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Biomedical subjects

L F Wilson

Publications and source records attributed to L F Wilson.

At least 19 recordsLinked to original sources
PubMed2006

The radiological appearances of thalassaemia.

The skeletal changes of untreated thalassaemia result from ineffective erythropoiesis and expansion of the bone marrow and affect every part of the skeleton. These changes include osteoporosis, growth retardation, platyspondyly and kyphosis. Erythropoiesis occurs at extra-medullary sites, most commonly resulting in a paraspinal mass but occasionally affecting organs containing pluripotential stem cells. Repeated transfusion unaccompanied by iron chelation causes haemosiderosis; iron is deposited at various sites causing functional impairment. Iron-chelation therapy with desferrioxamine (DFX) prevents haemosiderosis but causes a skeletal dysplasia predominantly affecting the rapidly growing long bones, in particular the distal ulna, and causing irregularity and sclerosis of the physeal-metaphyseal junction and splaying of the metaphysis. DFX also exacerbates the observed growth retardation. DFX-induced skeletal dysplasia may herald toxicity, which is associated with visual and auditory impairment. Therefore, careful balancing of the transfusion regimen and iron-chelation therapy is required. Magnetic resonance imaging (MRI) is the most sensitive technique for the detection of DFX-induced dysplasia.

Adult↗
PubMed2005

L5 radiculopathy secondary to intrapelvic placement of acetabular cup fixation screw.

We report a case of L5 radiculopathy secondary to intrapelvic placement of an acetabular screw impinging on the lumbosacral trunk. A 43-year-old man underwent revision of an uncemented total hip replacement to a custom-made femoral component and uncemented cup. He subsequently developed hip pain, dysesthesia, and L5 radiculopathy. Spiral computed tomography (CT) and plain radiographs raised the possibility of an acetabular screw abutting the neurovascular bundle within the pelvis. Operative removal of the intrapelvic portion of the screw resulted in the immediate relief of the patient's radicular symptoms. This case report highlights the importance of the positioning of intrapelvic screws and the need for an anatomic awareness of the structures at risk during acetabular screw placement.

Acetabulum↗
PubMed2003

High-intensity zone, intradiscal electrothermal therapy, and magnetic resonance imaging.

Magnetic resonance imaging changes to the symptomatic intervertebral disc following intradiscal electrothermal therapy were determined in this prospective study. Magnetic resonance images before the intradiscal electrothermal therapy procedure were compared with those taken at 6 months postprocedure in 10 patients. The presence and absence of high-intensity zone, the disc height and hydration, and Modic changes were determined from the images. In six of the 10 patients, a high-intensity zone was present on the magnetic resonance images of the disc before the intradiscal electrothermal therapy procedure. In all six patients, a high-intensity zone was still present after the procedure. In all 10 patients, there were no changes to other disc parameters assessed. Our findings question the clinical relevance of the high-intensity zone. They also suggest that the main mechanism of action of intradiscal electrothermal therapy may be other than that of sealing the anular tear.

Adult↗
PubMed2003

"Pig Tail" technique in intradiscal electrothermal therapy.

To describe a new method of catheter insertion in intradiscal electrothermal therapy, which eliminates the need for reinsertion of the cannula and catheter from the contralateral side in those patients in whom optimal positioning is not achieved with the standard technique. This new technique has not been described before. In those patients in whom adequate catheter position cannot be achieved with the standard technique, instead of withdrawing the cannula after the initial treatment, we recommend rotating the cannula 180 degrees through its long axis. This will allow the catheter to hit the anterior anulus and deflect backwards toward the cannula. It can then be negotiated across the midline to adequately thermally treat the whole posterior anulus. We have performed our technique in 42 consecutive patients in whom initial navigation was difficult. This new method proved to be simple and did not cause patients additional discomfort. The "pig tail" technique is safe and effective in intradiscal electrothermal therapy of those patients with difficult navigation. It avoids the need for second needle insertion, therefore avoiding the use of more local anesthesia, further discomfort for the patient, and additional radiographic exposure.

Algorithms↗
PubMed1996

Adolescent disc protrusions. A long-term follow-up of surgery compared to chymopapain.

STUDY DESIGN: This study compared chymopapain with primary surgery in the treatment of 60 radiologically proven adolescent lumbar disc protrusions and symptoms of low back pain and sciatica; the failures of intradiscal therapy were treated by surgical discectomy. OBJECTIVES: To establish whether chymopapain is as good as primary surgery in treating adolescents with proven lumbar disc protrusions. SUMMARY OF BACKGROUND DATA: Symptomatic lumbar disc protrusions are rare in white adolescents; the reported incidence varies from 0.8% to 3.2% of all lumbar disc protrusions. This is the largest study with long-term follow-up in the world literature. METHODS: Forty-two patients between the ages of 13 and 19 years with proven lumbar disc protrusions were initially treated with chymopapain; the failures of intradiscal therapy were treated by surgical discectomy. Eighteen patients were treated with surgical discectomy. After initial review at 1, 3, 6, and 12 months, the patients were assessed using a postal questionnaire and telephone interview at a minimum of 5 years' follow-up (means: 8.5 years for chymopapain group, 7.2 years for surgery group). RESULTS: Full replies were received from 16 of 18 (89%) in the surgery group and 42 of 42 (100%) in the chymopapain group. The long-term outcome is classed as good or excellent in 81% of the surgical group and 64% in the chymopapain group. If chymopapain is used as a first-line treatment, with surgery reserved for the failures, the long-term outcome is good or excellent in 82%. The chymopapain group had a shorter hospital stay. The surgical group were more likely to be unemployed and were less able to perform manual work and less able to engage in sporting activity. CONCLUSIONS: Back pain, radicular pain, and tension signs are common, but neurologic signs are less frequent in this age group. Long-term results of surgery are no better than the results of first-line chymopapain treatment with surgery being reserved for the failures. In 60% to 70% of patients, the morbidity, cost, and hospital stay were lessened. The patient is more likely to be in satisfactory employment after chemonucleolysis than after primary surgery.

Activities of Daily Living↗
PubMed1992

Holoprosencephaly and midline facial anomalies: redefining classification and management.

Holoprosencephaly encompasses a series of midline defects of the brain and face. Most cases are associated with severe malformations of the brain which are incompatible with life. At the other end of the spectrum, however, are patients with midline facial defects and normal or near-normal brain development. Although some are mentally retarded, others have the potential for achieving near-normal mentality and a full life expectancy. The latter patients do not fit clearly into the previously defined classification system. Proposed is a new classification focusing on those patients with normal or lobar brain morphology but with a wide range of facial anomalies. The classification aids in planning treatment. Coupled with CT scan findings of the brain and a period of observation, patients unlikely to thrive can be distinguished from those who will benefit from surgical intervention. Repair of the false median cleft lip and palate may suffice in patients with moderate mental retardation. Patients exhibiting normal or near-normal mentality with hypotelorbitism and nasomaxillary hypoplasia can be treated with a simultaneous midface advancement, facial bipartition expansion, and nasal reconstruction.

Child↗
PubMed1992

Fracture of the femoral stem of the Ring TCH hip prosthesis.

We report the clinical and operative details of seven cases of fracture of the femoral stem of the Ring TiMESH cementless hip prosthesis (two were cemented and five uncemented). Six fractures occurred in the proximal one-third of the stem and one at mid-stem. The failures are attributed mainly to two defects in stem design, the narrowness of the anteroposterior dimensions and the depth of the recess for the titanium mesh pads. Great difficulty was experienced in removing the osseo-integrated distal fragments of the broken stems.

Biomechanical Phenomena↗
PubMed1985

Dentofacial findings in a child with unrepaired median cleft of the lip at 4 years of age.

Dentofacial findings, audiometric and tympanometric studies, and the results of a speech evaluation of a 4-year-old boy from Yucatan, Mexico, with a rare median facial cleft are reported. It is of interest to note that all the abnormalities present in this patient were limited to the midline structures of the maxillary arch. The case presented fits into the second of the two groups of median facial anomalies described by DeMyer and his associates. There was minimal deficiency of the midline facial tissue, and there were no apparent abnormalities of the underlying brain. A brief description of the surgical techniques used for repair of the lip and palate is presented.

Child, Preschool↗
PubMed1985

Diazepam mixed micelle--comparison with diazepam in propylene glycol and midazolam.

A mixed micelle formulation of diazepam was compared with midazolam and diazepam in propylene glycol for evidence of venous intolerance following IV injection. The overall incidence of venous morbidity was 17% for diazepam mixed micelle, 26% for midazolam and 90% for diazepam in propylene glycol. Diazepam mixed micelle is suggested as a preferable alternative to the standard formulation.

Benzodiazepines↗
PubMed1985

Correction of residual deformities of the lip and nose in repaired clefts of the primary palate (lip and alveolus).

Residual deformities of the lip and nose in individuals with repaired unilateral and bilateral clefts may very in severity depending on the state of the original defect, the care taken in the initial surgical procedure, the pattern of the patient's facial growth, and the effectiveness of interceptive orthodontic techniques. Because each patient has a unique combination of deformities, their surgical reconstruction usually requires the modification and combination of several surgical techniques. In this article, a summary of various reconstructive techniques is presented, beginning with an evaluation of secondary cleft defects.

Alveoloplasty↗
PubMed1976

Burns of the foot.

The most severe trauma a patient can sustain is a major burn. When a person is seriously burned, initial care begins with maintaining an adequate airway and adequate blood volume and urinary output by intravenous fluids. After the patient has been stabilized, the wound is of primary importance, and postage stamp split thickness grafts are used for skin coverage. When these are secure and a maximal range of motion has been obtained, reconstructive procedures should be started.

Burns↗