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Biomedical subjects

M H Weiss

Publications and source records attributed to M H Weiss.

At least 145 records · Page 8Linked to original sources
PubMed1979

Specific cellular immune responses in patients with malignant gliomas.

The leukocyte adherence inhibition assay was used to measure cell-mediated immunity in 26 patients with malignant glial neoplasms and 41 control subjects. A significant inhibition of leukocyte adherence was observed in 21 of 26 (80%) glioma patients in the presence of a 3 M KCl extract of glioma tissue, as compared to that of normal brain extract. Among the control group, no significant difference in the percentage of nonadherent leukocytes was noted in the presence of either antigen. To study the specificity of the reaction, a 3 M KCl extract of meningioma, pituitary tumor, carcinomas of breast, and lung, melanoma, brain, and heart tissues were used as nonspecific antigens. Such studies revealed significantly lower values of nonadherent leukocytes. These data indicate that patients with malignant glial neoplasms manifest a cellular immune response to glioma-associated antigens which can be measured by the tube leukocyte adherence inhibition assay and that leukocyte adherence inhibition assay may render additional useful information in diagnostic and prognostic evaluation of malignant glial neoplasms.

Antigens, Neoplasm↗
PubMed1978

Modulation of CSF production by alterations in cerebral perfusion pressure.

The rate of CSF production in cats was studied in relation to changes in intracranial pressure (ICP), systemic arterial pressure (SAP), and the resultant alterations in cerebral perfusion pressure (CPP). When ICP is raised to the point where CPP falls below 55 mm Hg, CSF production will diminish. Elevation of ICP does not appear to influence CSF production rate if CPP is maintained above 70 mm Hg.

Animals↗
PubMed1978

The influence of acute ethanol intoxication on intracranial physical dynamics.

The influence of acute ethanolic intoxication on intracranial physical dynamics was assessed in 42 adult cats. Acute ethanolism significantly alters intracranial tissue compliance as determined by the intracranial volume-pressure response. Cerebral vasodilatation, secondary to ethanol administration, appears to be an underlying mechanism, possibly augmented by secondary cerebral edema. Studies of CSF production and absorption as well as osmolar ratio show no changes under conditions of acute ethanol intoxication. The observed decrease in cerebral compliance may well relate to the poor prognosis, in general, of the alcoholic brain that is subjected to trauma.

Alcoholic Intoxication↗
PubMed1977

Acquired spontaneous, nontraumatic normal-pressure cerebrospinal fluid fistulas originating from the middle fossa.

Five cases of spontaneous cerebrospinal fluid (CSF) fistulas originating from the middle fossa are described, including one patient with an "empty" sella. It is suggested that acquired meningocele and meningoencephalocele progress to become CSF fistulas. The normal anatomical and physiological factors which give rise to acquired bone/dural/arachnoid dehiscences are discussed and illustrated.

Bone Diseases↗
PubMed1977

Experiences with sterilization of the operating microscope.

Experiments were conducted to assess the feasibility of both paraformaldehyde and ethylene oxide gas sterilization of the operating microscope. From these experiments and practical experience, it is concluded that ethylene oxide sterilization of the operating microscope is a feasible and desirable alternative to cumbersome draping technique.

Ethylene Oxide↗
PubMed1977

Surgery of the pituitary gland.

Increasing diagnostic sophistication among endocrinologists has continually expanded the horizon of surgical treatment of adenohypophyseal problems. This advancement in endocrinology has been paralleled by improvement in the technical sophistication of neurosurgeons which has resulted in an increasingly aggressive approach to these serious disorders. Neurosurgical treatment is clearly able to provide resolution of significant physical disorders with minimal sequelae. The apparent potential for transsphenoidal approaches to the sella turcica as described within this paper has intrigued a number of neurosurgeons throughout this century. Their continuing interest has carried this procedure to a secure position in the management of many of these complex problems. This paper describes the author's experience with 132 consecutive transsphenoidal hypophysectomies.

Acromegaly↗
PubMed1977

Epidural spinal metastases: factors related to selection of cases for decompressive laminectomy.

We have treated a selected series of patients with spinal epidural metastatic tumors by dorsal decompression according to principles we presumed would produce the most favorable therapeutic results. There was no operative mortality, and morbidity was minor. In the first postoperative week, improvement in motor function was apparent in 44% of cases. By 3 months postoperatively, 40% of the patients were independently ambulatory and an additional 28% were ambulatory with minimal assistance. This 68% composite compares favorably to the 30 to 40% results in several series of unselected cases. On the basis of this data, it is concluded that consideration of the tumor's histological type, biological history, the host's response, the extent of neurological deficit, the progression of neurological deficit, and dissemination of disease will aid in the definition of those cases with epidural metastases which may be expected to benefit from surgical decompression.

Adult↗
PubMed1977

The influence of myoneural blockers on intracranial dynamics.

A series of animals was studied to evaluate the effect of commonly used myoneural blockers (curare, succinylcholine, gallamine, and pancuronium) on intracranial physical dynamics. Of this group, only curare alters intracranial pressure. Histamine release secondary to curare administration results in bronchoconstriction with subsequent major alterations in pulmonary ventilation. Resultant hypercarbia along with a decreased cerebral vascular resistance affects intracranial dynamics by alterations in cerebral blood flow; changes in CSF flow patterns passively reflect the alterations in intracranial pressure. These changes can be blocked by prior treatment with antihistamines.

Animals↗
PubMed1977

Failure of selective pituitary adenomectomy to cure acromegaly.

Complete selective pituitary adenomectomy for acromegaly may fail to cure the underlying endocrinopathy. A 40-year-old man who had acromegaly of ten-years duration was initially treated with pituitary irradiation eight years prior to surgery. Three years after irradiation his mean GH concentration decreased from 53 to 9.0 ng/ml, then subsequently increased, and was associated with development of severe hyperglycemia. A transsphenoidal microdissection was performed, and a discrete pituitary adenoma was visualized and totally removed at surgery. GH concentrations decreased from 46 to 5.0 ng/ml one week after surgery and to 3.0 ng/ml 10 months after surgery. Despite improvement postoperatively, the patient still demonstrated abnormal GH dynamics and responses to the GTT, abnormal nocturnal and random GH sampling, and abnormal responses to the L-dopa, apomorphine, and TRH stimulation tests. Acromegaly could be caused by either hypothalamic hyperfunction, an autonomous pituitary tumor, or both; but the latter would not explain the results obtained in this patient. This suggests that reduction of GH to normal concentrations following selective pituitary adenomectomy is not synonomous with curing acromegaly.

Acromegaly↗
PubMed1976

Pituitary apoplexy, therapeutic assessment.

The management of pituitary apoplexy with reference to both diagnosis and operative sequelae remains a major challenge. Acute onset of retro-orbital headache in association with visual loss and ophthalmoplegia are the cardinal symptoms; however, obtundation and signs of subarachnoid hemorrhage also may be present. Good quality plain skull radiographs and complete angiography prove sufficient for preoperative radiographic studies. Preoperative endocrine preparation focuses on supplemental glucocorticoids since these patients must be presumed deficient in cortisol reserve. Residual visual deficit appears to be more a function of the extent of damage at the time of ictus rather than rapidity of decompression. Our experience indicates that transsphenoidal decompression in appropriate cases offers an ideal opportunity to minimize mortality and morbidity. The acute onset of severe retro-orbital headache in association with stupor and ocular palsies would alert most physicians to the potential diagnosis of spontaneous subarachnoid hemorrhage. The association of complex ophthalmoplegias and visual defects in this constellation of symptoms should, in addition, alert one to the possibility of an acute intrasellar or parassellar expansile process. During the past two years, we have had the opportunity to care for 8 such patients with confirmed diagnoses of acute hemorrhagic infarction of the pituitary enabling us to formulate diagnostic and therapeutic schemata with reference to management of this problem.

Adult↗
PubMed1976

Anatomico-physiological considerations in exploration of the fourth ventricle.

The advancement of surgical techniques has enabled the neurosurgeon to undertake a continually more aggressive approach toward lesions within the fourth ventricle. Laboratory and clinical observations have enabled us to conclude that (1) exploration of the fourth ventricle is feasible without anatomical disruption of the vermis, (2) controlled ventilation during such explorations is physiologically most desirable, and (3) irrigation of neural structures must consider acid-base and ionic parameters in order to maintain physiologic stability.

Adolescent↗
PubMed1975

Alterations in ventricular fluid pressure during ketamine anesthesia in hydrocephalic children.

We studies ventricular fluid pressure changes in 26 hydrocephalic children following administration of ketamine. The increase in VFP previously found with intravenously administered ketamine was compared with changes after ketamine given intramuscularly, and the possible alteration of this increase with sedative premedicants was studies. Changing the route of administration did not change the time to peak VFP changes or the duration of pressure elevation. There was no demonstrable alteration of the increase in VFP by premedication with secobarbital, dorperidol, or diazepam in clinical dosage. We feel that acute rises of VFP may affect areas of marginal cerebral blood flow and may increase the risk of herniation of brain tissue.

Adolescent↗