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Malignant primary pulmonary paraganglioma with hilar metastasis [Letter]
Lemonick, D M; Pai, P B; Hines, G L
PMID: 2308374
ISSN: 0022-5223
CID: 3497522
Total occlusion of the common carotid artery with a patent internal carotid artery; identification by duplex ultrasonography: report of a case [Letter]
Bebry, A J; Hines, G L
PMID: 2677418
ISSN: 0741-5214
CID: 3497552
DRGs: nursing documentation contributes to the bottom line
Hines, G L
Nursing documentation in the medical record is an important source of information for the medical record coder. Coded data are necessary for quality assurance, risk management, research and statistical purposes, as well as for proper DRG assignment for reimbursement. Facts gleaned from nursing documentation, supported by physician documentation and laboratory data, can often result in increased reimbursement for the hospital.
PMID: 3138673
ISSN: 0029-6465
CID: 3497582
Crossover femoral-popliteal and femoral-tibial bypass [Case Report]
Hines, G L
Crossover femoral-popliteal or femoral-tibial bypass has been employed as an alternative extra-anatomic bypass in 3 patients who had occlusion of an iliac artery with subsequent occlusion of the ipsilateral femoral artery with patency of either a popliteal or tibial artery and a patency of the contralateral common femoral artery. Each patient had a contraindication to a more conventional type of procedure. All procedures were performed with reinforced PTFE grafts. All grafts have remained patent for 6 months to 3 years. This operation should be considered as an alternative extra-anatomic reconstructive procedure in patients with the appropriate anatomy and who are not candidates for more standard types of vascular reconstruction.
PMID: 3360845
ISSN: 0021-9509
CID: 3497592
The post endarterectomy carotid bruit. Evaluation by Duplex scan [Case Report]
Hines, G L; Harvey, V
The presence of a bruit after carotid endarterectomy may indicate a persistent or recurrent lesion. The authors noninvasively evaluated, by Duplex scanning, 18 asymptomatic postoperative patients who underwent a total of 23 carotid endarterectomies and who developed a postoperative bruit to determine the significance of the bruit. Eleven men and seven women were studied from 6 weeks to 2 years postsurgery. Ages ranged from 49 to 75 years (63.6 +/- 8.0 years). Indications for endarterectomy were: transient ischemic attacks (including amaurosis fugax), 17 vessels; completed stroke with significant functional recovery and residual carotid disease, 3 vessels; and asymptomatic bruit with hemodynamically significant carotid stenosis, 3 vessels. Each patient had a Duplex scan performed to noninvasively evaluate the carotid artery. All scans were independently reviewed by two observers. Real-time B images were interpreted as normal in 14 vessels, mild thickening in eight vessels, and moderate thickening in only one vessel. Doppler recordings demonstrated a spectral range of 15-40 cm/sec (26 +/- 8 cm/sec). Ratio of velocity in the internal carotid artery to common carotid artery (VIC/VCC) ranged from 0.389 to 1.281 (0.779 +/- 0.250). This study demonstrates that the presence of a postoperative carotid bruit does not necessarily signify the presence of residual carotid disease or a hemodynamically significant lesion.
PMID: 3901847
ISSN: 0003-1348
CID: 3497612
Papaverine hydrochloride as an adjunct to asanguinous cardioplegia, is it beneficial?
Hines, G L; Wehbe, U; Mele, V
Papaverine hydrochloride was added to a standard asanguinous cardioplegic solution to study its effect on cardioplegic distribution by evaluating coronary resistance, myocardial temperature, and postoperative enzyme changes. Seventeen patients were randomized into a control group (8 patients) and a papaverine group (9 patients). All patients received 300 cc of a standard asanguinous cardioplegic solution into the aortic root after systemic cooling to 28 degrees C and measurement of septal temperature (To). The duration of infusion (t1), root pressure (p1), and septal temperature (T1) were recorded. All patients received a subsequent infusion of 200 cc of cardioplegia to which had been added either 10 cc normal saline (control group) or 1 mg papaverine hydrochloride in 10 cc normal saline (papaverine group). Time of infusion, root pressure, and septal temperature (t2, p2, T2) were recorded. Coronary resistance was calculated. Postoperative CPK and CPK-MB were recorded and compared. Mean high CPK in the papaverine group was 163 units and 182 units in the control group. There was no statistically significant difference in any parameter between groups. This study, in contradistinction to experience with animal research models, failed to demonstrate any significant value in adding papaverine hydrochloride to standard cardioplegic solutions.
PMID: 3872304
ISSN: 0021-9509
CID: 3497602
Femoral-femoral bypass. Non-invasive hemodynamic evaluation
Hines, G L; Rivera, G
Seven patients who underwent femoral-femoral by pass between June 1980 and September 1982 underwent pre-operative angiography and pre and post-operative non-invasive evaluation to determine: (1) the hemodynamic effects created by the crossover graft, and (2) if angiographic findings would be predicative of post-operative results. The mean ankle/arm (a/a) index in the donor extremity changed from 0.82 +/- 0.20 to 0.70 +/- 0.27 (NS). The a/a index in the recipient extremity increased from 0.39 +/- 0.30 to 0.74 +/- (p less than 0.02). One patient developed a "steal" syndrome. There was no correlation between angiographic findings and post-operative changes. This study demonstrated a significant increase in recipient extremity ankle pressure and a clinically insignificant decrease in donor limb pressure.
PMID: 6736117
ISSN: 0021-9509
CID: 3497662
Osteoradionecrosis of the chest wall. Management of postresection defects using Marlex mesh and a rotated latissimus dorsi myocutaneous flap [Case Report]
Hines, G L; Lee, G
Full thickness chest wall resection and single stage reconstruction for osteoradionecrosis of the chest wall was performed on five patients. All patients had undergone radical mastectomy and radiation therapy from 5 to 18 years prior to chest wall resection. Defects varied from 12 X 5 cm to 15 X 15 cm, and included from two to four ribs. Reconstruction was performed using Marlex mesh to reconstruct the bony thorax and a rotated latissimus dorsi myocutaneous flap. Coverage was successfully performed in all cases, and no patient experienced postoperative pulmonary dysfunction. There were no complications related to either the bony thorax reconstruction or the latissimus flap. The use of this technique has provided a safe, convenient, and reliable method of chest wall reconstruction.
PMID: 6638701
ISSN: 0003-1348
CID: 3497642
Congenital diaphragmatic hernia in the adult [Case Report]
Hines, G L; Romero, C
The onset of symptoms from a congenital posterolateral (Bochdalek Hernia) defect is rare in the adult. We are reporting a 25-year-old female with a previously asymptomatic Bochdalek hernia who presented with acute intestinal obstruction. The abnormal embryology, pathophysiology, and clinical manifestations of this condition in the adult are discussed.
PMID: 6668159
ISSN: 0020-8868
CID: 3497652
Chest wall reconstruction using a latissimus dorsi myocutaneous flap [Case Report]
Lee, G W; Hines, G L
PMID: 6575279
ISSN: 0028-7628
CID: 3497632