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Biomedical subjects

R C Hewes

Publications and source records attributed to R C Hewes.

7 recordsLinked to original sources
PubMed1987

Long-segment femoropopliteal stenoses: is angioplasty a boon or a bust?

Analysis of 193 femoropopliteal angioplasties demonstrated patency rates in the stenotic group of 75.5% at 6 months and 54.4% at 54 months. The patency rates for the occlusive group were 93.7% at 6 months and 72.9% at 54 months; these rates were significantly better than those in patients with stenoses. A group of 14 patients with long-segment (greater than 7 cm) stenosis had the highest risk of early failure, with a 6-month patency of 23.1%. After removal of the long-segment stenosis group from the results, there were no significant differences between the long-term patencies for stenotic and occlusive lesions. If angioplasty of long stenoses is attempted, a high initial success rate but early failure should be anticipated.

Angioplasty, Balloon↗
PubMed1986

Long-term results of superficial femoral artery angioplasty.

Short-term results of superficial femoral artery and popliteal percutaneous transluminal angioplasty have been good, but long-term results and factors influencing long-term patency are less commonly reported. One hundred thirty-seven superficial femoral artery angioplasties with follow-up for 54 months were reviewed. The 4-year patency for stenoses was 61% and for occlusions was 68%. If the initial result was clinically successful, the 4-year patency was not influenced by the quality or patency of runoff or by the length of the occlusion. Nineteen patients returned for redilatation, eight of whom had developed new lesions. Patency was adversely affected in patients with diabetes or with long-segment stenoses. Modifications of equipment and technique that may improve long-term patency rates are discussed.

Angioplasty, Balloon↗
PubMed1986

Hip changes in spastic cerebral palsy.

Radiographs of the hips of 69 patients with cerebral palsy were evaluated for the angle of Wiberg, acetabular angle, degree of subluxation, shape of the femoral head, and, when the appropriate studies had been performed, anteversion and neck-shaft angles. Abnormalities included various degrees of superior lateral subluxation or dislocation, dysplasia of the acetabulum associated with femoral head displacement, flattening of the medial and/or lateral portions of the femoral head, an increase in the anteversion angle, functional increase in the neck-shaft angle, and, in long-standing cases, secondary degenerative joint disease and pseudoarticulation. Neuromuscular imbalances and abnormal ambulation caused by cerebral palsy change the biomechanical forces on the hip and result in characteristic osseous changes. Recognition and proper treatment of these changes can significantly alter the clinical course of the disease.

Adolescent↗
PubMed1985

Cerebral embolism--first manifestation of pulmonary arteriovenous malformation in patients with hereditary hemorrhagic telangiectasia.

Four of five patients with asymptomatic small or moderate-size pulmonary arteriovenous malformation (PAVM) presented with a paradoxical embolus and stroke. In these patients chest radiographic findings were subtle and arterial hypoxemia provided the real clue to diagnosis. Computed tomography (CT) and cerebral arteriography confirmed embolic occlusion in four of five patients. Careful family screening including posteroanterior (PA) and lateral chest radiographs and arterial oxygen determinations in sitting or standing positions are recommended for early detection of asymptomatic patients with PAVM. Early therapeutic intervention (with balloon embolotherapy) is recommended to avoid paradoxical embolization.

Adult↗
PubMed1983

Percutaneous bone biopsy: the importance of aspirated osseous blood.

The diagnostic value of the microscopic examination of bone core specimen versus osseous blood, obtained by 110 percutaneous biopsies performed on 100 patients, was evaluated. A diagnosis of malignancy was made by biopsy in 54 cases. In 52 cases in which osseous blood (clot and smears) was available for examination, a positive diagnosis for malignancy was made microscopically in 49 (94%). In 46 cases in which bone cores were studied separately, a microscopic diagnosis of malignancy was made from the bone core in 39 (85%). If osseous blood had not been available for examination only 39 (72%) of the 54 biopsies would have been positive for malignancy; the other 14 biopsies would have been classified as either negative or insufficient for diagnosis. In those biopsies where both bone cores and osseous blood were available, the osseous blood showed better malignant tissue morphology and was considered better diagnostic material in 19 cases, whereas bone cores were considered better diagnostic material in only three cases. Osseous blood, which is usually easily available in bone biopsies, is valuable diagnostic material; it should be treated as a tissue specimen and not discarded.

Adenocarcinoma↗
PubMed1979

Iatrogenic hydromediastinum simulating aortic laceration.

Widening of the mediastinum after blunt, deceleration injuries to the chest in three patients suggested thoracic aortic lacerations. In each patient, the aorta was found to be intact and the iatrogenic hydromediastinum was caused by malpositioned central venous pressure lines. The radiographic appearance of the central venous pressure catheter is illustrated and clinical characteristics of the malpositioned catheter are discussed.

Adolescent↗