
A 67-year-old man presented with worsening shortness of breath on exertion and peripheral oedema ... more A 67-year-old man presented with worsening shortness of breath on exertion and peripheral oedema of 3 months duration. He had evidence of heart failure including raised jugular venous pressure, gallop rhythm and bilateral pedal oedema. …
Clinical Radiology, 2006
To evaluate the diagnostic performance of an interactive, adaptively averaged (AA) two-dimensiona... more To evaluate the diagnostic performance of an interactive, adaptively averaged (AA) two-dimensional (2D) magnetic resonance cholangiography (MRC) technique in patients with suspected biliary disease by comparison to the standard MRC technique. MATERIALS AND METHODS: The AA 2D MRC method registers the images after acquisition, allowing summation of multiple images to improve the signal:noise ratio (SNR) and thereby potentially improve the visualization of bile ducts. One hundred and twenty-eight patients underwent both 2D conventional and AA magnetic resonance cholangiopancreatography (MRCP). Twenty-seven patients were excluded from the analysis as AA images could not be properly obtained due to technical failures. All examinations were performed using a 1.5 T whole-body MR system and a four-channel torso phased array coil. Images of 101 patients were adaptively averaged using an in-house developed program written in IDL. Two readers qualitatively evaluated the studies in consensus, blinded to acquisition details and without knowledge of clinical information. RESULTS: The AA technique was significantly better than the conventional 2D MRC for the visualization of the second-order branch intrahepatic ducts (p < 00001). Overall, there was no significant difference in the diagnostic confidence between two techniques (p ¼ 0.12). However, the AA technique showed a trend towards more confident diagnosis of biliary strictures (p ¼ 0.055), likely due to better diagnostic confidence in identifying second order branch intrahepatic duct strictures (p ¼ 0.054). CONCLUSION: Excluding those patients those patients in whom either satisfactory respiratory gating or a suitable kernel placement was not achieved, AA 2D MRC demonstrated a significant improvement in visualization of intrahepatic duct branches compared to standard MRC.
British Journal of Medical and Surgical Urology, 2011
Objective: To determine the diagnostic accuracy of ultra-low dose contrast-enhanced CT (ULDCECT) ... more Objective: To determine the diagnostic accuracy of ultra-low dose contrast-enhanced CT (ULDCECT) and its ability to measure differential renal function (DRF) in patients presenting clinically with acute ureteric colic by comparison to IVU (using an equivalent radiation exposure) and DMSA, respectively. Patients and methods: Fifty-three patients presenting clinically with acute ureteric colic underwent IVU, ULDCECT and DMSA on the same day of their hospital admission. Diagnostic accuracy of ULDCECT and IVU was compared to interventional findings and clinical outcome. Estimation of DRF by ULDCECT was derived through measurement of enhancing renal volumes and DMSA. Results: ULDCECT had superior sensitivity (97%) and specificity (100%) in the identification of renal tract stone disease compared to IVU (84 and 95% respectively), with comparable radiation exposure (1.7 mSv versus 1.4 mSv). Furthermore, ULDCECT revealed non-urological pathology in eight patients (15%), including perforated...
Journal of Endovascular Therapy, 2003
To report the embolization of a renal artery aneurysm using Onyx, a radiopaque nonadhesive liquid... more To report the embolization of a renal artery aneurysm using Onyx, a radiopaque nonadhesive liquid embolic agent. Case Report: A 28-year-old woman with hypertension and fibromuscular dysplasia presented with a 20-mm renal artery aneurysm. In order to avoid any migration of embolic material into the parent vessel, a compliant balloon was inflated to exclude the aneurysm from the blood flow while injecting the liquid embolic agent. Complete aneurysm exclusion was achieved immediately, with no angiographic or duplex evidence of distal embolization or intra-aneurysmal flow. The Doppler ultrasound at 6 months confirmed aneurysm exclusion. Conclusions: The ease of use and nature of this material makes Onyx an effective and safe option in the treatment of wide-necked renal aneurysms.
British Journal of Radiology, 2006
Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effe... more Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effects at organ level are not well understood, especially the effect on liver fat storage. Such studies require serial hepatic fat measurements, for which liver biopsy is impractical. In 10 healthy volunteers we demonstrate the use of rapid (total 2 min acquisition time, 10 min magnet room time), non-invasive, quantitative MRI to serially measure hepatic fat changes induced by following a low carbohydrate diet for 10 days. A significant (p&amp;lt;0.01) reduction in hepatic fat after 3 days of dieting was observed in 5 subjects. All subjects demonstrated significant (p&amp;lt;0.01) reductions in hepatic fat by day 10. A strong correlation (kappa = 0.81) existed between the initial fat content and the percentage fat content reduction in the first 3 days of the diet. All subjects lost weight (average 1.7 kg at day 3 and 3.0 kg at day 10), but this was not correlated with hepatic fat loss after 3 days or 10 days of dieting. The results presented illustrate the potential value of MR hepatic fat quantification in longitudinal studies of hepatic fat content.
Endocrinology, Diabetes & Metabolism Case Reports
Summary An insulinoma is a rare tumour with an incidence of four cases per million per year in ad... more Summary An insulinoma is a rare tumour with an incidence of four cases per million per year in adults. The incidence in children is not established. There is limited literature available in children with insulinoma, and only one case is reported in association with Down’s syndrome in adults. Insulinoma diagnosis is frequently missed in adults as well as in children. The Whipple triad is the most striking feature although it has limited application in young children. Hypoglycaemia with elevated insulin, C-peptide and absent ketones is highly suggestive of hyperinsulinism. We present a case of 10-year-old boy with Down’s syndrome with recurrent insulinoma. He was initially misdiagnosed as having an adrenal insufficiency and developed cushingoid features and obesity secondary to hydrocortisone treatment and excessive sugar intake. The tumour was successfully localised in the head of the pancreas with an MRI and octreotide scan on first presentation. Medical treatment with diazoxide and...
CardioVascular and Interventional Radiology, 2004
We report our experience with a combined approach of endovascular biopsy followed by immediate st... more We report our experience with a combined approach of endovascular biopsy followed by immediate stenting in the management of superior vena cava (SVC) syndrome secondary to obstructing mediastinal masses. A diagnosis of malignancy was obtained in six of eight (75%) biopsies and symptomatic relief was accomplished in all patients. We have found this to be a rapid, safe and effective management strategy that we now consider for all patients presenting with de novo SVC syndrome.
Biosciences Biotechnology Research Asia, 2011
Biosciences Biotechnology Research Asia, 2012
Radiology, 2004
To evaluate one-stage antegrade ureteral stent placement without postprocedural nephrostomy tube.... more To evaluate one-stage antegrade ureteral stent placement without postprocedural nephrostomy tube. Tubeless ureteral stent insertion was attempted in 41 (30 men, 11 women; eight, benign obstruction; nine outpatients) of 97 adults (56 excluded). Patients were clinically stable with known ureteral obstruction and had been referred for antegrade ureteral stent insertion. Exclusion criteria were infection, coagulopathy, or emergency cases. After renal access was achieved, ureteral stents were inserted. If drainage was satisfactory and there was no marked procedural bleeding, all access was removed without leaving a nephrostomy tube behind. Technical and clinical success rates and complications were assessed with review of radiologic and clinical notes. If one-stage stent insertion was unsuccessful, a nephrostomy tube was inserted and two-stage stent placement was performed. All 56 patients excluded from this study underwent two-stage stent placement. Major complication rate was assessed (Fisher test). One-stage stent insertion was technically successful in 36 (88%) patients; two with an identifiable risk factor (recent bladder operation, retrograde ureteral instrumentation) developed septicemia that required repeat nephrostomy tube insertion and 2-8 extra days of hospitalization. Clinical success rate was 83% (34 of 41). No major bleeding occurred. In 13 (36%) of 36 patients, hematuria lasted longer than 24 hours but resolved without further intervention or blood transfusion. In those who underwent two-stage stent placement (n = 61), technical success rate was 100%, but clinical success rate was 98%; one patient developed septicemia, and no major hemorrhage occurred. Difference in major complication rate between groups was not significant (6% [two of 36] vs 2% [one of 61]; P =.55). One-stage tubeless antegrade ureteral stent insertion in selected cases showed 88% technical success rate and 83% clinical success rate, with no major hemorrhage.
European Journal of Pediatric Surgery, 2003
Hyperlactaemia has been shown to predict mortality in preterm babies undergoing intensive care. T... more Hyperlactaemia has been shown to predict mortality in preterm babies undergoing intensive care. The value of such measurement has not been evaluated in babies undergoing laparotomy for necrotising enterocolitis (NEC). The aim of this study was to determine whether peri-operative blood lactate measurements (L) can be used to predict outcome in preterm babies with necrotising enterocolitis. Clinical and laboratory data in 24 babies who underwent laparotomy for NEC over 3 years were collected. The data were analysed to correlate blood lactate level with the clinical outcome. There were no statistically significant differences between babies who died and those who survived in terms of gestation, birth weight, condition at birth, etc. There was no difference in pre-operative acid-base status parameters between the groups. Median (range) of pre- and post-operative blood lactate measurements (L) are shown: Pre-op Lactate: 0.9 (0.3 to 2.4) n = 15 (Survivors); 2.7 (0.5 to 10.9) n = 5, p = 0.05 (Non-survivors). Post-op Lactate: 1.2 (0.5 to 6) n = 19 (Survivors); 4.7 (0.2 to 19.5) n = 5, p = 0.06 (Non-survivors). Babies with pre-operative hyperlactaemia ([L] > 1.6 mmol/L) were more likely to die. (Odd's Ratio 22, Confidence Interval 1.54 to 314.3, p = 0.04). Pre-operative L was not higher in babies who subsequently had bowel resection compared to those who had no bowel resection ([L] = 0.88 mmol/L [0.3 to 10.9] vs. 1.6 mmol/L [0.6 to 2.7], [p = 0.2]). Post-operative L was generally higher than pre-operative L but was a less useful predictor of death. This study suggests that elevation of L in the pre-operative period carries a poor prognosis in babies with NEC. As L was not significantly different between babies who had necrotic bowel and those who had a healthy bowel, we postulate that it reflects inadequate global tissue oxygen delivery rather than local disease process. Pre-operative optimisation of oxygen delivery has been shown to reduce mortality in high-risk adult surgical patients. Babies with NEC may also benefit from further peri-operative resuscitation.
European Journal of Pediatric Surgery, 2006
Abdominoscrotal hydrocele (ASH) is an uncommon entity. It consists of large inguinoscrotal swelli... more Abdominoscrotal hydrocele (ASH) is an uncommon entity. It consists of large inguinoscrotal swelling which is dumbbell shaped, and in theory, communicates with its intra-abdominal component. Although various theories have been proposed, the aetiology is still unclear. To date, the only reported management is by surgical excision. Spontaneous resolution has not been documented in the literature. We present a case of proven abdominoscrotal hydrocele successfully managed by conservative approach.
Child's Nervous System, 2001
Spontaneous resolution of acute hydrocephalus without aspiration of cerebral fluid is rare. In a ... more Spontaneous resolution of acute hydrocephalus without aspiration of cerebral fluid is rare. In a neonate born at full term this has only been reported once before. We report on one further case that was caused by intraventricular haemorrhage (IVH). The probable mechanism is resolution of the acute haemorrhage in the region of the aqueduct, resulting in resolution of the hydrocephalus itself. The importance of considering conservative management of acute hydrocephalus in the clinically stable neonate is emphasised.
CardioVascular and Interventional Radiology, 2004
We report our experience with a combined approach of endovascular biopsy followed by immediate st... more We report our experience with a combined approach of endovascular biopsy followed by immediate stenting in the management of superior vena cava (SVC) syndrome secondary to obstructing mediastinal masses. A diagnosis of malignancy was obtained in six of eight (75%) biopsies and symptomatic relief was accomplished in all patients. We have found this to be a rapid, safe and effective management strategy that we now consider for all patients presenting with de novo SVC syndrome.
British Journal of Radiology, 2006
Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effe... more Low carbohydrate diets are currently fashionable for inducing weight loss, but the metabolic effects at organ level are not well understood, especially the effect on liver fat storage. Such studies require serial hepatic fat measurements, for which liver biopsy is impractical. In 10 healthy volunteers we demonstrate the use of rapid (total 2 min acquisition time, 10 min magnet room time), non-invasive, quantitative MRI to serially measure hepatic fat changes induced by following a low carbohydrate diet for 10 days. A significant (p,0.01) reduction in hepatic fat after 3 days of dieting was observed in 5 subjects. All subjects demonstrated significant (p,0.01) reductions in hepatic fat by day 10. A strong correlation (k50.81) existed between the initial fat content and the percentage fat content reduction in the first 3 days of the diet. All subjects lost weight (average 1.7 kg at day 3 and 3.0 kg at day 10), but this was not correlated with hepatic fat loss after 3 days or 10 days of dieting. The results presented illustrate the potential value of MR hepatic fat quantification in longitudinal studies of hepatic fat content.