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Biomedical subjects

D L Erickson

Publications and source records attributed to D L Erickson.

At least 37 records · Page 2Linked to original sources

New technique for retrograde left heart catheterization in aortic stenosis.

Retrograde catheterization of the left ventricle in patients with aortic stenosis is frequently difficult and occasionally impossible. We have developed a new technique to facilitate this problem. A standard #8 "pigtail" catheter is preformed with a 145 degrees angle 7 cm from the catheter tip. With this catheter in the ascending aorta, the preformed angle lifts the catheter tip leftward and superiorly, allowing a straight guidewire a direct approach to the orifice of the stenotic aortic valve. Utilizing this technique, we were able to cross the stenotic aortic valve in 26-29 consecutive patients with isolated aortic stenosis (mean gradient +/- 0.22 cm2, mean fluoroscopy time for crossing: 32 +/- 40 seconds). The 145 degree angle also lifts the catheter off the posterior wall of the left ventricle and allows a more parallel alignment of the catheter with the long axis of the left ventricle, leading to a more stable position with less ventricular dysrhythmias during angiography. Thus a preformed angle in the "pigtail" catheter facilitates crossing of the stenotic aortic valve and produces a more stable position in the left ventricle.

Adult↗

Vasospasm following transcranial removal of large pituitary adenomas. Report of three cases.

The authors report three cases of cerebral vascular spasm following transfrontal removal of large pituitary neoplasms. One patient awakened from surgery hemiparetic, but has since recovered. A second patient developed hemiparesis with confusion on the fifth postoperative day and eventually died. The third patient developed hemiplegia on the tenth postoperative day, but recovered completely. Vascular spasm was documented angiographically in all three cases. Possible mechanisms underlying this unusual complication are discussed.

Adenoma↗

Mucoceles with intracranial and extracranial extensions. Report of two cases.

Two cases of unusual childhood mucocele are presented. These serve to illustrate the great potential these lesions have for slow, insidious development and insinuation of themselves into regions of the head and face where they are difficult to remove surgically. A description of the staged surgical excision is presented to emphasize the importance of radical removal of these benign lesions.

Adolescent↗

Prognosis of seventh nerve palsy following removal of a large acoustic tumors.

Before the advent of microsurgery for acoustic tumors, it was accepted that the majority of seventh nerves would be lost during the removal of large tumors. It is now possible to preserve these attenuated seventh nerves, even with very large tumors. Postoperative facial palsy may be present even with an anatomically intact seventh nerve, but our experience has demonstrated that recovery will ultimately occur. Eight of our nin patients with this situation have regained facial function, although in some the first clinical evidence of recovery did not occur for 1 year.

Facial Nerve↗

Harrington instrumentation and spine fusion for unstable fractures and fracture-dislocations of the thoracic and lumbar spine.

Of forty patients with unstable fractures and fracture-dislocations of the thoracic or lumbar spine treated with Harrington instrumentation and spine fusion, thirty-five had a neural deficit (twenty-three with incomplete or cauda equina lesions and twelve with complete lesions). Laminectomy or posterolateral decompression was performed prior to instrumentation and fusion in twenty-three patients and at the time of stabilization, in thirteen. Solid fusion was obtained in all but one patient. Back pain persisted in four. No patient had residual spinal deformity. Twenty-one patients with incomplete or cauda equina lesions regained some neural function, while all twelve with complete lesions remained unchanged. The advantages of this technique include effective stabilization of the spine, early mobilization and rehabilitation, and prevention of late deformity.

Adolescent↗

Pituitary adenomas of adolescents.

A review of four cases of chromophobe adenomas in adolescents suggests that extracapsular extension with invasion of parasellar structures is more common in this age group than in adults. A syndrome of adolescent obesity, oculomotor palsies, and plain x-ray changes of the sella characterizes this group.

Adenoma, Chromophobe↗

Percutaneous trial of stimulation for patient selection for implantable stimulating devices.

The author describes a flexible electrode which can be inserted percutaneously for a period of several days in candidates for an implantable electrical stimulating device for pain relief. This allows the patient a trial of stimulation which closely mimics that of the intended implantable system. If this trial does not give adequate pain relief in a variety of situations, the patient is not considered to be a suitable candidate for an implantable device. The trial of stimulation in no way obviates the need for careful scrutiny of the social and psychological factors accompanying chronic pain problems.

Electric Stimulation Therapy↗