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Biomedical subjects

H A Wilkinson

Publications and source records attributed to H A Wilkinson.

At least 73 records · Page 4Linked to original sources
PubMed1978

Intracranial pressure reserve testing. Initial clinical observations.

Sequential subdural injections of fluid through an intracranial pressure (ICP) monitoring cup catheter have been employed to measure "ICP reserve" in a series of 136 determinations in 30 patients over a total of 155 days of recordings. This dynamic method of quantitating the brain's ability to adapt to increased intracranial volume tests the brain's compensatory mechanisms over a five-minute time span. The test, incorporating several safety features, has been found to be reliable, safe, and well tolerated. A series of observations have been made using this test in patients with subdural drains and in response to fluid, mannitol, and dexamethasone therapy. Deteriorating ICP reserve gave early warning of the need for reoperation for postoperative hematoma, massive brain swelling, or cystic reaccumulation. Intracranial pressure reserve testing also quantitated the evolution of postoperative brain edema. Changes in ICP reserve could be detected as much as 48 hours before changes in baseline ICP and as much as 72 hours before clinical deterioration was evident.

Brain↗
PubMed1978

Failed disk syndrome.

Over half the patients in most pain clinics in the United States are seeking relief from the "failed disk syndrome." Careful initial diagnostic evaluation and aggressive nonoperative therapy are essential to avoid poor results. Causes of continued pain after disk surgery include original pain syndromes not due to a disk, inadequate surgery, development of arthritis, additional disk disorders and nerve root fibrosis. Treatment demands precise diagnosis. Diagnostic injections and nerve blocks are helpful when other techniques fail.

Arachnoiditis↗
PubMed1977

Focal chemotherapy of brain tumours using semipermeable membranes.

Semipermeable silastic rubber membranes can be used to diffuse focally a variety of chemicals including antitumour drugs. Of the eight drugs tested, in vitro tests showed the best diffusion with dactinomycin, mithramycin, and oncovin, and the poorest diffusion with bleomycin, fluorouracil, and thiotepa. Biological testing was performed with mithramycin, dactinomycin, and oncovin using tissue cultures of human glioblastoma and subcutaneous implants of mouse ependymoblastoma. All three drugs caused rapid tissue culture cell death with direct injection, and impeded tumour growth when given intraperitoneally. Dactinomycin by silastic diffusion proved more effective than mithramycin against tissue cultures, but neither drug had a significant effect against local tumours treated with implanted drug capsules. Silastic diffusion of oncovin reduced tumour sizes significantly ipsilateral to the implant, compared to contralateral implants and to untreated controls.

Animals↗
PubMed1974

Corticosteroid therapy of experimental hydrocephalus after intraventricular-subarachnoid haemorrhage.

Symptomatic hydrocephalus after subarachnoid haemorrhage seems to result both from mechanical obstruction of arachnoid villi and basilar cisterns and from an inflammatory cellular reaction in the villi. Subarachnoid haemorrhage was induced in rabbits using whole blood injected through an implanted intraventricular needle. Control rabbits receiving intraventricular methyl prednisolone acetate but no blood, developed ventricular dilation significantly more often than untreated controls. Eighty-three per cent of rabbits with untreated experimental subarachnoid haemorrhage developed moderate to severe hydrocephalus. Intramuscular steroid therapy significantly reduced the incidence of hydrocephalus.

Animals↗
PubMed1971

Diuretic synergy in the treatment of acute experimental cerebral edema.

Acute cerebral edema was created in dogs by the intracarotid injection of sodium lauryl sulfate, a method that produces no structural or vascular disruption in the brain. Cerebrospinal fluid (CSF) pressure elevations were measured through subdural balloons, and ranged from 300 to 1500 mm H2O. The nature of the cerebral edema produced was studied with intravital Trypan blue, electrocorticography, and visual observation of cerebral circulation, and by postmortem histological sections and determinations of brain water content. Two dissimilar diuretic agents were studied: the osmotic diuretic, mannitol; and the renal diuretic, ethacrynic acid. As expected, mannitol reduced CSF pressure effectively, with no significant rebound overshoot. Ethacrynic acid, despite favorable reports, proved to have only a slight effect on CSF pressure but did prove to be a potent diuretic. Unexpectedly, the two agents were found to act synergistically. When both agents were administered, significantly greater reductions in pressure were obtained and pressure reductions were maintained for longer periods.

Animals↗
PubMed1970

Bladder exstrophy.

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Abnormalities, Multiple↗