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Biomedical subjects

W S Hare

Publications and source records attributed to W S Hare.

At least 37 records · Page 2Linked to original sources
PubMed1986

Ureteral calculi: percutaneous removal using modified basket extractors and fluoroscopy.

Two modified helical basket extractors are described that have increased the success rate of removing ureteral calculi using fluoroscopy from 63% to 92%. Initially a rather stiff and expandable basket with a 20-cm filiform tip is used with coaxial catheters and sheath (stage 1). If this procedure is unsuccessful, a basket with two long cable ends is passed from the nephrostomy out through the urethra (stage 2). When used with coaxial bladder catheters, this technique allows dilatation of the vesicoureteric junction and retrograde catheterization and injection of fluids or gas to dislodge the stone prior to extraction. In a series of 38 patients, stones were removed in all but three (a success rate of 92%). In five cases small stones (less than 5 mm) were not retrieved but subsequent studies were normal. Ureteral stones were found in the abdominal ureter in 28 cases, in the pelvic ureter in seven cases, and in multiple sites in three cases. Stones were larger than 1 cm in 27.7% of cases. Postextraction mucosal edema with reduced ureteral patency was common but usually cleared in 2-3 days. Occasional complications were related to the nephrostomy.

Fluoroscopy↗
PubMed1985

Percutaneous ultrasonic disintegration and removal of renal calculi.

The results of percutaneous renal stone removal in the first 50 patients to undergo this procedure are presented. The procedure was successful in 40 patients; in 16 of these, ultrasonic disintegration was necessary. The technique failed in 10 patients. The difficulties encountered and the resulting modifications of technique are described.

Dilatation↗
PubMed1985

Intravenous digital subtraction angiography in patients with carotid territory ischemia: a prospective trial.

To evaluate the place of intravenous digital subtraction angiography (IV-DSA) in the investigation of patients with carotid territory ischemia, we have compared the IV-DSA and conventional angiographic (CA) findings in 40 patients in a prospective study. Arterial disease was assessed by grading stenosis from zero (normal artery) to six (complete occlusion) and recording any luminal ulceration. In 59 of 66 bifurcations imaged by both techniques, the IV-DSA evaluation of any internal carotid artery origin disease was within one grade of the CA assessment, with three false negatives and four false positives. Luminal ulceration was less reliably predicted, and two clinically important middle cerebral artery lesions were missed by IV-DSA. In 11 patients who had carotid endarterectomy, there was a good correlation between surgical, CA, and IV-DSA findings, although some ulcerations were not detected by either angiographic technique. These results suggest that IV-DSA is a sensitive technique for detection of carotid bifurcation stenosis when the study is of good quality, but that intracranial lesions may be missed.

Carotid Artery, External↗
PubMed1983

Percutaneous ultrasonic disintegration and removal of renal calculi.

We report the first use in Australia of the technique of percutaneous ultrasonic disintegration and removal of renal calculi. The first three patients who underwent the procedure had a successful outcome. These three patients are described, the method is detailed and the problems which were encountered are discussed.

Aged↗
PubMed1983

Paresis following internal iliac artery embolization.

Extensive lower limb paresis developed in three patients with terminal cancer following internal iliac (hypogastric) artery embolization. This procedure was carried out for control of hemorrhage in two of the patients and for reduction of the bulk of metastatic tumor in another. The embolic materials used resulted in extensive obliteration of small and large vessels of the posterior and anterior divisions of the internal iliac artery. The paresis is attributed to the resulting ischemia of the sciatic and femoral nerves; previous radiotherapy may also have been a contributing factor. To reduce the incidence of paralysis, identification of the bleeding vessels and selective embolization are recommended. If this cannot be achieved, and the catheter lies in the main stem, it is recommended that the emboli should not be smaller than Gelfoam pledgets (1 X 1 X 10 mm) to preserve the peripheral circulation and lessen the risk of complication.

Adult↗
PubMed1981

Balloon dilatation in the treatment of early intermittent claudication.

Balloon dilation of atherosclerotic arteries is an established procedure with a high success rate and low morbidity. In the past 18 months, 71 patients underwent balloon dilatation at the Royal Melbourne Hospital, with a success rate of 90%. This technique is most successful in short stenoses or occlusions, and earlier investigation of selected patients with intermittent claudication is recommended.

Angioplasty, Balloon↗
PubMed1981

Skinny needle pyelography. An advance in uroradiology.

Diagnostic puncture of the renal pelvis with a fine-gauge needle inserted under radiological and ultrasound control, has been performed in more than 100 cases. The method is safe, easy to perform for those trained in imaging modalities, and causes little discomfort. Pyelography and pressure flow studies can be made and urine specimens obtained from the upper urinary tract. Skinny needle pyelography is indicated in unilateral non-visualization of the ureter on intravenous pyelography, in acute oliguric renal failure when ultrasound reveals dilated ureters, and when retrograde pyelography is not feasible. The method is cost-effective, as it can be performed on outpatients as a follow-on procedure after intravenous pyelography or renal ultrasound scanning.

Acute Kidney Injury↗
PubMed1981

Percutaneous transvesical antegrade passage of urethral strictures.

Failure to pass a urethral stricture by retrograde instrumentation is generally accepted as excluding the possibility of closed internal urethrotomy. In 2 patients with impassable strictures percutaneous transvesical antegrade passage of a guide wire through the stricture was successful, paving the way for balloon dilatation of the stricture and visual internal urethrotomy. In view of the success rate of internal urethrotomy in treating strictures, it is recommended that this radiological method of dealing with an impassable stricture from above be used to avoid open operation and to allow internal urethrotomy to proceed. A protocol for the procedure is suggested.

Adult↗
PubMed1981

The scalenus medius band and the seventh cervical transverse process.

A case is reported of compression of the lowest trunk of the brachial plexus by a fibrous scalenus medius band. The band, when present, connects the transverse process of the seventh cervical vertebra, to the first rib. Its presence may on occasions be inferred from the abnormal shape of the seventh cervical transverse process. Similar case reports are reviewed. A study of the length and shape of the transverse process in symptoms-free patients was contrasted with the appearance in a patient with a scalenus medius band and symptoms of brachial neuritis. It is concluded that the shape rather than the length of the process is the clue to the diagnosis.

Adult↗