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Biomedical subjects

J R Mawk

Publications and source records attributed to J R Mawk.

At least 19 recordsLinked to original sources

Multilevel lumbar disc herniation in 12-year-old twins.

Herniation of a lumbar disc in the pediatric age group is rare. A 12-year-old female twin developed backache and left sciatica after a mild lifting injury. Magnetic resonance imaging of the spine showed multilevel lumbar disc herniation. The patient was managed conservatively and her symptoms subsided within 6 weeks. Magnetic resonance imaging of her asymptomatic twin sister revealed a similar pattern of disc degeneration and multilevel herniation. This report emphasizes the hereditary nature of juvenile lumbar disc degeneration.

Child↗

High activity iodine 125 endocurietherapy for recurrent skull base tumors.

Experience with endocurietherapy of skull base tumors is reviewed. We present our cases of recurrent pituitary hemangiopericytoma, radiation-induced recurrent meningioma, recurrent clival chordoma, recurrent nasopharyngeal cancer involving the cavernous sinus, and recurrent parotid carcinoma of the skull base which were all successfully retreated with high-activity 125iodine (I-125) permanent implantation.

Adenocarcinoma↗

Intracranial arterial duplex Doppler waveform analysis in infants.

Duplex sonography of the brain was performed on 130 pediatric patients: 53 with normal brains, 22 with intracranial hemorrhage, 15 with hypoxic-ischemic encephalopathy, 29 with hydrocephalus requiring ventricular shunting, and 11 with ventriculomegaly without hemorrhage or shunting. Doppler arterial waveforms from the Circle of Willis showed increased pulsatility in 82% of patients with intracranial hemorrhage, 53% of patients with hypoxic-ischemic change, and in only 31% of patients with hydrocephalus requiring shunt and 36% of patients with ventriculomegaly without shunt or hemorrhage. Mean pulsatility was increased (p less than 0.05) in all groups except ventriculomegaly without hemorrhage or shunt. No statistical difference was found in the diagnostic efficiency of three indices of pulsatility (frequency index profile, pulsatility index, systolic to diastolic ratio).

Brain Ischemia↗

Outpatient pediatric neurosurgery.

In a 16-month period, 31 children underwent outpatient operations for a variety of neurosurgical problems. None of the patients experienced any anesthetic complications. One patient was admitted for management of a surgical complication and was discharged uneventfully 4 days later. A saving of at least 49.5% in hospital charges was produced when surgery was performed in the outpatient surgical facility, and a 19.8% reduction in costs was achieved when the main hospital operating suite was used on an outpatient basis. Neurosurgical procedures can be safely and inexpensively performed on an outpatient basis, even in children.

Ambulatory Care↗

Neurosurgical complications of pediatric orthotopic liver transplantation.

Liver transplantation is the only definitive treatment of end-stage liver disease. The University of Nebraska began its hepatic transplantation program in July 1985. Since that time, 43 children and 48 adults have undergone orthotopic liver transplantation (OLTx) with survival rates to date of 79.1% and 79.2%, respectively. Eight children developed complications of neurosurgical interest (18.6% incidence). Hemorrhagic complications were the most frequent. Neurosurgical salvage was achieved in five patients, but delayed complications of the transplant caused the death of two of these children. Two survivors are functioning well at home and in kindergarten, one child is doing well but is still hospitalized, and one child is vegetative. Aggressive management of life-threatening CNS problems is thus appropriate in this population. The authors review the pathophysiology of these complications, as well as potential pitfalls in their management.

Brain Abscess↗

Metameric capillary hemangioma producing complete myelographic block in an infant. Case report.

A variety of lesions of ectodermal, mesodermal, (rarely) endodermal, or mixed-cell layer origin involve the region of the conus medullaris. Some of these abnormalities produce cord tethering and others, such as lipoma, frequently present as masses. In the present case, an infant was discovered to have a lesion most closely resembling a capillary hemangioma involving the skin of the midline and right buttock, the deep soft tissues of the right buttock, the dura, and the conus medullaris. The origin of this congenital spinal tumor from primitive mesoderm is proposed in light of its metameric pattern of distribution.

Aortography↗

Percutaneous shunts.

Explore the source record for details and available documents.

Cerebrospinal Fluid Shunts↗

Recurrent bacterial meningitis: coronal thin-section cranial computed tomography to delineate anatomic defects.

Three patients with histories of recurrent bacterial meningitis were previously examined with skull and sinus radiographs, routine cranial computed tomography, intrathecal radioisotope tracer studies, and immunologic evaluation. None of these studies were diagnostic. Pneumococcal vaccine and prophylactic penicillin therapy were ineffective in preventing recurrent episodes in two cases. Thin-section (2-mm) direct coronal computed cranial tomography demonstrated anatomic defects in all three patients. The use of metrizamide cisternography was not necessary to diagnose the defects. All patients had basiethmoidal encephaloceles which were repaired surgically. Direct coronal computed tomography offers a relatively easy noninvasive method for delineating anatomic abnormalities in patients with recurrent meningitis.

Child↗

Aspergillus infections of the lumbar disc spaces. Report of three cases.

Three cases of lumbar vertebral interspace infection due to the Aspergillus fungus are presented. Two patients responded to vigorous surgical therapy in combination with prolonged administration of antifungal agents. The third patient died of complications related to the antibiotic therapy. Possible etiologies of this unusual problem are reviewed in light of the changing spectrum of nosocomial and spontaneously acquired infectious processes. Combined aggressive medical and surgical therapy is discussed with respect to the known difficulties in eradicating deep-seated osseous mycotic infections.

Adult↗