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Biomedical subjects

J Punt

Publications and source records attributed to J Punt.

At least 37 records · Page 2Linked to original sources
PubMed1999

Subtemporal decompression: the treatment of noncompliant ventricle syndrome.

OBJECTIVE: To explore the effects of subtemporal decompression (STD) on the frequency of shunt revision and attendances with symptoms of raised intracranial pressure secondary to slit ventricle syndrome and slit ventricle-like syndrome. A renaming of these syndromes as noncompliant ventricle syndrome is suggested. METHOD: A retrospective review of the notes of all patients at our institution having STD from 1984 to 1997 was conducted. RESULTS: Twenty-eight patients underwent STD (age range, 4-31 yr). Thirty-two STD procedures were performed. The mean follow-up duration after STD was 5.3 years (range, 0-12 yr). The number of shunt revisions before STD was 128 (mean, 4.6 revisions; range, 0-30 revisions) and after STD was 28 (mean, 1.0 revision; range, 0-7 revisions). The number of attendances before STD was 213 (mean, 6.7 attendances; range, 1-31 attendances) and after STD was 57 (mean, 1.8 attendances; range, 0-10 attendances). Among 15 patients for whom there was sufficient clinical data, 7 revisions were required during the 3 years before STD and 22 during the 3 years after STD. There were 53 admissions during the 3 years before STD and 11 during the 3 years after STD. CONCLUSION: Although the overall incidence of shunt revision decreases, there is an early increase in the frequency of revision after STD. The number of admissions of patients with raised intracranial pressure symptoms reduces after STD, and we think that this is a more important factor in the consideration of this procedure than the number of recent revisions. We explore these arguments in this article.

Adolescent↗
PubMed1998

Liliequist's membrane in minimally invasive endoscopic neurosurgery.

Liliequist's membrane, an arachnoid condensation extending from the upper border of the dorsum sellae to the anterior edge of the mammillary bodies and formerly a relatively insignificant structure, has been found to be extremely important in the neuroendoscopic management of hydrocephalus. Failure to open this membrane can lead to the failure of third ventriculostomies.

Arachnoid↗
PubMed1998

Neuroendoscopy in the premature population.

The population born prematurely is particularly prone to hydrocephalus. Shunting techniques, whilst still the gold standard, have considerable failure rates and contribute significant morbidity and mortality. The role of neuroendoscopic techniques in the treatment of such patients is explored, and a series of 19 patients born prematurely and operated on neuroendoscopically before their 1st birthdays is described.

Cerebral Hemorrhage↗
PubMed1998

Listeria monocytogenes meningitis in a penicillin-allergic paediatric renal transplant patient.

Currently in many centres the extended spectrum cephalosporins (e.g. cefotaxime and ceftriaxone) are being used empirically for patients with suspected bacterial meningitis. We present a case of meningitis in a penicillin allergic paediatric renal transplant patient from whose cerebrospinal fluid (CSF) Listeria monocytogenes was cultured, despite four days of cefotaxime therapy. The patient was successfully treated with meropenem but required neuro-endoscopic intervention for hydrocephalus.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed1998

Neuroendoscopic third ventriculostomy in patients less than 1 year old.

A series of neuroendoscopic third ventriculostomies in children less than 1 year old is reported. Twenty-seven patients underwent the procedure with 21 (77%) failing within a mean of 1.36 months of the procedure. Nineteen were subsequently shunted. The presence or absence of flow through the ventriculostomy and the size of the lateral ventricles on post-operative imaging were not an indicator of success or failure. Only 4 (15%) had a complication of the procedure. Although the majority fail, approximately 1/3 are spared the added morbidity and mortality of having a shunt. With such a low morbidity and zero mortality the procedure has many benefits over shunting. Consequently, neuroendoscopic third ventriculostomy is used in this institution, where possible, rather than a shunt.

Age Factors↗
PubMed1997

Incomplete endoplasmic reticulum (ER) retention in immature thymocytes as revealed by surface expression of "ER-resident" molecular chaperones.

The folding and assembly of nascent proteins in the endoplasmic reticulum (ER) is assisted by molecular chaperones that are themselves retained within the ER. We now report that a number of different ER proteins, including molecular chaperones, are selectively expressed on the surface of immature thymocytes, but their surface expression is extinguished upon further differentiation. Escape from the ER is only possible for newly synthesized ER proteins before they become permanently retained. Thus, the cellular process of ER retention is incomplete in immature thymocytes and provides an explanation for surface expression of partial receptor complexes that transduce differentiative signals during thymic development.

Blotting, Western↗
PubMed1997

Neuro-endoscopic third ventriculostomy: evaluation with magnetic resonance imaging.

We have performed a prospective study of the use of magnetic resonance (MR) imaging in 14 patients undergoing neuro-endoscopic third ventriculostomy. MR imaging was undertaken prior to the endoscopy and serial studies were carried out after the procedure. MR imaging provides important information concerning the morphology of the third ventricle and allows the identification of an appropriate puncture site in the floor of the third ventricle. In particular, the relationship of the third ventricular floor to the basilar artery is well demonstrated. Following an endoscopic septostomy, MR imaging allows visualisation of any change in ventricular size. A cerebro-spinal fluid (CSF) flow void in the anterior inferior third ventricle, sometimes extending into the suprasellar cisterns was frequently demonstrated and this was found to be a more constant feature than reduction in ventricular size. MR imaging provides an indispensable tool for both planning and follow-up of endoscopic third ventriculostomy.

Basilar Artery↗
PubMed1997

Choroid plexus papilloma producing symptoms by secretion of cerebrospinal fluid.

A choroid plexus papilloma of the lateral ventricle presenting in early infancy and producing symptoms purely by secretion of cerebrospinal fluid with formation of a large cyst is presented. Initial conservative management by cyst-peritoneal shunt was followed by late recurrence of symptoms due to reformation of the cyst when the shunt blocked. Excision of the tumour afforded definitive relief.

Brain Diseases↗
PubMed1991

Primary non-Hodgkin's lymphoma of the central nervous system: phase II study of chemotherapy (BVAM) prior to radiotherapy.

Ten patients were diagnosed as having primary non-Hodgkin's lymphoma of the central nervous system at University Hospital, Nottingham, between September 1986 and April 1989. None had clinical evidence of HIV-1 infection. All the patients started treatment with chemotherapy (BVAM), designed to cross the blood-brain barrier, followed by radiotherapy. Seven patients completed both chemotherapy and radiotherapy. Dose reduction during chemotherapy was necessary in three patients because of neutropenia. In two of the six patients with solitary tumours, complete resection was achieved surgically prior to treatment. Five of the remaining eight patients (63%) had radiological evidence of a complete response with chemotherapy. The other three patients had no response to chemotherapy but one had a complete response after radiotherapy. The two-year cause-specific survival of the 10 patients was 37%. Two of the three patients who had a postoperative performance status of 0 or 1 (ECOG/WHO) are alive and disease-free at 26 and 46 months from diagnosis. The median survival of the seven patients with a performance status of 2-4 was 10 months with two patients alive and disease-free at 19 and 26 months. The two-year cause-specific survival of these seven patients was 22%.

Adult↗
PubMed1986

Spontaneous subhyaloid and retinal haemorrhages in an infant.

A 6 week old girl from a socially isolated family presented with seizures and was found to have a full fontanelle, retinal and subhyaloid haemorrhages, and anaemia. These findings were not the result of a shaking injury but of a ruptured intracerebral arterial aneurysm.

Cerebral Hemorrhage↗
PubMed1986

The relative contribution of magnetic resonance imaging to the assessment and differential diagnosis of cerebellopontine angle mass lesions.

Forty-nine patients with a space occupying lesion in the cerebellopontine angle cistern were examined by computed tomography (CT), magnetic imaging (MRI) and, where appropriate, conventional neuroradiologic techniques. The presence of an intracanalicular extension and a high signal on T2 weighted sequences were typical of acoustic neuroma and allowed separation from meningioma. Contrast enhancement with gadolinium DTPA was particularly valuable in recurrent acoustic neuroma. Typically epidermoids had long T1 and T2 values. Sequences which highlight flow allow vascular lesions to be identified without the use of contrast media. In separating the several pathologies MRI was superior to CT and also gave information on tissue composition in acoustic neuroma.

Cerebellar Neoplasms↗