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Biomedical subjects

A J Fox

Publications and source records attributed to A J Fox.

At least 235 records · Page 13Linked to original sources
PubMed1983

Spinal cord size in syringomyelia: change with position on metrizamide myelography.

Change in the anteroposterior diameter of the cervical spinal cord was demonstrated on metrizamide myelography in 20 out of 40 cases of cervical syringomyelia. Twelve of these were normal-sized cords, four were small, and four enlarged. Comparable lateral cervical myelograms in the prone and supine positions were sufficient to show size change for normal-sized or small cords. Additional myelograms in the erect and Trendelenburg positions were necessary to show size change in enlarged cervical cords, especially with associated Chiari malformation. A localized change in cord size suggests syringomyelia. If the change in cord size is diffuse, then change less than 10% is not necessarily significant. In undiagnosed myelopathy, metrizamide myelography has the potential to detect unsuspected syringomyelia even when the cord is normal-sized or small. Myelographic study may also be useful as an adjunct to delayed computed tomographic studies.

Humans↗
PubMed1983

Peripheral aneurysms of the cerebellar arteries. Review of 16 cases.

True congenital peripheral aneurysms of the cerebral arteries are rare and may constitute a special group. The authors report on 16 cases of peripheral aneurysms of the cerebellar arteries; six of them arising from vessels feeding arteriovenous malformations (AVM's). The possible causative role of increased blood flow versus developmental factors in the frequent occurrence in cases of AVM of this otherwise rare type of aneurysm is discussed. In five of the six cases with AVM's (one dural and five parenchymal), the aneurysm rather than the AVM proved to be the source of the hemorrhage. The occurrence of spasm was in inverse proportion to the distance of the aneurysm from the main arteries. The surgical result was good in 11 cases. One patient with associated AVM died, and four patients had residual symptoms.

Adult↗
PubMed1983

Balloon occlusion of a spontaneous fistula of the posterior inferior cerebellar artery. Case report.

A case is reported of a large spontaneous right posterior inferior cerebellar artery fistula in which the patient presented with a right cerebellopontine (CP) angle and right cerebellar syndrome. The patient was successfully treated by balloon occlusion at the fistula site. The location of the arteriovenous fistula, the mass effect of its enlarged draining veins on the cerebellum and CP angle structures, and the simple therapeutic endovascular occlusion with a detachable balloon make this case unique.

Adult↗
PubMed1983

Detachable calibrated-leak balloon for superselective angiography and embolization of dural arteriovenous malformations.

The authors describe a system comprising a small latex balloon attached to a Teflon catheter. The balloon has a distal calibrated leak which is used for intravascular embolization with isobutyl-2-cyanoacrylate. The balloon is easily detached after embolization. The combination of manual control of the balloon-catheter system, plus the ability of the balloon to navigate intra-arterially with the blood flow, makes this system suitable for superselective angiography and embolization of lesions supplied by the external carotid artery (ECA). This system avoids intimal dissection and concomitant arterial vasospasm when trying to negotiate steep distal curves of the ECA branches. Experimental embolization of several branches of the ECA in the dog, and clinical examples of treatment of dural arteriovenous malformations in three patients are described.

Adult↗
PubMed1982

The histologic effect of intraventricular injection of metrizamide.

A patient with sudden apoplexy and coma was found to have hydrocephalus on computed tomographic scan, and metrizamide was instilled into the ventricles. Subsequent autopsy disclosed a brainstem infarct secondary to a primary dissecting aneurysm of the basilar artery, and a histologic picture of encephalitis in the walls of the lateral and third ventricles. Metrizamide may cause pathologic changes that must be recognized for the correct interpretation by the pathologist of tissue sections previously exposed to metrizamide. In the present case, the changes were seen 11 days after exposure of the tissue to metrizamide, consonant with the time course of similar changes observed in animals. The localization of the cellular infiltrates to the Virchow-Robin spaces corroborates evidence from the literature that metrizamide enters brain parenchyma via these spaces.

Adult↗
PubMed1982

Selection and mortality differentials.

The Office of Population Censuses and Surveys Longitudinal Study provides reliable mortality data by a much wider range of characteristics than are available for other national sources. Although it is based on only a 1% sample of the population, it broadens the scope of mortality analysis and permits study of changes in relationships using different aspects of the time dimension. Data from this study have made us increasingly aware of the importance of selection to the interpretation and understanding of observed mortality differentials. Here we focus on that aspect of selection called "health-related mobility," which is associated with the relative health of people acquiring or losing individual characteristics. It is suggested that, for characteristics affected by health-related mobility, mortality differentials would narrow or widen with increased duration of follow-up. One of the basis of this argument the contribution of health-related mobility to mortality differentials by economic position and social class, to regional differentials, and to family and household differentials is investigated. Selection can thus be shown to operate when people change economic position, when they migrate, or when they change marital status. While the effects of these selection processes can be shown to contribute to social class gradients they do not explain regional differentials and contribute only to a limited degree to differentials by marital status. Differentials by household circumstances also reflect the product of selection processes.

Employment↗
PubMed1982

Mortality of female gas mask assemblers.

A 30-year follow-up study of the mortality of 500 women employed in manufacturing gas masks during the second world war showed a pronounced excess of deaths from mesothelioma and lung cancer. Although these women were subject only to short periods of exposure, greater excesses were found for those exposed for between one and five years than for those exposed for under one year. Even in the latter group, however, five deaths from lung cancer and four deaths from mesothelioma were recorded compared with 1.5 deaths and 0.1 deaths expected (p approximately equal to 0.02). An excess of deaths from cancer of the ovary was also found, and this appeared to be related to exposure to asbestos.

Adult↗
PubMed1982

New perspectives in computed tomography of multiple sclerosis.

A prospective clinical study was performed in 70 consecutive patients with known or strong clinical suspicion of acute or relapsing multiple sclerosis. The study was designed to compare the results of standard computed tomography and high-volume contrast-delayed scanning for the detection of enhancing lesions. In 39 cases with clinically definitive multiple sclerosis, the conventional enhanced scan was positive in 25 cases and the high-volume delay scan in 32. The high-volume enhanced scan added information in 23 of these 32 cases. In 21 cases, suspicious of multiple sclerosis but not clinically confirmed, the standard enhanced scan was positive in two cases and the high-volume delay scan in five. In these cases, computed tomography was definitive in establishing the diagnosis by showing clinically unsuspected brain lesions. In 10 cases in which the disease was eventually excluded, the scans were negative in all instances. For the first time, by the high-volume delayed technique, enhancing plaques in the cortical gray matter and in the gray/white matter regions were demonstrated. This technique is a very useful diagnostic tool, not only for morphologic assessment when multiple sclerosis is known, but for the positive diagnosis of this disease when the first clinical presentation is diagnostically uncertain.

Humans↗
PubMed1982

Aspirin and systemic heparinization in diagnostic and interventional neuroradiology.

To decrease the risk of iatrogenic thromboembolic complications during interventional procedures with coaxial catheter systems, aspirin and systemic heparinization were used in 57 consecutive cases. No thromboembolic complications occurred. This group was compared with a second group of 25 patients who also had interventional procedures with coaxial systems but who had only a continuous heparinized drip infusion flushing the inside of the coaxial system. Two patients had an embolic complication and two others had thrombus formation inside or outside the catheters without neurologic symptoms. The use of systemic heparinization has been extended to all prolonged angiographic procedures except in cases of acute or recent subarachnoid hemorrhage.

Angiography↗
PubMed1982

Thoracic myelopathy secondary to ossified ligamentum flavum.

The authors report a case of ossification of the ligamentum flavum at T-10 and T-11 associated with compressive myelopathy. Metrizamide myelography with computerized tomography allowed precise preoperative diagnosis and anatomic localization of the lesion. The patient had satisfactory and prompt improvement after surgical intervention.

Humans↗
PubMed1982

Hemorrhagic encephalitis produced by selective non-occlusive intracarotid BCNU injection in dogs.

A selective non-occlusive technique was developed for administration of BCNU (1,3-bis(2-chloroethyl)-1-nitrosourea) into the internal carotid artery of the dog, and the neuropathological effects in the brain were studied. One out of three dogs showed ipsilateral hemorrhagic necrotizing encephalitis at doses of 102 mg/sq m, and all of three dogs showed similar but more severe pathology at doses of 215 to 232 mg/sq m. This study and previous studies in the dog and monkey suggest definite thresholds above which cerebral toxicity occurs when BCNU is administered via the intracarotid route. Greater dilution of drug in the larger territory of supply of the human internal carotid artery allows somewhat higher doses in man. The pathology of the lesion induced by BCNU suggests a primary vascular injury as a pathogenic mechanism, consonant with similar findings following high-dose systemic BCNU administration in man. Investigators conducting ongoing and future trials of intracarotid BCNU in the human for the treatment of intracranial neoplasms should be especially vigilant for a similar toxic effect.

Animals↗
PubMed1981

Spinal cord swelling in multiple sclerosis.

Three cases of subacutely progressive spinal paraparesis had myelographic evidence of spinal cord swelling suggesting the diagnosis of intramedullary tumour. The diagnosis of multiple sclerosis (MS) was made in each case with the aid of CSF protein electrophoresis, evoked responses and CT scan. Because acute MS may produce cord swelling simulating tumor or syrinx, these additional investigations may be necessary to make a correct diagnosis.

Adult↗