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Biomedical subjects

K H Langford

Publications and source records attributed to K H Langford.

12 recordsLinked to original sources

Spinal cord stimulation for the failed back syndrome.

Thirty-two patients with failed back syndrome received a trial of spinal cord stimulation. Stimulators were internalized in 26; long-term follow-up was available for 23 of these patients. Seventy-six percent of the 22 patients with stimulators still present at 1 year and 74% of the 19 patients with stimulators still present at 2 years were receiving 50% or better pain relief. Patients routinely underwent pain team evaluation and therapy, psychological testing and a transcutaneous electrical nerve stimulator trial prior to consideration of spinal cord stimulation. The most common complication was electrode migration. Spinal cord stimulation should be considered as an important therapeutic modality in carefully selected patients with failed back syndrome.

Electric Stimulation Therapy

Computed tomography and magnetic resonance imaging in traumatic locked-in syndrome.

The first reported case of traumatic locked-in syndrome with computed tomographic and magnetic resonance scan confirmation of the brain stem lesion is presented. The lesion responsible for the patient's condition consisted of a hemorrhage in the ventral pontomedullary junction. The pathophysiology of the production of such lesions is discussed.

Adult

Hydroxylapatite: an adjunct to cranial bone grafting.

Hydroxylapatite is a dense pure ceramic material which has been used extensively in the reconstruction of atrophic maxillary and mandibular ridges. The authors describe a technique for the use of hydroxylapatite in combination with grafting of bone, either autogenous or from the bone bank, to restore contour to cranial defects. The use of hydroxylapatite in combination with bone grafting for contour restoration is recommended, as attempts to place the material directly on dura were not successful.

Adolescent

Symptomatic spinal epidural lipomatosis as a complication of steroid immunosuppression in cardiac transplant patients. Report of two cases.

Patients with Cushing's syndrome may develop spinal epidural lipomatosis, an abnormal accumulation of fat in the spinal epidural space. This accumulation of fat may cause compression of the spinal cord or cauda equina with resulting neurological deficit. Two cases of symptomatic spinal lipomatosis are reported in cardiac transplant patients receiving chronic corticosteroid treatment. The literature is reviewed, and diagnostic and therapeutic considerations are discussed.

Adrenal Cortex Hormones

Disk herniation.

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Chronic Disease

Migration of detachable mini-balloon from the ICA causing occlusion of the MCA. Case report.

This patient had an aneurysm on the internal carotid artery that was responsible for episodes of severe hemorrhage through the nose. During occlusion of the aneurysm by a detachable balloon, the balloon became dislodged and migrated, obstructing the middle cerebral artery territory and causing a life-threatening situation. This was treated promptly and successfully by removal of the balloon and repair of the artery. Attention is drawn to the risk of such migration occurring, and the possible causes.

Adult

Pulmonary toxicity associated with bischloroethylnitrosourea (BCNU).

Ten patients developed pulmonary fibrosis after bischloroethylnitrosourea (BCNU) therapy for malignancy. This was lethal in seven patients, four of whom had no evidence of tumor at autopsy. Presenting symptoms were either the insidious onset of cough and dyspnea or the sudden onset of respiratory failure. Physical findings were unremarkable. Chest roentgenogram usually showed interstitial infiltrates. Pulmonary function studies showed resting hypoxia with diffusion and restrictive defects. This complication of therapy does not appear to be dose related and may be made more likely by the concomitant administration of cyclophosphamide. Prednisone therapy did not benefit most patients. The literature and the implications of the use of BCNU alone or in combination are reviewed.

Adolescent

Abnormal brain scan with subacute extradural haematomas.

Four patients are described with proven subacute extradural haematomas, each with an abnormal cerebral scan of diagnostic assistance. A possible mechanism of production of the subacute extradural haematoma is discussed, and appears to be similar to the mechanism involved in the subacute subdural haematoma. The means by which the abnormal scan results in such cases is also examined, from which it appears that non-specific meningeal membrane inflammatory reaction surrounding the haematoma is significant.

Adolescent