A. Parkin
St James's University Hospital
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Featured researches published by A. Parkin.
Phlebology | 1999
P. J. Kent; J. Maughan; M. Burniston; T. Nicholas; A. Parkin; P. J. Robinson
Objective: To compare the extent of thigh haematoma formation after perforation-invagination (PIN) stripping with that occurring after standard plication stripping of the long saphenous vein. Design: Prospective, within-case, randomised study with analysis on an intention-to-treat basis. Setting: The radioisotope department of a university teaching hospital. Patients: Fourteen patients undergoing bilateral varicose vein surgery. Interventions: Red blood cell labelling in vivo with 99Tcm. Preoperative imaging of the long saphenous vein using a gamma camera. Randomisation of one leg to PIN stripping and the other to standard stripping of the long saphenous vein to the knee. Patients were reimaged 6 h postoperatively. Main outcome measures: The extent of thigh haematoma formation. Results: There was no significant difference with respect to the severity of varicosities in the long saphenous vein in the thigh between the limbs assigned to each group (n = 11) on the preoperative images (T = 25, 0.5>p>0.1, Wilcoxon signed rank test). Thigh haematoma in the limbs that had undergone PIN stripping of the long saphenous vein was significantly less than that in the limbs that had undergone standard stripping (T = 10, 0.05>p>0.01, Wilcoxon signed rank test). Conclusion: PIN stripping of the long saphenous vein results in significantly decreased haematoma formation compared with standard stripping.
Archives of Disease in Childhood | 1999
Daniel Wilson; Maria Burniston; Eduardo Moya; A. Parkin; Stephen W. Smye; Phillip Robinson; J M Littlewood
AIM To investigate deposition patterns and to assess the delivery rate of two nebuliser systems in children with cystic fibrosis (CF). METHODS Thirty three children with CF on regular treatment with nebulised antibiotics had radioisotope scans performed using technetium-99m labelled aerosol antibiotic generated by a Ventstream nebuliser (median mass diameter (MMD), 3.3 μm; delivery rate, 0.075 ml/min) under conditions similar to their routine home practice. The inhomogeneity of the images was scored on a 1–10 rating scale (a low score indicating even distribution of the antibiotic), and stomach deposition was measured as a percentage of overall deposition. Twenty patients had a repeat scan using an Optimist nebuliser (MMD, 1.8 μm; delivery rate, 0.02 ml/min). RESULTS The mean inhomogeneity scores were 5.4 in the Ventstream group and 3.5 in the Optimist group. Mean stomach deposition was 17.3% in the 33 patients using the Ventstream nebuliser. There was an inverse relation between height and stomach deposition (r = 0.69). In the 20 patients who had both nebulisers, the mean percentages of stomach deposition for the Ventstream and Optimist nebulisers were 11.8% and 1.6%, respectively. The Ventstream nebuliser delivered antibiotic at an average 2.8 times faster rate than the Optimist nebuliser. IMPLICATIONS A smaller particle size results in a more homogenous distribution of the antibiotic in the lungs with decreased stomach deposition. This should not be seen as a recommendation to use the Optimist nebuliser because more antibiotic was delivered to most parts of the lung with the Ventstream because of its increased delivery rate.
Journal of Biomedical Engineering | 1992
S.W Smye; A. Parkin; M.I.G Bloor
A radionuclide technique (PT) for measuring the blood flow to a limb during reactive hyperaemia is described and analysed. Patients are positioned with lower limbs within the field of view of the gamma camera and pneumatic cuffs are placed below the knees to isolate the blood and induce a hyperaemic response. The remaining blood pool is labelled with 99Tcm-human serum albumin. Following release of the occlusion the rate of inflow to the limb of the radionuclide is measured and hyperaemic flow then determined, during the initial phase of the hyperaemia. The results may be analysed using a single compartment to represent the vascular pool in the lower limb. During the initial phase, activity entered the pool at a constant rate from which the blood flow may be calculated. Results were obtained in a group of 20 normal control volunteers and 20 patients with occlusive arterial disease. They indicate that following release of the cuff the blood flow rises rapidly (within 1-2 s) to a constant value which is maintained for at least 10-12 s in normal subjects and a longer period in arteriopaths. The mean flow in the normal group was 14.4 ml/100 ml min-1 and in the arteriopathic group was 4.6 ml/100 ml min-1. The constant flow measured by PT during the initial phase of reactive hyperaemia appears to differ from the results of venous occlusion plethysmography and washout of a freely diffusible tracer and possible reasons for these differences are discussed.
Journal of Biomedical Engineering | 1991
S. Ashley; S.G. Brooks; A.A. Gehani; Thorley Pj; A. Parkin; R. C. Kester; M.R. Rees
A technique of isotope limb blood flow (ILBF) measurement employing Technetium-labelled human albumin and a gamma camera, was used to assess limb perfusion in 19 patients undergoing percutaneous laser angioplasty, both before and one month after treatment. Twenty-three limbs with femoro-popliteal occlusions ranging in length from 3-35 cm (median 8 cm) were recanalized using an Nd-YAG laser and sapphire tipped optical fibre. Primary angiographic success was achieved in 19 lesions of which 6 re-occluded within the first month, and 13 remained patent with relief of symptoms. Clinically successful procedures were associated with a large increase in ILBF. However, normal blood flow was restored in only 54% of limbs. There was a slight decrease in limb perfusion after failed laser angioplasty but this was not statistically significant in this small series. Furthermore, there was no clinically apparent circulatory compromise, or need for urgent surgical bypass in failed cases. We conclude that ILBF is a useful means of assessing patients undergoing laser angioplasty, particularly for detecting small flow changes in patients who are unable to complete a standard exercise test. Its use can be recommended for assessing blood flow changes following other forms of limb revascularization.
Angiology | 1990
D. Wilkinson; A. Parkin; Peter Vowden; Philip Robinson; R. C. Kester
To evaluate a new method for limb blood flow measurement using a radioactive isotope and a gamma camera, blood flow measurements have ben made on 108 patients with peripheral vascular disease. Thirty-six patients had ischaemic rest pain, of whom two had previously undergone unilateral amputation. Five had bilateral symptoms, giving 29 asymptomatic limbs and 41 limbs with critical ischaemia. In 72 patients with intermittent claudication a series of exercise tests were attempted, in 33 these were unsatisfactory; 13 patients had a greater than 20% variability in the maximum walking distance between four tests and in 20 walking distance was limited by factors other than claudication. In these 33 patients the limb blood flow to the symptomatic leg was 3.95 (1.36-11.08) ml/100 ml of tissue/minute. This is not significantly different from the limb blood flow to the symptomatic leg of the 39 patients who satisfactorily completed four exercise tests, 3.75 (1.08-8.25) ml/100 ml of tissue/minute. In these 39 patients the mean pain-free walking distance was 40 metres and the mean maximum walking distance was 63 metres. The limb blood flow to the 41 symptomatic limbs of 36 patients with rest pain was 1.90 (0.90-4.49) ml/100 ml of tissue/minute, which is significantly less than that obtained in claudicants. There was a wide range of blood flow values found in the asymptomatic limbs of all the patients and in many cases the flow was markedly reduced from normal. This method of limb blood flow measurement is accurate and reproducible and may be recommended for assessment of peripheral vascular disease.
British Journal of Surgery | 1991
P. Kent; S. Ashley; Thorley Pj; Shaw A; A. Parkin; R. C. Kester
British Journal of Surgery | 1987
D. Wilkinson; P. Vowden; A. Parkin; P. A. Wiggins; Philip Robinson; R. C. Kester
British Journal of Surgery | 1987
A. Parkin; P. A. Wiggins; Philip Robinson; P. Vowden; R. C. Kester; Fiona M. Ware
Journal of Biomedical Engineering | 1991
P. Kent; D. Wilkinson; A. Parkin; R. C. Kester
The Journal of Nuclear Medicine | 1989
A. Parkin; Stephen W. Smye; Nicholas Bishop; D. Wilkinson; Michael Rees; Peter Vowden; R. C. Kester