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Biomedical subjects

B Kendall

Publications and source records attributed to B Kendall.

At least 109 records · Page 6Linked to original sources
PubMed1979

Surgical treatment of giant pituitary adenomas.

Multidirectional extension and invasive spread are important features of giant pituitary adenomas. Operability cannot be established merely by determining the size of the most prominent part of the tumour. Detailed radiological evaluation with plain films, computed tomography, angiography, and air studies all contribute to evaluation of the precise anatomy before surgery. In the final decision risks of surgical treatment must be balanced against the patient's age and prospects of long-term useful survival. Unfavourable cases for surgical treatment in our hands were those tumours embedded in the hypothalamus with thalamic and posterior extensions. Partial removal of such cases gave poor results. Where the mass proves soft, radical excision may be possible, but not otherwise. Limited biopsy for histological study, followed by a shunt procedure and x-ray therapy seems still the only recourse.

Adenoma↗
PubMed1979

Responses of baboon cerebral and extracerebral arteries to prostacyclin and prostaglandin endoperoxide in vitro and in vivo.

The responses of baboon cerebral and extracerebral arteries to prostaglandin endoperoxide (PGH2) and prostacyclin (PGI2) were investigated on isolated arteries and in vivo by serial angiography. Both PGH2 and PGI2 could produce dose-dependent contraction or relaxation of isolated arteries. PGH2 induced relaxation was indicative of prostacyclin synthetase activity, the enzyme which converts PGH2 to PGI2. In isolated arteries tested one to four hours post mortem only the vertebral artery showed prostacyclin synthetase activity. Thus PGH2 induced contraction of cerebral arteries may be indicative of a physiological function. Vasomotor tone may in part be the result of a balance between PGH2 constriction and PGI2 dilatation. In vivo PGI2 infusion caused pronounced and prolonged dilatation of cerebral arteries, which lasted longer than the cardiovascular changes. As PGI2 is the most potent cerebral vasodilator drug tested, it may be of clinical use in the treatment of cerebral vasospasm.

Animals↗
PubMed1978

Coincidental aneurysms with tumours of pituitary origin.

Angiographic studies on 150 pituitary adenomas and 33 craniopharyngiomas presenting for surgical treatment are reviewed. Eleven incidental silent aneurysms (four arising from the intracavernous and four from the supraclinoid carotid artery, and three from the anterior cerebral artery complex) are shown. Intracavernous aneurysms were also present in two acromegalic patients who had been treated previously with yttrium implantation. Although encasement of vessels by these tumours is unusual, the relevance of vascular abnormalities to surgical treatment is sufficient to justify routine magnification angiography.

Adenoma↗
PubMed1978

Progression in idiopathic scoliosis: A preliminary report of a possible mechanism.

Recent surveys have shown that idiopathic structural scoliosis of mild degree is generally not progressive. We will propose a mechanism which may be responsible for deterioration in the few. It has been observed that the spinal cord, although displaced towards the concavity, does not rotate in company with the vertebrae, thus exposing the emerging nerve roots to the effects of traction and possibly of entrapment. We suggest that progression occurs when the neuraxis is unable to adjust to the change in the anatomy of vertebral column. Our proposition is based upon our findings in a complete spinal column obtained from a baby with structural scoliosis. Support is provided by intercostal angiography, and by observations upon normal anatomy, the pathological anatomy of mature scoliotic spines and the anatomy of contrived scoliosis in normal spines. Although our histological and electrophysiological investigations are incomplete we can demonstrate a significant increase in degenerate cells in the dorsal root ganglia at the apex on the convex side. Lack of suitable necropsy material prevents us from confirming our observations so that our report is inevitably preliminary. We enter a plea that careful examination of the neuraxis be undertaken whenever a specimen of a scoliotic spine becomes available.

Ganglia, Spinal↗
PubMed1977

Investigation of patients presenting with cerebellopontine angle syndromes.

Many neuroradiological procedures are available for the elucidation of lesions presenting with clinical evidence of a cerebellopontine angle syndrome. For 10 years we have favoured plain skull rays, sometimes supplemented by gamma encephalography, followed by angiography and have uncommonly needed further information from other contrast studies before operation. The innocuous value of computed tomography (C.T.) made it necessary to consider modification of this routine which had been found to be very satisfactory in routine practice. To obtain precise information on the diagnostic reliability and complications of the method we reviewed a large consecutive series of patients presenting with angle lesions. The radiological signs in such cases have been described many times and are well known, but our findings in a single comprehensive series emphasize the value of the method and are presented in a review. The modifications induced by CT are discussed.

Brain Diseases↗
PubMed1977

Therapeutic embolisation of the external carotid arterial tree.

Intra-arterial embolisation is a valuable adjunct to the treatment of many vascular lesions, including neoplasms such as glomus tumours or juvenile angiofibromas, and arteriovenous malformations. Its place in the management of the individual patient should be established before any surgical procedure is carried out, as this may prejudice the eventual result. The indications for the procedure, the technique, and possible complications are discussed in this paper, and it is emphasised that the latter are best avoided by the use of a scrupulous technique and adequate technical facilities.

Adult↗
PubMed1977

The radiological investigation of intramedullary spinal tumours.

The place of the various radiological techniques in the diagnosis of spinal cord tumours is described. With appropriate regard to the clinical picture, the choice of selective angiography. Metrizamide or Myodil myelography, and possible cyst puncture and endomyelogram, may be made with accuracy. Air myelography is less useful and less frequently employed. With these radiological aids, accurate localisation of tumour nodules for biopsy or excision is usually possible, and the necessity for long exploratory laminectomies avoided.

Angiography↗