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Biomedical subjects

R K Jelsma

Publications and source records attributed to R K Jelsma.

14 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↗
PubMed1992

A portable traction device for cervical fractures. Technical note.

A lightweight and completely self-contained traction device is described. It has been used to immobilize the cervical spine during radiographic evaluation and treatment of patients with cervical fracture, and for therapeutic traction in patients with a ruptured disc. Other applications are possible, but have not yet been investigated.

Cervical Vertebrae↗
PubMed1989

Brain metastasis from nonseminomatous germ cell tumors of the testis: case report and review of the role of surgery.

The prognosis for patients with nonseminomatous germ cell tumor of the testis is good, even when extensive metastatic disease is present, because this tumor is very sensitive to chemotherapy with cisplatin, vinblastine, and bleomycin (PVB). If a metastasis occurs in the brain, however, the prognosis is poor because the blood-brain barrier limits the entrance of these drugs into the brain and creates a sanctuary for tumor. The current treatment for a brain metastasis is either standard PVB chemotherapy plus whole brain radiation therapy or a rigorous chemotheraputic regimen that penetrates the blood-brain barrier better than PVB. Surgery is seldom used for brain metastasis, largely because of the poor results with surgical debulking in noncentral nervous system disease. This is the report of a patient with disseminated nonseminomatous germ cell tumor and multiple large brain metastases, who was treated with surgery, PVB, and whole brain radiation therapy and cured. Evidence is presented to support a role for surgical debulking in patients with large brain metastasis.

Adolescent↗
PubMed1985

Cerebral glioblastomas can be cured!

In 1959, a 30-year-old man underwent the removal of a glioblastoma multiforme from the right parietal lobe of his brain. After the operation, he received x-ray therapy. He made a complete recovery. Today, over 25 years later, he is alive and well and is regularly employed full-time. If glioblastomas and other cerebral gliomas are removed completely, the patients can be cured of their tumors.

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↗
PubMed1980

The treatment of malignancy of a vertebral body.

Five cases with collapse of a vertebral body due to malignancy were surgically treated. A posterior exposure was adequate for removal of the tumor within the vertebral body; and stabilization of the spine appears to have been achieved satisfactorily with Harrington rods. The indications for surgical treatment and the results are discussed. In selected cases, this procedure has been worthwhile. It has relieved pain, restored ambulation, and allowed a normal existence for patients who otherwise would have been bedridden.

Adenocarcinoma↗