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Biomedical subjects

E L Foltz

Publications and source records attributed to E L Foltz.

15 recordsLinked to original sources
PubMed1991

Hydrocephalus: overdrainage by ventricular shunts. A review and recommendations.

Selected literature review of the clinical course of patients with ventricular shunts for hydrocephalus shows that the effects of cerebrospinal fluid overdrainage are subdural hematoma, craniosynostosis, slit ventricle syndrome, and low intracranial pressure syndrome. These occur sequentially at different age groups, but approximate averages of incidence and time of occurrence after first shunt reveal an overall incidence of 10%-12% for at least one of these appearing at 6.5 years after shunting. The basic etiology, diagnosis, and variety of treatment modalities available are reviewed, including the need for shunt closing intracranial pressure control. Included is a hydrocephalus program designed to minimize the need for long-term extracranial shunts and to maximize therapeutic intracranial procedures for hydrocephalus.

Cerebral Ventricles↗
PubMed1990

CSF pulsatility in hydrocephalus: respiratory effect on pulse wave slope as an indicator of intracranial compliance.

The effect of inspiration and expiration on the systolic slope of the cerebrospinal fluid (CSF) pulse wave has been studied in 83 shunted and non-shunted patients undergoing diagnostic tests for suspected hydrocephalus. A ratio of the systolic CSF pulse slope on inspiration to the same in expiration (I/E ratio or index) has proved statistically valid in identifying non-hydrocephalic patients from hydrocephalic patients and in separating hydrocephalic patients into arrested, communicating and aqueductal stenosis hydrocephalus. The I/E ratio depends on the comparative damping effect of intracranial venous venting on the systolic CSF pulse slope during inspiration (I) when venous volume is evacuated from the cranium by negative mediastinal pressure, and during expiration (E) when cranial venous volume flow to heart is minimal due to positive mediastinal pressure. The low cranial venous outflow on expiration produces little effect on the normal damping of the systolic CSF pulse slope. The high venous outflow on inspiration produces a loss of damping, causing a high systolic CSF pulse slope. Therefore, exhausted cranial venous volume, or exhausted intracranial compliance, produces an I/E ratio approaching 1.0, whereas a normal I/E ratio is between 2.0 and 3.0. The I/E ratio can presumably be used to assess intracranial compliance changes occurring before the dangerous late intracranial pressure (ICP) upward surge related to the volume-pressure curve in all clinical problems of increasing ICP. The I/E ratio may be used likewise to assess the urgency of treatment for any hydrocephalus and increased intracranial pressure problem, i.e. the closer to unity the greater the urgency.

Adolescent↗
PubMed1979

Cerebrospinal fluid bulk flow study: radioiodinated serum albumin (R131ISA) and technetium-99m-labeled diethylenetriaminepentaacetic acid (DTPA) retention in the ventricles of normal and hydrocephalic dogs.

Eight normal dogs were studied and then made hydrocephalic (kaolin induced) to demonstrate and compare the use of R131ISA and 99mTcDTPA in cerebrospinal fluid (CSF) bulk flow studies. The radioisotopes were simultaneously injected into the CSF space in the cisterna magna of normal dogs and into the lateral ventricles of hydrocephalic dogs after an equal volume of CSF had been removed. The average dose of RISA was 100 muCi, and for TcDTPA it was 7 mCi. A bag of lactated Ringer's solution (500 ml) was used as a control phantom after being injected with the same dose of isotope as used in the animals. Brain scans were obtained with the gamma ray camera at 4 and 24 hours after injection. We used four criteria to evaluate results: clinical state of the animal, CSF ventricular pressures with challenges, percentage of retained isotope in counts per minute, and ventricular size at postmortem examination. The results demonstrate that the amount of isotope retention over 20 hours and the clinical state of the dog are better correlated when RISA is used than when TcDTPA is used. The study indicates that RISA is more reliable than TcDTPA as an indicator of CSF bulk flow in both normal and hydrocephalic dogs.

Animals↗
PubMed1977

Effect of fosfomycin on the fecal microflora of man.

Use of broad-spectrum antibiotics is known to cause changes in the intestinal microflora of man. The present study was initiated to determine the effect of oral fosfomycin calcium on several groups of microorganisms indigenous to the gut. Data from this double-blind study indicate that 2 g of fosfomycin given daily in four divided doses for 28 days increased the incidence of soft stools. No significant changes in numbers of staphylococci or Candida were observed during treatment. Although there was no significant change in total coliforms, the numbers of E. coli decreased markedly from 10(5) to 10(2) organisms/g feces. Concurrent with this decrease, the Klebsiella-Enterobacter counts increased from 10(3) to 10(6) organisms/g feces. Two weeks posttreatment the E. coli and the Klebsiella-Enterobacter counts approached pretreatment levels. These observations are similar to those reported for ampicillin. During the course of treatment when the E. coli dropped precipitously the few surviving E. coli still were suceptible to fosfomycin as determined by an agar diffusion disc test.

Anti-Bacterial Agents↗
PubMed1977

Malignant hyperthermia.

The authors report the case of an infant with noncommunicating hydrocephalus, Arnold-Chiari malformation, and a lumbar myelomeningocele, in whom malignant hyperthermia occurred. The genetics and presumed etiology of this unusual problem are reviewed. The management is directed toward establishing effective cooling measures, reversing tissue hypoxia, and correcting respiratory and metabolic acidosis.

Acidosis↗
PubMed1976

Pharmacokinetics of methyldopa in man.

Single doses of methyldopa were administered orally and intravenously as aqueous solutions to 12 healthy volunteers in a crossover study. Serial plasma and urine samples were analyzed specifically for methyldopa and its O-sulfate conjugate. Kinetic analyses of the results indicated that methyldopa disposition could be adequately represented by a two-compartment open model. Renal excretion accounted for about two-thirds of the plasma clearance of methylodopa. Absorption profiles were constructed with the aid of the pharmacokinetic model and contrasted with estimates of absorption which were model-independent. The mean fraction reaching the systemic circulation as methyldopa was estimated to be 0.25 (range 0.08-0.62 for n = 11). Although most of the absorption occurred within the first 5 hours oral administration, a minor component, suggestive of limited enterohepatic circulation, persisted from 9 to 36 hours. O-sulfate conjugation was route-dependent and appeared to be derived predominantly, if not exclusively, as a first-pass effect of absorption and/or enterophepatic circulation.

Administration, Oral↗
PubMed1976

Avoidance behavior and ileum motility post-cingulumotomy in monkey.

Two experiments were conducted utilizing rhesus monkeys to determine (i) the effects of cingulumotomy on conditioned-avoidance acquisition and extinction and (ii) the effects of avoidance learning on distal ileum motility in control- and cingulum-lesioned animals. Active (AAR) and passive (PAR) avoidance schedules singly or in combination were employed during short daily periods (less than 2 hr) of "shaping," training, acquisition, and extinction. The data indicated that the control-lesion and cingulum groups did not differ in the acquisition or extinction of an AAR. The cingulum group, however, showed a significant deficit in the acquisition of a PAR and a noticeably slower rate of lever pulling during avoidance trials in the combined avoidance training sessions. The results also suggested that ileum motility and avoidance behavior parallel on another, i.e., if either changed the other often changed in the same direction; that cingulum monkeys seemed to be less "reactive" than control-lesion monkeys; and that cingulum animals may been somewhat more regular in their percent daily motility patterns than the control animals.

Animals↗
PubMed1975

Follow-up comparison of hydrocephalus with and without myelomeningocele.

A series of 454 hydrocephalic patients with and without myelomeningocele and with and without treatment is reviewed. The survival rates for hydrocephalus alone and for hydrocephalus with myelodysplasia are comparable. The authors reach the conclusion that treatment of the hycrocephalic process and its complications is the most critical therapeutic consideration. Mental retardation is the major unalterable cause for failure to develop independence; some lesser emotional causes can be modified by encouragement. Repeated reassessment of the patient's condition and adjustment are important. Before treatment is started parents or guardians should be fully informed of the child's future potential for independent life and mental development.

Abnormalities, Multiple↗
PubMed1975

Craniosynostosis.

The authors review the embryopathology and clinical manifestations of craniosynostosis and analyze a series of 27 children. The operative procedure of linear craniectomy and immediate cranioplasty is described and evaluated. Since few children with craniosynostosis have neurological deficits that can be ascribed to the skull anomalies, surgery to prevent neurological complications is only rarely justified. However, it is often possible to ameliorate the cosmetic deformity in many of these patients if operative intervention is undertaken in early infancy.

Cephalometry↗
PubMed1975

Double compartment hydrocephalus in a patient with cysticercosis meningitis.

The authors discuss encystment of the fourth ventricle and upward herniation complicating a case of cysticercosis cerebri. The "double compartment" hydrocephalus followed occlusion of the aqueduct of Sylvius and the foramena of Luschka and Magendie in a patient who had previously received a ventriculo-atrial shunt for communicating hydrocephalus. The clinical presentation of this particular form of double compartment hydrocephalus is discussed.

Adult↗