Search PubMed⌕ Search

Biomedical subjects

J H Foster

Publications and source records attributed to J H Foster.

At least 55 records · Page 3Linked to original sources
PubMed1978

Survival after liver resection for secondary tumors.

The results achieved by liver resection for metastatic cancer in more than 400 patients have been studied in a collected review. Certain conclusions seem justified: The liver is no longer the surgeon's "no-man's-land," and local excision of metastatic tumor can achieve clinical cure in some patients. The risk-benefit ratio for hepatic resection for secondaries seems to be shifting in favor of benefit for selected patients with primary colorectal tumors. At present liver resection for tumors metastatic from pancreas, breast, lung, stomach, kidney, reproductive organs, and skin (melanoma) cannot be recommended. Liver resection may play an important part in the multi-modal therapy of children with extensive malignant disease.

Colonic Neoplasms↗
PubMed1978

Hypertension secondary to complete occlusion of the renal artery.

In summary, we feel the results of this study support an aggressive approach toward the diagnostic evaluation and operative management of patients with renovascular hypertension secondary to complete occlusion of the renal artery. Further, the frequent presence of contralateral disease and the progressive nature of renal artery occlusions represent a significant threat to renal function. Since renal function is frequently compromised but potentially retrievable by revascularization, nephrectomy should be employed only when hypertension is difficult to control, revascularization is impossible, and excretory function in the affected kidney is minimal.

Aged↗
PubMed1977

Primary benign solid tumors of the liver.

The benign solid primary tumors of the liver separate into three major groups: (1) the most common lesions--small, nodular tumors, often found incidentally with histologic features suggesting a reactive etiology, that never rupture or metastasize, that seem to grow most rapidly in children and pregnant women, and that are probably unrelated to birth control medication; (2) the less common adenomas that are purely epithelial, that most often occur in menstruating females, that often show necrosis and rupture, and that are closely associated with oral contraceptive agents; and (3) very rare tumors, usually mesenchymal, occurring solely in children. The therapeutic and prognostic implications of these tumors are defined based upon a study of 111 patients, all but one of whom have undergone resection.

Adolescent↗
PubMed1977

Surgical management of renovascular hypertension in older patients.

In hypertensive patients over 50 years of age, the high prevalence of renovascular hypertension (31 per cent), the low operative risk for its correction (1 to 2 per cent), and the frequency of benefit from operation (80 to 87 per cent) support an aggressive attitude toward screening and management. Diastolic hypertension greater than 105 mm Hg in the older patient warrants investigation. If such a patient has advanced atherosclerosis with evidence of significant cardiac disease or cerebrovascular disease, the indications for operative management of renovascular hypertension correlated with the severity of hypertension, difficulty of control, and imminence of renal function deterioration. If complicating risk factors are not severe, any patient with diastolic hypertension greater than 105 mm Hg is considered an appropriate operative candidate. In contrast, when risk factors are severe, operative management is undertaken only when hypertension is difficult to control or deterioration of renal function is thought to be secondary to the renal artery stenosis. In these patients the risk of operation is obviously greater and the long term benefits are more limited. Nevertheless, based on our experience, we feel the risk of poorly controlled hypertension or impending renal failure is even higher and justifies operative intervention. Hypertension accelerates the progress of atherosclerosis, and halting or slowing the unrelenting course of atherosclerosis is worthwhile objective if this can be done without unnecessary risk.

Female↗
PubMed1977

Saralasin infusion in the recognition of renovascular hypertension.

Saralasin, an angiotensin II antagonist, was infused into 49 patients with renal artery stenosis, 10 patients with essential hypertension and normal renal arteriograms, and five patients with "low-renin essential hypertension." Renal venous renin and differential renal function studies were used to assess the functional significance of arterial stenoses. "Response" to saralasin, evidenced by a fall in blood pressure during infusion, occurred in no patients with "low renin" hypertension and in only 20% of patients with normal renal arteriograms. In contrast, saralasin "response" occurred in more than 80% of patients with renal artery stenosis and lateralizing functional studies and 100% of cases of "proven" renovascular hypertension (cure or improvement of hypertension after operative treatment). We suggest that saralasin infusion might be a valuable screening test for the recognition of renovascular hypertension.

Angiotensin II↗
PubMed1977

Bilateral renal artery stenosis and renovascular hypertension.

Experience with the diagnostic evaluation and operative management of 38 hypertensive patients having bilateral renal revascularization is presented. Twenty-four patients had atherosclerotic occlusions and 14 had fibromuscular dysplasia. Renal vein renin assays (RVRA) and/or split renal function studies (SRFS) were performed in 37 of the 38 patients before operation. Although RVRA was negative in 29 percent and SRFS negative in 31 percent, 24 of 26 patients (92 percent) having both tests done had at least one positive study. Twenty-one patients had simultaneous bilateral repairs and 12 had staged bilateral reconstructions. The incidence of technical failures in these two groups was 21 and 9 percent, respectively. Excluding three uncorrected technical failures and two patients with recurrent branch renal artery lesions, 90 percent of patients with atherosclerosis and all patients with fibromuscular dysplasia had a favorable blood pressure response to operation. This study supports the use of both RVRA and SRFS in the diagnostic evaluation of hypertensive patients with renal artery stenosis. If these functional tests lateralize to one side, repair of that side only is recommended. If the functional studies do not lateralize, operation is suggested only when hypertension is severe and is not controlled readily with medications. In this circumstance reconstruction of the side that appears to be diseased most severely is recommended. Contralateral repair is undertaken only when hypertension persists and when repeat functional studies lateralize to the unoperated side.

Adult↗
PubMed1976

Renal carcinoma discovered incidentally by arteriography during evaluation for hypertension.

Since June 1, 1971 patients undergoing evaluation for hypertension have been evaluated with rapid sequence excretary urography, abdominal aortography and selective renal arteriography. Renal venous assays have been done in selected patients. Through July 31, 1974, 812 arteriographic studies in new hypertensive patients have been done. In 6 of these patients renal tumors were discovered by arteriography only and were not suggested by symptoms, urinalysis nor diagnosed on hypertensive excretory urography. This high incidence surprised us and we hope others will review their arteriographic series of hypertensive patients.

Adenocarcinoma↗
PubMed1976

Femoropopliteal bypass for salvage and claudication: a comparison of long-term results.

Seventy-seven femoropopliteal grafts placed for salvage were compared to 51 grafts placed for claudication. Patient profiles of age, preexisting cardiovascular disease, and risk factors were notably similar. Previous vascular procedures were twice as common in the salvage group. The accumulated graft patency in the salvage group of 77% at one month and 58% at two years is compared to 90% and 80% during the same risk intervals in the claudication group. The salvage group sustained 34 complications (44%) and nine deaths (12%), compared to one death (2%) and seven complications (14%) in the claudication group. One half of all grafts placed in diabetic males failed. Nearly half of all early failures were thought to be due to errors of patient selection. Though new technics are making more extremities potentially salvageable, this study suggests that improved patient selection will be necessary to lower high complication rates.

Amputation, Surgical↗
PubMed1976

Report of the Inter-Society Commission for Heart Disease Resources. Optimal resources for vascular surgery--a supplement.

This supplement is an updated and expanded planning and optimal resource guideline for vascular surgery. Activities relating to examination and certification in vascular surgery are reviewed and hospital resource requirements are identified for different categories of vascular operations. There is a detailed summary of results of common vascular operations as reported by leading vascular surgeons. The statement will be of value in planning and organizing vascular surgery programs and in assessing the results of vascular operations locally.

Aorta, Abdominal↗