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Biomedical subjects

S L Wald

Publications and source records attributed to S L Wald.

28 records · Page 2Linked to original sources
PubMed1984

Intradural spinal metastasis in Ewing's sarcoma: case report and review of the literature.

Ewing's sarcoma is a rare primary osseous neoplasm of children and young adults. The use of radiotherapy and adjuvant chemotherapy has favorably influenced the outcome of patients and dramatically reduced the rate of local disease recurrence. However, distant metastasis, usually to the lung and skeletal system, continues to be a frequent preterminal event. Metastasis to the central nervous system is infrequent unless related to adjacent bone involvement. We report a case of intraneural, intradural metastasis in a young man with a previously treated Ewing's sarcoma of the ilium. Metastasis to this part of the nervous system has not been previously reported.

Adolescent↗
PubMed1982

Cystic thalamic gliomas.

Primary tumours of the thalamus are rare and present several diagnostic and therapeutic problems. Cystic thalamic lesions tend to be low grade astrocytomas and have only been reported in children. Signs and symptoms can be divided into those due to intracranial hypertension and those due to loss of function of thalamic nuclei and surrounding structures. Histologic diagnosis can be established by CT-guided needle biopsy and therapy begun by evacuation of the cyst contents. The prognosis remains uncertain.

Astrocytoma↗
PubMed1982

Oral glycerol for the treatment of traumatic intracranial hypertension.

Hyperosmolar agents are a primary therapeutic modality employed in the treatment of traumatic intracranial hypertension. Profound hyperosmolarity accompanied by systemic dehydration is a potentially serious problem when these drugs are used repeatedly for control of intracranial pressure. Because glycerol, a water-soluble alcohol, is metabolized in the liver, its dehydrating capacity may be reduced in comparison to other agents. A series of 15 patients were treated with oral glycerol (0.5 to 1.0 gm/kg) with only minor changes in serum electrolytes, glucose, and urea nitrogen. Serum osmolarity rose from a baseline of 305 mOsm/liter to 355 mOsm/liter after 10 days of therapy. Glycerol was found to be effective and safe when employed in this protocol and proved to be a valuable adjunct to the standard methods available for control of intracranial hypertension.

Administration, Oral↗
PubMed1980

Cerebrospinal fluid antibiotic levels during treatment of shunt infections.

Twenty patients with documented cerebrospinal fluid shunt infections were treated with daily intraventricular injections of methicillin, cephalothin, or gentamicin without removal of the shunt or external ventricular drainage. Periodic determinations of intraventricular antibiotic concentration revealed significant levels in relation to the established minimum inhibitory concentration in all cases.

Adolescent↗
PubMedDate not supplied

Mondini dysplasia: spontaneous cerebrospinal fluid otorrhea. New perspectives in management.

The Mondini dysplasia represents a developmental arrest during the embryogenesis of the inner ear. The malformation, commonly associated with deafness, is frequently heralded by meningitis secondary to communication of the middle ear with the subarachnoid space. Early recognition and successful repair of the CSF leak is important to avoid the sequelae of repeated episodes of meningitis. We believe the addition of CSF diversion in the form of a lumbar drain during and after surgery will result in improved success.

Cerebrospinal Fluid Otorrhea↗
PubMedDate not supplied

Shunt-associated glomerulonephritis.

Six patients with glomerulonephritis in association with a ventriculovascular shunt were treated with three basic modes of therapy. Direct intraventricular instillation of antibiotic was used on seven occasions in five patients either as the definitive mode of therapy or as an adjunct to shunt removal. Ventricular fluid antibiotic concentrations were monitored in two patients and demonstrate that effective levels as compared to the specific minimal inhibitory concentration can only be achieved by this method. With resolution of the shunt infection, improvement in the clinical and laboratory parameters of renal function was noted. A recommended treatment protocol is outlined, including specific dosages for intraventricular antibiotics. The need for detailed and frequent post-treatment examination including serum immunoglobulin profile is stressed.

Anti-Bacterial Agents↗