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Biomedical subjects

T Jaspan

Publications and source records attributed to T Jaspan.

64 records · Page 4Linked to original sources

A comparative study of magnetic resonance imaging and computed tomography-assisted myelography in spinal dysraphism.

Thirty-seven patients with a wide spectrum of spinal dysraphic lesions were studied by both magnetic resonance imaging (MRI) and myelography complemented by computed tomography (CT). Magnetic resonance imaging proved to be superior for tissue characterization, overall anatomical definition, topographical relationships of the cranio-cervical junction and demonstration of the presence and extent of hydrosyringomyelia. Demonstration by CT myelography of fine neural structures such as the filum terminale and nerve roots remains the superior technique; however, with constantly improving spatial resolution and thinner-slice imaging, MRI will become increasingly competitive in this respect. The osseous component of these lesions was best demonstrated by CT myelography. A high incidence of associated syrinx (8/15 cases) was found in the diastematomyelia group, with an overall incidence of 15 cases in all the dysraphic patients studied. The use of both T1- and T2-weighted sequences is required for tissue characterization. Whilst both imaging modalities proved complementary in the investigation of spinal dysraphism, we suggest that, with its superior tissue characterization and anatomical display of these lesions. MRI should be the primary imaging technique. Avoidance of an invasive procedure and use of ionizing radiation confers additional benefits upon MRI. The relative ease and shorter examination time of MRI makes this technique ideal for pre- and post-operative monitoring and assessment.

Adolescent↗

When should we request radionuclide brain scans in elderly patients?

The radionuclide brain scans performed on a gamma camera (GC scans) in 146 patients over 65 years of age during a 6-month period are reviewed. Forty-four scans (30.1%) were reported as showing an abnormality. Three patients subsequently underwent surgery and drug therapy was commenced in 11 cases. However, in most cases the GC scan proved unhelpful in the patients' management. The usage and role of GC scanning in elderly patients admitted with a neurological disorder is examined.

Aged↗

Tamoxifen as an anti-tumour agent: oestrogen binding as a predictive test for tumour response.

Rats with growing 7,12-dimethylbenz(alpha)anthracene (DMBA)-induced rat mammary carcinomata were biopsied and oestrogen-binding capacity was measured using a Sephadex LH-20 chromatography method. Tumours were measured with calipers and animals were treated for 3 weeks with tamoxifen (50 mug/day, S.C.). Tumour response was determined by the size (cm2) before and after therapy. An increase in tumour regression (ten tumours) was seen with increasing oestrogen-binding sites determined by Scatchard analysis (P less than 0.01). Thirty tumours were used to determine oestrogen binding with a single dose of [3H]-oestradiol. The percentage tumour regression was linearly correlated with oestrogen-binding capacity (P less than 0.01), although some tumours with high oestrogen-binding capacities only partially regressed in response to tamoxifen therapy. The time of the oestrous cycle when biopsy occurred was not a critical factor in determining oestrogen binding for prediction of response. Oestrogen binding was reduced during tamoxifen therapy.

Animals↗

The 'unified hypothesis' of Geddes et al. is not supported by the data.

Inflicted head injury to the developing brain frequently results in serious disability. The pathogenesis of the neuraxial and ocular findings in infants believed to have suffered inflicted head injury remains the subject of considerable debate. Recent neuropathology studies of fatal cases of inflicted head injury and of a foetal/perinatal non-traumatic model have led to the proposal that there is a 'unified hypothesis', the essential feature of which is hypoxic brain swelling secondary to cervicomedullary injury. It has been suggested that less than violent forces may be involved and even that some cases may not be due to trauma at all. The purpose of this paper is to provide a critical review of the data upon which these suppositions are based on a background of what is already known. It is submitted that there are serious flaws in the methodology; the conclusions reached cannot logically be drawn from the data; and the 'unified hypothesis' is not supported by the evidence. On the basis of the data presented, it is also difficult to sustain the secondary hypothesis purporting to describe a minority cohort with 'infantile encephalopathy with subdural and retinal bleeding' of non-traumatic causation.

Brain↗

Antiphospholipid antibody syndrome presenting with complex partial seizures and transient ischaemic attacks due to widespread small cerebral arterial thrombosis.

The neuropathological findings in a young man with the antiphospholipid antibody syndrome presenting with complex partial seizures and transient ischaemic attacks are described. Whilst some of his symptoms could be attributed to large vessel thrombosis, the dominant pathological process was widespread small cerebral arterial thrombosis causing extensive microinfarcts within the cerebral cortex. These findings help to explain the neurological manifestations of the antiphospholipid antibody syndrome.

Adult↗

Delayed reconfiguration of a Guglielmi detachable coil mass associated with late occlusion of an adjacent aneurysm and parent vessel.

We present a case of asymptomatic, progressive, late occlusion of the left superior cerebellar artery (SCA) and an aneurysm arising from the junction of the SCA and basilar artery after embolization of an adjacent aneurysm arising between the left posterior cerebral artery and the left SCA. The delayed occlusion was associated with reconfiguration of the Guglielmi detachable coils at the neck of the treated aneurysm.

Angiography, Digital Subtraction↗