301
|
Abstract
Six cases of posterior cervical fusion with rib grafts in children are reported. Four of the children had sustained cervical spine injuries in accidents, and two had congenital absence of the odontoid. Three-level fusions (C1-3) were done in four children, and four-level fusions (C1-4) in two. One child died of unrelated causes 3 months after the operation. The other five children have been followed for 5 to 13 years. All are doing well and each has a remarkably supple, stable neck and no neurological deficit.
Collapse
|
302
|
Walker MD, Alexander E, Hunt WE, Leventhal CM, Mahaley MS, Mealey J, Norrell HA, Owens G, Ransohoff J, Wilson CB, Gehan EA. Evaluation of mithramycin in the treatment of anaplastic gliomas. J Neurosurg 1976; 44:655-67. [PMID: 178838 DOI: 10.3171/jns.1976.44.6.0655] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A controlled, prospective, randomized study evaluated the use of mithramycin in the treatment of anaplastic glioma compared to a similar group of patients receiving best conventional care. From a total of 116 patients in the study, 96 were within the valid study group. All patients were operated on, had histological confirmation of anaplastic glioma, and received radiotherapy at the discretion of the principal investigator. Fifty-two patients received mithramycin at a dose of 25 mug/kg/day for 21 days, while 44 patients were in the control group. There was no significant difference in the median survival from time of randomization in those receiving mithramycin (21 weeks) as compared to those not receiving mithramycin (26 weeks). There was no significant difference between the two groups in relation to age distribution, sex, location, diagnosis, tumor characteristics, signs or symptoms, or radiotherapy received. Duration of symptoms correlates positively with survival and was also significantly longer in the control group than in the treated group. This, however, did not account for the failure of mithramycin to be found an effective agent. Although the study was not designed to evaluate the efficacy of radiotherapy, patients who were so treated had a significant improvement in survival. The toxic complications of mithramycin included gastrointestinal symptoms, dermatological involvement, anemia, and liver dysfunction, indicating the need for close supervision.
Collapse
|
303
|
Alexander E, Sanders S, Braylan R. Purported difference between human T-and B-cell surface morphology is an artefact. Nature 1976; 261:239-41. [PMID: 1083959 DOI: 10.1038/261239a0] [Citation(s) in RCA: 42] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
304
|
Buerkert J, Alexander E, Purkerson ML, Klahr S. On the site of decreased fluid reabsorption after release of ureteral obstruction in the rat. THE JOURNAL OF LABORATORY AND CLINICAL MEDICINE 1976; 87:397-410. [PMID: 1249472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Fluid reabsorption in surface nephrons was studied by micropuncture 3 hours after release of complete left ureteral ligation (LUL) or after unilateral release of bilateral ureteral ligation (BUL). In 11 rats with LUL, glomerular filtration rate (GFR) averaged 0.23 +/- 0.04 ml. per minute in the experimental vs. 1.25 +/- 0.11 ml. per minute in the control kidney. GFR averaged 0.18 +/- 0.02 ml. per minute in BUL. Single nephron glomerular filtration rate (SNGFR) was decreased in the experimental kidney of LUL or BUL when determined at proximal or distal sites as compared to the SNGFR determined in shams or the left kidney following right ureteral ligation (RUL). Fractional water excretion was increased after release of obstruction. LUL 2.72 +/- 0.66 per cent; BUL 12.3 +/- 2.82 per cent when compared to sham-operated rats (0.48 +/- 0.07 per cent) or to the untouched kidneys of the RUL group (0.60 +/- 0.09 per cent). Despite increased water and sodium excretion after release of unilateral ureteral ligation and BUL there were marked differences in tubular fluid reabsorption between these two groups. Following release of LUL there was increased fractional water reabsorption along the accessible length of surface nephrons of the experimental kidney. At 55 per cent of proximal tubular length TF/Pin averaged 4.02 +/- 0.02 in LUL vs. 2.18 +/- 0.06 in shams. The mean TF/Pin at 90 per cent of distal tubular length was 31.0 +/- 1.37 in LUL vs. 10.6 +/- 0.08 in sham-operated rats. In contrast, water reabsorption after BUL was slightly but significantly suppressed proximally (TF/Pin 1.95 +/- 0.02) and markedly depressed distally (TF/Pin 3.35 +/- 0.29). These results suggest that the change in fluid reabsorption observed after relief of LUL is located at a site beyond the accessible length of surface nephrons, most likely in the collecting duct. However, the data could also be explained by alterations in fluid reabsorption in deep nephrons. The changes in fluid reabsorption seen following release of BUL reflect the additive effects of release of obstruction and a marked reduction in functioning nephron mass.
Collapse
|
305
|
Alexander E, Henkart P. The adherence of human Fc receptor-bearing lymphocytes to antigen-antibody complexes. II. Morphologic alterations induced by the substrate. J Exp Med 1976; 143:329-47. [PMID: 814196 PMCID: PMC2190128 DOI: 10.1084/jem.143.2.329] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The adhesion of human Fc receptor-bearing lymphocytes to immobilized antigen-antibody complexes is accompanied by marked alterations in cell shape, resulting in flattening of greater than 90% of the adherent cells. In addition, about 65% of the adherent cells become elongated, with distinct uropods being present in about 1/3 of these cells. Scanning electron microscopy demonstrates that most of the surface microvilli are lost, while ruffled membranes and long microextensions are formed during the shape change. Time-lapse cinematography shows that the major shape changes occur within a few minutes after contact with the substrate, and that the adherent cells undergo translational motility. Both flattening and elongation of the adherent cells are inhibited by low temperature, chelating agents, cytochalasin B, and vinblastine, while sodium azide selectively inhibits elongation and uropod formation. It is argued that these morphological changes result from an active response of the cell to the immobilized complexes, and that such alterations may be related mechanistically to the ability of the cells to kill antibody-coated target cells.
Collapse
|
306
|
Alexander E. Henry L. Heyl, 1906-1975. SURGICAL NEUROLOGY 1975; 4:205-7. [PMID: 1099706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
307
|
Norwood CW, Poole GJ, Moody D, Alexander E. Proceedings: Successful treatment of delayed arterial spasm in the rhesus monkey after subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1975; 38:404. [PMID: 237988 PMCID: PMC491940 DOI: 10.1136/jnnp.38.4.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
308
|
Chow AW, Alexander E, Montgomerie JZ, Guze LB. Successful treatment of non-meningitic listerial brain abscess without operation. West J Med 1975; 122:167-71. [PMID: 1090091 PMCID: PMC1130318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
309
|
Norwood CW, Alexander E, Davis CH, Kelly DL. Recurrent and multiple suture closures after craniectomy for craniosynostosis. J Neurosurg 1974; 41:715-9. [PMID: 4424010 DOI: 10.3171/jns.1974.41.6.0715] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
✓ Six cases of craniosynostosis are reported in which recurrent and multiple closure of cranial sutures occurred after craniectomy and insertion of polyethylene film. In all patients there was closure of a second and sometimes a third suture as well as reclosure of the treated suture. In four children the second operations were done before the age of 18 months; none had increased intracranial pressure preoperatively and three who are living have normal intelligence. In two children, the second operations were not done until after the age of 3 years; both had increased intracranial pressure preoperatively, and both are now mentally retarded.
Collapse
|
310
|
Pollock ML, Miller HS, Linnerud AC, Laughridge E, Coleman E, Alexander E. Arm pedaling as an endurance training regimen for the disabled. Arch Phys Med Rehabil 1974; 55:418-24. [PMID: 4278000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
311
|
Abstract
✓ In his presidential address to the Society of Neurological Surgeons, the author commemorates a previous president of the society, Dr. Kenneth G. McKenzie, by relating reminiscences of his own and anecdotes told by colleagues and former residents of Dr. McKenzie.
Collapse
|
312
|
Alexander E. Harvey Cushing operating. SURGICAL NEUROLOGY 1974; 2:228-9. [PMID: 4600967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
313
|
Norwood CW, Kelly DL, Davis CH, Alexander E. Irradiation-induced mesodermal tumors of the central nervous system: report of two meningiomas following X-ray treatment for gliomas. SURGICAL NEUROLOGY 1974; 2:161-4. [PMID: 4829030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
314
|
Alexander E. Letter: Atlanto-axial joint fractures. J Neurosurg 1973; 39:678. [PMID: 4743577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
315
|
Kushner J, Meschan I, Alexander E. Cerebrospinal fluid rhinorrhea, aqueductal stenosis, and the empty sella. MARYLAND STATE MEDICAL JOURNAL 1973; 22:51-4. [PMID: 4540929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
316
|
Alexander E. Fractures of the odontoid process. JOURNAL OF NEUROSURGICAL NURSING 1972; 4:141-53. [PMID: 4485983 DOI: 10.1097/01376517-197212000-00004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
317
|
Kushner J, Alexander E, Davis CH, Kelly DL, Kushner AH. Crouzon's disease (craniofacial dysostosis). Modern diagnosis and treatment. J Neurosurg 1972; 37:434-41. [PMID: 5070870 DOI: 10.3171/jns.1972.37.4.0434] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
✓ This article discusses the nature and treatment of Crouzon's disease and reproduces a translation of part of Crouzon's original description. Six typical patients with this disease are presented, and the reasons for surgical treatment emphasized.
Collapse
|
318
|
Davidman M, Alexander E, Lalone R, Levinsky N. Nephron function during volume expansion in the rat. THE AMERICAN JOURNAL OF PHYSIOLOGY 1972; 223:188-93. [PMID: 5039062 DOI: 10.1152/ajplegacy.1972.223.1.188] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
319
|
Kelly DL, Alexander E, Davis CH, Smith JM. Acrylic fixation of atlanto-axial dislocations. Technical note. J Neurosurg 1972; 36:366-71. [PMID: 5059978 DOI: 10.3171/jns.1972.36.3.0366] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
✓ An operative technique using methyl methacrylate (acrylic) and wiring for the treatment of atlanto-axial dislocations is described. Long-term evaluation of a series of patients indicates that this is a safe and effective method of obtaining cervical fixation.
Collapse
|
320
|
|
321
|
Alexander E. Surgical management of head injuries in children in the acute phase. CLINICAL NEUROSURGERY 1972; 19:251-62. [PMID: 4637553 DOI: 10.1093/neurosurgery/19.cn_suppl_1.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
322
|
Abstract
✓ In a follow-up of 80 lumbar subarachnoid shunts for hydrocephalus, scoliosis with limitation of back flexion was found to have developed in approximately 50% of the surviving children, some of whom showed a disparity in the length and size of their legs. There was no correlation between the direction of the convexity of the scoliosis and the side of the shortened leg, or between the number of shunt revisions and the ultimate development of kyphoscoliosis, or between removal of laminae and the subsequent development of scoliosis. Three case histories are presented to illustrate the still unproven but possible relationship between arachnoiditis due to polyethylene tubes and the ensuing scoliosis. Removal of the lumbar shunts, decompression, and laminectomy seemed to have no beneficial effect in the reversal of the scoliosis in any of the cases reviewed.
Collapse
|
323
|
Abstract
✓ A long-term study has been made of a consecutive series of 37 patients with brain stem gliomas, 22 of whom were children and 15 adults. Surgical exploration was carried out in 34 of the 37 cases and only very rarely was a diagnosis made on clinical grounds or air study alone. In 10 cases a histological diagnosis was made at operation. In five patients a significantly large neoplastic cyst was found and evacuated, and four of these have had long-term useful survivals. There were nine postoperative deaths, most of them in the pre-Decadron era; 17 cases died during follow-up, with a mean survival of 33 months; and eight patients are living, with a mean survival of 3 months to 9 years. A plea is made for surgical exploration of these lesions in the hope of finding a surgically approachable cyst, and for the use of radiation therapy at a later time.
Collapse
|
324
|
Alexander E, Even-Zohar M, Fraenkel BS, Goldsmith S. Classification of Transitions in the euv Spectra of Y ix–xiii, Zr x–xiv, Nb xi–xv, and Mo xii–xvi*. ACTA ACUST UNITED AC 1971. [DOI: 10.1364/josa.61.000508] [Citation(s) in RCA: 71] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
325
|
Abstract
✓ A 7-year-old child with treated hydrocephalus became blind in the left eye as a consequence of malfunction of the ventriculoatrial shunt. This complication probably could have been avoided by elective revision of the shunt with growth.
Collapse
|