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Biomedical subjects

L F Jelsma

Publications and source records attributed to L F Jelsma.

12 recordsLinked to original sources
PubMed1993

Surgical removal of brainstem astrocytomas and hemangioblastomas: report of three cases and review.

The surgical removal of a brainstem astrocytoma or hemangioblastoma entails the risk of a major neurological injury, but if injury can be avoided, the benefits of surgery are considerable in some types of these tumors. Most brainstem astrocytomas are widely infiltrative diffuse tumors that frequency undergo malignant change and are not benefitted by surgery. However, dorsally exophytic brainstem astrocytomas, focal cervicomedullary astrocytomas, and focal brainstem astrocytomas have a more benign character and frequently are benefitted by surgical removal or other surgical intervention. Brainstem hemangioblastomas may be extramedullary tumors or cystic intramedullary tumors, and surgical removal of these tumors is usually possible and is the optimal treatment. Three cases are presented to illustrate that excellent results can be obtained by surgical resection of certain types of brainstem astrocytoma or hemangioblastoma. The clinical and radiographic characteristics and the results of surgical treatment for each of these types of brainstem tumor are discussed.

Adolescent↗
PubMed1985

Aspergillus osteomyelitis. Report of a case and review of the literature.

Aspergillus is a ubiquitous saprophytic fungus seldom pathogenic for normal hosts. Aspergillus osteomyelitis occurs infrequently and is typically limited to patients with predisposing factors, including leukocyte dysfunction, malignancy with neutropenia, steroid or antibiotic therapy, pulmonary aspergillosis, and surgical manipulation. The spine is most frequently affected, and the clinical presentation is nonspecific (50% afebrile). Diagnosis requires demonstration of characteristic, acutely branching, broad, septate hyphae in biopsy material, and culture of Aspergillus. Therapy includes debridement of necrotic bone and loculated purulence combined with amphotericin B and possibly 5-fluorocytosine or rifampin.

Adult↗
PubMed1984

A stretcher that facilitates the radiographic evaluation and closed reduction of spinal fractures.

A rigid and exceptionally radiolucent stretcher with an attachment for cervical traction has been constructed. A patient is able to remain on this stretcher in the same position during the entire radiographic examination of a spinal fracture, including plain x-ray and computed tomographic and myelographic studies. Two advantages are obtained if this stretcher is used: 1) A patient's spine is well supported and does not need to be moved at any time during these radiographic studies, and 2) the application of traction during the myelography or closed reduction of a cervical fracture is facilitated.

Equipment and Supplies↗
PubMed1982

The radiographic description of thoracolumbar fractures.

The X-ray films of 40 patients with thoracolumbar fractures were studied in order to classify the fractures, to investigate the causes of neural compression, and to define which fractures were unstable. Each fracture could be classified as a wedge fracture, a burst fracture, or a fracture-dislocation. The fragment of bone that produced neural compression in wedge and burst fractures almost always arose from the upper half of the vertebral body and had a characteristic triangular shape, as viewed on lateral x-ray films of the spine. Based on radiographic evidence, fracture-dislocations, severe burst fractures, and wedge fractures associated with marked subluxation, traumatic spondylolisthesis, or horizontal fractures of a pedicle were considered to be unstable. Mild burst fractures and most wedge fractures were considered to be stable.

Fracture Fixation, Internal↗
PubMed1982

The demonstration and significance of neural compression after spinal injury.

Standard metrizamide myeLography and CT myelography can accurately and safely define neural compression after a spinal injury. A lateral C1-C2 spinal puncture and a radiolucent fracture board reduce movement of the spine, and by injecting metrizamide in an isotonic concentration and by limiting the amount of contrast above a block, the risk of seizure is minimized. This capability for directly determining neural compression has important implications for the treatment of spinal fractures, and the significance of persisting posttraumatic neural compression is discussed. We believe neural compression should be the primary indication for surgical decompression after spinal injury and that evaluation for it should now be a standard part of the examination of patients with spinal fractures with potential for neurological recovery.

Diagnosis, Differential↗
PubMedDate not supplied

Spinal gliosarcoma: a light, immunohistochemical and ultrastructural study.

Gliosarcomas are mixed tumors of the brain containing both malignant neuroectodermal and mesenchymal components. Over 100 cases have been reported within the brain; however, to our knowledge, this is the first reported case located primarily within the spinal cord. Along with a review of the literature, the light, immunohistochemical and ultrastructural findings of a spinal gliosarcoma are reported in a 41-year-old woman with a previously diagnosed oligodendroglioma of the cerebellum 15 years earlier and a concurrent pituitary adenoma. The spinal tumor appears to be morphologically identical to its intracranial counterpart.

Adult↗