Biomedical subjects
Publications and source records attributed to G Brocklehurst.
Twelve years' experience in classification and coding by a neurosurgical department serving a population of about 1.5 million is presented. The involvement of clinicians and the relationship to health service resource management is demonstrated. The incorporation of a comprehensive coding system (the READ codes) is outlined.
A prospective, randomized study of continuous Polydioxanone with subcuticular vicryl closure is compared to interrupted Neurilon in a general neurosurgical practice. Ninety-nine patients were studied with 49 closed with Polydioxanone and 50 by Neurilon. The two groups were comparable with respect to risk factors and general composition. There was no significant difference in the rate of infection, wound dehiscence, CSF leak or suture protrusion, but Neurilon had a significantly higher incidence of palpable knots. Wound closure time was compared with no overall difference being found. We conclude that continuous Polydioxanone closure with subcuticular vicryl is an acceptable form of closure for neurosurgical wounds.
A study of the comparative morphology of the cerebrospinal fluid (CSF) system has been made in amphioxus, lamprey, dogfish, goldfish, lungfish, frog, salamander, turtle, pigeon, and mouse. Using mainly intracardiac fixation and a careful histological technique, serial sections have been obtained of the brain in situ surrounded by its various membranes and the skull. The ventricular system, the roof of the hindbrain, the meninges and subarachnoid space, the ependyma with its various derivatives, including the choroid plexuses and paraphysis, and the relationship between the various CSF compartments and the cerebrovascular system have all been compared in these animals. The hypothesis has been derived that the CSF system is primarily developed to maintain the chemical environment necessary to the function of the cells of the central nervous system, including the neuroendocrine pathways.
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The structure of the rhombencephalic roof has been studied by serial section histology in 12 adult frogs, 3 recently metamorphosed frogs and 8 tadpoles of the species Rana temporaria. The roof of the rhombencephalon caudal to the choroid plexus consists of a delicate layer of ependyma which appears to be intact from the time of its development in the tadpole until the stage of metamorphosis. In the adult frog it is an attenuated structure displaying variable deficiencies with an apparent communication between the rhombencephalic ventricle and the surrounding subarachnoid space. The significance of this acquired communication between internal and external cerebrospinal fluid compartments in the adult frog is discussed in relationship to the classical concepts of bulk flow of the CSF in humans. Some of the limitations of these classical concepts are also discussed, and the approach to these problems by studying the comparative morphology of the CSF system in vertebrate animals is justified.