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Biomedical subjects

B H Stewart

Publications and source records attributed to B H Stewart.

At least 73 records · Page 4Linked to original sources
PubMed1979

A new simplified approach to the diagnosis of pheochromocytoma.

Blood catecholamine assays have been used for diagnosis and computerized axial tomography for localization of proved pheochromocytomas in a series of 16 patients. Blood catecholamine assays were obtained in 15 of the patients and were significantly elevated in every instance. Successful localization of the tumor was accomplished by excretory urography in only 40 per cent of the cases, by selective angiography in 84 per cent of the cases and by abdominal computerized axial tomography in 84 per cent of the cases studied. In 4 patients preoperative identification and localization of tumor were correctly determined by computerized axial tomography alone. Data in this series suggest that the diagnosis and localization of pheochromocytoma usually can be accomplished by a simple test and body scan. More elaborate and sometimes hazardous studies should be necessary only in exceptional cases, usually with tumors less than 3 cm. in diameter.

Adrenal Gland Neoplasms↗
PubMed1979

A simplified, cost-effective approach to the diagnosis of pheochromocytoma.

Plasma catecholamines have been used for diagnosis and computerized tomography scanning for localization in 21 patients with proved pheochromocytoma. Blood catecholamines were obtained in 20 of the patients and were elevated significantly in every instance. Successful localization of the tumor was accomplished by excretory urography in only 47% of the cases, by selective angiography in 85% and by abdominal computerized tomography scanning in 88%. In 7 patients preoperative identification and localization of the tumor were determined correctly by computerized tomography scanning alone. Data in our series suggest that the diagnosis and localization of pheochromocytoma can be accomplished usually by a simple blood test and body scan. More elaborate and sometimes hazardous studies should be necessary only in exceptional cases, usually with tumors less than 3 cm. in diameter.

Adrenal Gland Neoplasms↗
PubMed1978

Dimethyl sulfoxide in treatment of inflammatory genitourinary disorders.

Intravesical dimethyl sulfoxide (DMSO) has been used in the treatment of 213 patients with various inflammatory conditions involving the lower genitourinary tract, including intractable interstitial cystitis, radiation cystitis, chronic prostatitis, and chronic female trigonitis. Significant symptomatic relief has been achieved in the majority of patients so treated, and no systemic or local toxicity has been noted. Some patients failed to respond entirely, and others relapsed after DMSO treatment periods of several months, ultimately coming to augmentation cystoplasty or urinary diversion. However, because of its simplicity and ease of administration, intravesical DMSO therapy is recommended in all noninfectious or non-neoplastic inflammatory conditions presenting initially with severe symptoms, or that have failed to respond to conventional therapy.

Adult↗
PubMed1978

Foreign body localization and removal utilizing computerized axial tomography.

In this preliminary report, computerized tomography guidance was instrumental in allowing the safe and rapid removal of a metallic foreign body from paravesical soft tissues deep within the male pelvis. Hopefully, expanded future experience with this technique will further clarify its value in the management of retained foreign bodies.

Foreign Bodies↗
PubMed1978

Mortality and morbidity in pretransplant bilateral nephrectomy: analysis of 305 cases.

The surgical riks were analyzed in 305 patients with end stage renal failure who underwent bilateral nephrectomy through midabdominal approach in preparation for kidney transplantation. The over-all mortality rate was 3.6 per cent. Age was the most significant risk factor in the mortality. Patients less than fifty years of age had an operative mortality rate of 3.1 per cent while those more than fifty years had an operative mortality of 11.1 per cent. Other pertinent risk factors were preoperative complications of renal failure and additional surgical procedures at the time of bilateral nephrectomy. The leading causes of death were those of cardiovascular complications and infection. The morbidity rate was 58.7 per cent being major in 18 per cent and minor in 40.7 per cent. Bilateral nephrectomy is recommended selectively in patients with (1) chronic pyelonephritis with urinary tract infection, (2) major vesicoureteral reflux, (3) immunologically active glomerulonephritis, (4) severe hypertension uncontrollable by adequate dialysis, and (5) extremely large or infected polycystic kidneys.

Abdomen↗
PubMed1978

Surgery for renal cell carcinoma extending into the inferior vena cava.

We have reviewed 26 patients with renal cell carcinoma extending into the inferior vena cava, 21 of whom underwent radical nephrectomy with either venacavotomy and tumor thrombectomy, or vena cava resection. Of 12 patients who presented with localized neoplasm 6 (50 per cent) are currently alive. Poor results were obtained in 9 patients who had preoperative metastatic disease. Over-all operative mortality was 14 per cent and morbidity was minimal, with no pulmonary emboli intraoperatively or postoperatively.

Adenocarcinoma↗
PubMed1978

Urological applications of computerized axial tomography: a preliminary report.

Computerized tomography scanning of the chest and abdomen has been used as a diagnostic technique in more than 4,500 patients since 1974, 190 of whom had histologically proved disorders of the genitourinary system and retroperitoneum. On the basis of this experience computerized tomography scanning has been found to be safe and effective, and offers certain advantages over conventional techniques. The number, extent and content of renal mass lesions can be determined with relatively great accuracy. The presence and extent of metastases into the retroperitoneum, liver and chest can often be shown by computerized tomography scanning when other tests are negative. Placement of needles for aspiration, biopsy, injection of contrast medium or insertion of drainage tubes can be done more accurately under computerized tomography control. Computerized tomography in itself is non-invasive, carries a low radiation exposure comparable to other radiographic procedures and therefore, can be valuable in following the course of patients with various diseases during and after therapy. While scanning will not replace other diagnostic procedures it should lead to a more judicious selection of potentially hazardous tests in selected cases, such as angiography, aspiration and open biopsy.

Adrenal Gland Neoplasms↗
PubMed1978

Surgical treatment of renovascular hypertension in the pediatric patient.

Of 27 children who underwent surgical treatment for renovascular hypertension 16 (59 per cent) were cured, 5 (19 per cent) were improved and 6 (22 per cent) were failures. Improved results were obtained in patients with unilateral renal artery stenosis. Several reconstructive vascular procedures were used, and their relative efficacy and indications are discussed. Renovascular hypertension in children is a curable disease and revascularization with preservation of renal parenchyma should be the aim of surgical therapy in most cases.

Adolescent↗
PubMed1978

Urological applications of computerized axial tomography.

Computerized tomography (CT scanning) of the chest and abdomen has been used as a diagnostic technique in more than 7,200 patients since 1974, 250 of whom had histological proved disorders of the genitourinary system and retroperitoneum. On the basis of this experience CT scanning has been found to be safe and effective, and offers certain advantages over conventional techniques. The number, extent and content of adrenal and renal mass lesions can be determined with relatively great accuracy. The presence and extent of metastases into the retroperitoneum, liver and chest often can be shown by CT scanning when other tests are negative. Placement of needles for aspiration, biopsy, injection of contrast medium or insertion of drainage tubes can be done accurately under computerized tomographic control. Air contrast scanning of the bladder can be of real help in staging bladder tumors, espically in obese patients. Computerized tomography in itself is non-invasive, carries a low radiation exposure comparable to other radiographic procedures and therefore, can, be valuable in following the course of patients with various diseases during and after therapy. While CT scanning will not replace other diagnostic procedures it should lead to a more judicious selection of potentially hazardous tests, such as angiography, aspiration and open biopsy.

Adenocarcinoma↗
PubMed1977

Experimental bladder substitution using biodegradable graft of natural tissue.

A controlled experimental study has been performed using a biodegradable graft of natural tissue to achieve vesical augmentation. The graft is progressively reabsorbed while normal capacity is maintained by concomitant regeneration of the layers of the bladder remnant. No significant complications were encountered, and the graft was equally successful when applied either to a histologically normal bladder or to a pathologic bladder of intramural fibrosis. This material is potentially ideal for clinical bladder substitution in humans.

Animals↗
PubMed1977

Pulmonary embolus presenting as the initial manifestation of renal cell carcinoma.

Recent literature suggests that pulmonary embolus secondary to renal cell carcinoma may by more common than previously suspected. Renal tumors are known for their ability to metastasize early, often before the primary lesion is apparent. A patient with renal cell carcinoma and having massive pulmonary tumor embolus is presented. Attention was called to the occult tumor by the identification of clear cell carcinoma in the pulmonary embolic material. Pulmonary embolectomy and surgical extirpation of the primary tumor resulted in long-term survival.

Adenocarcinoma↗
PubMed1977

Renal autotransplantation: current perspectives.

Autotransplantation, with or without an extracorporeal renal operation, has been done 39 times in 37 patients. Indications for the procedure included several ureteral injury in 4 patients, failed supravesical diversion in 2, renal carcinoma in a solitary kidney in 1, renovascular hypertension in 1 and donor arterial reconstruction before renal transplantation in 29. Success was obtained in all but 2 procedures, both of which involved previously operated kidneys with severe inflammation and adhesions involving the renal pelvis and pedicle. Based on our experience and a review of currently available literature we believe that renal autotransplantation and extracorporeal reconstruction can provide the best solution for patients with severe renovascular and ureteral disease not correctable by conventional operative techniques. The technique can be of particular value in removing centrally located tumors in solitary kidneys and in preparing donor kidneys with abnormal arteries for renal transplantation. The role of autotransplantation in the management of advanced renal trauma and calculus disease is less clear. A long-term comparison of patients treated by extracorporeal nephrolithotomy versus conventional lithotomy techniques will be necessary before a conclusion is reached in these disease categories.

Extracorporeal Circulation↗
PubMed1977

A case of a giant pheochromocytoma.

A case of a large pheochromocytoma weighing 1,150 gm. is reported. The surgical approach to this massive tumor is discussed. Early recognition of the various clinical and metabolic manifestations of the tumor are important objectives in the cure of this potentially lethal neoplasm.

Adrenal Gland Neoplasms↗
PubMed1977

Autogenous arterial grafts in the treatment of renal artery stenosis.

Twenty-three patients who underwent renal revascularization with autogenous arterial bypass grafts for renovascular hypertension are reviewed. The arterial autograft consisted of the hypogastric artery in 19 cases and a free splenic artery graft in 4. Eighteen patients were cured (78 per cent), 4 improved (18 per cent) and there was 1 failure (4 per cent). There were no cases of graft stenosis or occlusion. Postoperative morbidity was minimal and there was no operative mortality. When such grafts are available they provide an excellent means to achieve successful long-term renal revascularization.

Adolescent↗