Biomedical subjects
Publications and source records attributed to R J Lewis.
Six cases of oral adamantinoma, four in dogs, two in cats, are described. This is a rare tumor which arises from vestigial layers of the dental laminae in the gingiva, particularly of the mandible. Care must be exercised in not confusing this locally aggressive lesion with the much more common squamous cell carcinoma.
Twenty-nine modified chevron ostetotomies for symptomatic hallux valgus were performed in 17 patients, all of whom had excellent pain relief and acceptable cosmesis, with occasional discomfort persisting in only two of 29 feet. The average postoperative decrease in the intermetatarsal angle was 4 degrees, and in the metatarsophalangeal angle 13 degrees. Overall results were similar to those obtained with the Mitchell and chevron metatarsal osteotomies, but the increased mechanical stability afforded by the modified procedure permitted shorter periods of postoperative immobilization and a return to normal footwear by four weeks.
Explore the source record for details and available documents.
Subsequent to the publication of the 1977 edition of the NIOSH Registry of Toxic Effects of Chemical Substances (RTECS), several additions and changes were introduced that substantially improved the content and accessibility of the RTECS data file. Content additions included primary irritation data for both skin and eyes, in vitro mutagenicity data, and citations to toxicology review articles and to the Toxic Substances Control Act inventory. Also undertaken was a re-evalution of existing tumorigenic entries based on revised selection criteria. Accessibility to RTECS data has been facilitated by the introduction of on-line interactive computer searching, and the preparation and distribution of Computer Output Microfiche (COM-fiche) and magnetic tape copies of the file which supplement the annual publication.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The case of a patient with Wegner's granulomatosis who died with haemorrhagic adrenal infarction is described. Thyroid involvement, another feature not previously reported in this disease, was also noted.
Explore the source record for details and available documents.
Acute capture myopathy was diagnosed in 3 elk (Cervus canadensis). In 2 of the elk, hindlimb lameness developed within 10 days of capture. Clinical signs were not observed in the third elk, which was found dead 7 days after its capture. Elks 1 and 2 were euthanatized and all 3 animals were necropsied. In elks 1 and 2, rupture of the semi-membranosus muscle was associated with massive hemorrhage and swelling. Microscopic findings included hemorrhage, edema, myofibril fragmentation, and evidence of attempted muscular regeneration. In elk 3, several of the large muscles of the hindlimbs as well as the biceps brachii muscles of the forelimbs appeared pale, dry, and friable. Except for lack of hemorrhage and edema, microscopic findings in this elk were similar to those of elks 1 and 2.
Two cases of nodular angioblastic hyperplasia with eosinophilia and lymphofolliculosis are presented. The position of such lesions in a histopathologic classification is discussed. The possible relationship to Kimura's disease and low-grade angiosarcoma is considered.
Long-term morbidity was assessed in fifty-five patients with Ewing's sarcoma who survived two years or longer. Primary site, radiation dosage, and age of the patient all had an important bearing on the end result. Guidelines for treatment of the primary tumor were developed. Patients with upper-extremity lesions were generally best treated by radiotherapy. Young children and some of the older patients with lesions in the lower extremity were generally best treated by primary amputation, depending on the site of the lesion.
Mnostotic Paget's disease in the spine often presents with an atypical clinical and radiographic picture. Paget's disease should be included in the differential diagnosis of any sclerotic lesion of the spine. Although uncommon, the disease occurs even in young adults, and may present a diagnostic problem.
A prospective study was undertaken to determine the frequency of bacteremia after endoscopy of the upper gastrointestinal tract. Three of 100 patients (3%) demonstrated positive blood cultures after the endoscopic procedure. Bacteriologic surveys disclosed that routine cleansing procedures of the endoscopy room and the endoscope itself frequently failed to achieve optimal sterile conditions. Particularly noteworthy was the growth of Enterobacter liquefaciens and Candida albicans on one occasion from the endoscope tip. We conclude that, although the incidence of postendoscopy positive blood cultures is low, a more vigorous approach to using clean equipment in clean surroundings is needed when dealing with a potentially susceptible host.
Direct diagnostic thoracoscopy under general anesthesia using the mediastinoscope or bronchoscope has been done in 40 patients. No deaths or serious morbidity occurred. We recommend the use of this technique when other efforts fail to establish a diagnosis in patients with pleural disease.
Explore the source record for details and available documents.
Cellulitis caused by Diplococcus pneumoniae was diagnosed in two heroin users. To our knowledge, this medical emergency, clinically indistinguishable from deep fasciitis of pyomyositis, has not previously been reported as having been caused by the agent identified in these two patients.
Massive intraoperative blood loss and poor graft take have been the major problems associated with early excision and immediate grafting of full-thickness burns. By employing electrosurgery, excessive blood loss was virtually eliminated in a series of major burn excisions. Immediate graft take was excellent on electrosurgical wounds after primary burn excisions and in late reconstructive procedures. Simplicity, improved hemostasia, good graft take, and the absence of special anesthetic requirements make this method particularly applicable to the management of patients with burn injury.