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Biomedical subjects

R Cope

Publications and source records attributed to R Cope.

At least 37 records · Page 2Linked to original sources
PubMed1990

Regression of tendon xanthomas in patients with familial hypercholesterolemia treated with lovastatin.

Plasma concentrations of total and low-density lipoprotein cholesterol are increased twofold to threefold in patients with heterozygous familial hypercholesterolemia. This sustained increase leads to accelerated rates of cholesterol deposition in the coronary arteries and to the development of tendon xanthomas. To assess whether hypolipidemic therapy with lovastatin, alone and in combination therapy with colestipol hydrochloride or nicotinic acid, results in regression of lipid deposits in the tendons of these patients, we have measured Achilles tendon diameters by xeroradiography before and after treatment. In 20 patients treated for a mean of 43 months (during which time plasma cholesterol concentrations decreased from 430 to 247 mg/dL), the diameter of both the left and right Achilles tendons measured at three different locations decreased by 0.55 to 1.5 mm. Larger reductions were seen in the tendons of seven of these patients who were treated for a mean of 64 months and whose mean concentrations of cholesterol fell from 488 to 279 mg/dL. We conclude that effective long-term hypolipidemic therapy leads to diminution in the size of Achilles tendon xanthomas in patients with heterozygous familial hypercholesterolemia and that such therapy is associated with mobilization of tissue stores of cholesterol in these patients.

Achilles Tendon↗
PubMed1990

Heterotopic ossification.

Heterotopic ossification is becoming increasingly recognized as a phenomenon that can complicate trauma to the head and spinal cord. It can be a disabling accompaniment of thermal injury, and it may seriously compromise results in hip arthroplasty and the treatment of acetabular fractures. Etiologic factors, which are imprecise and incompletely understood, vary with the clinical situation. The five cases reported here illustrate the radiologic appearances, complications, and diagnostic problems, including the difficulty in determining the timing of surgical resection. Reported for the first time are cases of neurogenic heterotopic ossification associated with bilateral shoulder involvement and bilateral ulnar nerve entrapment at the elbow. Heterotopic ossification may mimic acute arthritis.

Adult↗
PubMed1989

The surgery of the rheumatoid wrist: postoperative appearances and complications of the more common procedures.

There is considerable orthopedic interest in the surgical management of rheumatoid arthritis involving the wrist. Surgery is being used more frequently in treating this condition, and many surgical options are available. The biomechanical basis, indications, postoperative appearances, and complications of these many operations should be known to the radiologist involved in preoperative care and postoperative follow-up. Some of the more frequent procedures are presented, and the complications are discussed.

Adult↗
PubMed1988

Posterior dislocation of the sternoclavicular joint: report of two cases, with emphasis on radiologic management and early diagnosis.

Posterior dislocations of the sternoclavicular joint are uncommon, but are potentially quite serious. Radiologic diagnosis and management are frequently difficult. The specialized projections available are not widely known, and the role of plain films is poorly understood. The incidence, pathomechanics, and clinical manifestations of such dislocations are presented and the radiologic diagnosis is discussed.

Adolescent↗
PubMed1988

Acute traumatic spondylolysis. Report of a case and review of the literature.

Acute traumatic bilateral spondylolysis and spondylolisthesis was observed in a 34-year-old man. The literature on pathologic and biomechanical factors leading to acute fracture of the pars interarticularis emphasizes the importance of distinguishing spondylolysis resulting from acute trauma from the more common lytic-fatigue pars defect.

Accidental Falls↗
PubMed1987

Metacarpophalangeal arthropathy associated with manual labor (Missouri metacarpal syndrome). Clinical radiographic, and pathologic characteristics of an unusual degeneration process.

We describe 7 manual laborers with painful, palpably enlarged metacarpophalangeal joints. Characteristic radiographic changes were joint space loss, prominent osteophytes, and cystic metacarpal heads most prominent in the second and third metacarpophalangeal joints. In 3 of 4 patients, joint biopsy specimens showed subsynovial fibrosis and villous hyperplasia. All 7 patients had similar backgrounds of heavy work demanding sustained gripping motions of both hands, for periods that exceeded 30 years. We designated their condition metacarpophalangeal arthropathy associated with manual labor.

Aged↗
PubMed1987

Abnormalities of the cervical spine in Down's syndrome: diagnosis, risks, and review of the literature, with particular reference to the Special Olympics.

Over a four-month period, we did roentgenographic examinations of the cervical spine on 35 individuals with Down's syndrome, most of whom planned to participate in the Special Olympics. There were abnormalities in 40%, the most frequent being atlantoaxial subluxation. The presentations, risks, and recognition of this abnormality are discussed, as well as the pathomechanics. Many parents and some physicians may still be unaware of the possible hazards involving these spinal abnormalities, and of the recommendations and screening procedures that should be followed before individuals with Down's syndrome engage in strenuous activities.

Adolescent↗
PubMed1987

The compulsory detention of males of different ethnic groups, with special reference to offender patients.

Compulsory detention rates of white, West Indian and Asian males under Part IV and Part V (offenders) of the 1959 Mental Health Act were compared: British-born West Indians and Asians were differentiated from migrants. Rates for Asians were similar to those for whites, but West Indians were significantly over-represented amongst compulsory detentions, especially as offender patients. A high total number of admissions and diagnostic differences accounted for the excess of West Indians admitted under Part IV, but not Part V.

Adolescent↗
PubMed1986

Bilateral tracheal bronchi.

A case of bilateral tracheal bronchi, first diagnosed at 14 months, is reported in a child who is currently alive and well at more than two years of age. This is only the second such case to be described in the world literature and is the only case to survive the first year of life. A tracheal accessory lung was also present. The varieties of tracheal bronchi are described. The importance of considering this uncommon abnormality in a number of clinical situations is emphasized.

Bronchi↗
PubMed1986

Minimal spinal hyperostosis with low-dose isotretinoin therapy.

Skeletal abnormalities have been reported on numerous occasions in patients who have received high doses of vitamin A and its derivatives. Recently, a new derivative, isotretinoin (Accutane, Hoffman-LaRoche, Inc.), has become available for the treatment of cystic acne. Ninety-six patients treated for a minimum of four months with low doses of this drug at two University centers have shown overall good to excellent clinical responses. However, ten of these patients have developed small pointed excrescences on the anterior margins of cervical, thoracic, or lumbar vertebral bodies. The findings are of unknown clinical significance but show some similarities to the spinal findings in DISH syndrome. Follow-up studies will be obtained, but, at the present time, the drug still can be recommended for patients who have severe cystic acne because of the excellent clinical response.

Acne Vulgaris↗
PubMed1983

Multiple endocrine neoplasia, type 2b, as a cause of megacolon.

A case of multiple endocrine neoplasia, type 2b, is reported presenting with weight loss, neck masses, and constipation. A medullary thyroid carcinoma was found to be present together with a megacolon. In this syndrome, the diagnosis of the thyroid tumor is rarely made before it is well established; hence an appreciation of the accompanying gastrointestinal symptoms and signs may lead to early diagnosis. The case had many classical features, such as ganglioneuromata involving the tongue, lips, and eyelids and typical biochemical findings. However, several unusual findings were present, such as the absence of any skeletal abnormalities, an acute onset of constipation, and the presence of bony metastases and the case is reported to illustrate the complexity of this uncommon entity.

Adult↗