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Biomedical subjects

C B Adams

Publications and source records attributed to C B Adams.

At least 73 records · Page 4Linked to original sources
PubMed1983

Circulating immune complexes in experimental syphilis: identification of treponemal antigens and specific antibodies to treponemal antigens in isolated complexes.

As a prelude to characterization of the host and treponemal antigens present in purified immune complexes from the sera of rabbits with disseminated syphilis, autoradiographic and immunoenzymatic analyses of solubilized extracts of Treponema pallidum, Treponema phagedenis biotype Reiter, and Treponema refringens were performed on electroblots of polypeptides first separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Electroblots of purified immune complexes were developed with the same panel of antisera so that protein profiles could be compared. Eight treponemal antigens were consistently present in isolated complexes; four of these cross-reacted with antisera prepared against avirulent treponemes. The average molecular weights of these antigens were 87,000, 76,000, 66,000, and 45,000. Antibodies dissociated from isolated immune complexes, when used for the development of T. pallidum electroblots, reacted with four antigens of comparable molecular weight. Antibodies to those polypeptides were also present in the sera of animals immunized with immune complexes. The demonstration of treponemal antigens in purified immune complexes convincingly argues that their occurrence in experimental syphilis is not merely due to tissue destruction and responses to endogenous host antigens.

Animals↗
PubMed1983

The 5-hydroxytryptamine antagonist ketanserin inhibits the vasoconstrictor activity of per-operative CSF, from subarachnoid haemorrhage patients, on isolated tissues.

Peri-aneurysmal CSF was obtained at operation from 13 patients with subarachnoid haemorrhage from ruptured intracranial aneurysms. The 5-hydroxytryptamine antagonist ketanserin inhibited contractions of isolated human intracranial arteries, elicited by this CSF. The presence of 5-HT in CSF was confirmed by high performance liquid chromatography. The use of ketanserin in the therapy of postoperative cerebral vasospasm is discussed.

Adult↗
PubMed1983

Hemispherectomy--a modification.

Hemispherectomy is probably the best operation for treating epilepsy. It was abandoned because of the delayed haemorrhagic complications that developed some years after the operation. A hypothesis is described to account for the mechanism of such complications and modifications made to the operative technique to prevent such complications. This modified hemispherectomy has been carried out on four patients since 1980.

Brain↗
PubMed1982

The treatment of trigeminal neuralgia by posterior fossa microsurgery.

Between 1972 and 1981 57 patients underwent posterior fossa exploration in Oxford by a single surgeon for the treatment of trigeminal neuralgia. Fifty-four of these had either partial or total section of the trigeminal sensory root, 2 had microvascular decompression operations and one had both a partial sensory root section and microvascular decompression. There was no mortality and no significant morbidity. Fifty-four patients were followed up for a mean period of 4 . 5 years. Fifty-two patients (96%) had either no further pain or only minor twinges requiring no further treatment. Two other patients who had partial sections suffered no further trigeminal neuralgia after subsequent total sections. One patient who had a partial root section developed anaesthesia dolorosa and one who had a microvascular decompression developed painful dysaesthesia. All patients having partial root sections retained previously intact corneal responses--the sensory impairment in the face corresponded to the appropriate part of the portio major cut. Only 11% of patients were found to have a vascular abnormality.

Adult↗
PubMed1981

Evaluation of rosaramicin phosphate in treatment of experimental syphilis in rabbits.

The in vivo activity of rosaramicin phosphate in disseminated and localized Treponema pallidum infections in rabbits was compared with that of penicillin G benzathine. Rabbits were injected either intradermally or intravenously to establish infection. Groups of four animals each then received either two weekly injections of 200,000 U of penicillin G benzathine, injections of 12.5 or 25 mg of rosaramicin per kg of body weight twice a day for 10 days, or no antibiotic therapy. Treatment of the intradermal and intravenous infections was initiated on days 7 and 14 postinfection, respectively. With both infection models, striking differences were noted between the untreated control rabbits and the three groups receiving treatment; no discernible differences, however, were detected among any of the treated groups. Rabbits that had been infected intravenously did not develop disseminated lesions or orchitis after treatment, and chancres produced by intradermal infection regressed and healed rapidly after the initiation of therapy. Continued increases in treponemal and nontreponemal antibody titers posttreatment did not occur in any of the treated rabbits. Infectivity studies also suggested that the lymph nodes and testes of treated animals were free from infectious organisms. Overall, at the dosage regimens employed, both rosaramicin and penicillin G benzathine appeared to effect complete control of the experimental disease.

Animals↗
PubMed1981

Extradural diamorphine in the control of pain following lumbar laminectomy.

Catheters were inserted into the extradural space under direct vision at the time of surgery for prolapsed intervertebral disc or lumbar canal stenosis. In the post-operative period, diamorphine (3 mg in 5 ml water) was injected through the catheter when patients requested analgesia. In only four of 49 patients was significant pain relief not achieved after extradural diamorphine injection. In four other patients it was not possible to use this method of analgesia throughout the two post-operative days as planned. As judged by the improved mobility and by grading on a linear analogue pain scale, the quality of analgesia achieved was better than after intramuscular papaveretum (10-20 mg) and extradural diamorphine was requested less frequently. There were no serious side-effects in the patients studied, although the technique was not used in patients over 55 years of age. Extradural diamorphine appeared to be less effective in two patients who had undergone re-explorations.

Adolescent↗
PubMed1981

Hemifacial spasm: a long term follow-up of patients treated by posterior fossa surgery and facial nerve wrapping.

Sixteen patients with hemifacial spasm were treated by posterior fossa surgery and wrapping of sponge around their facial nerve. A good or excellent result has been obtained in fourteen of the sixteen cases, and in seven cases followed by four years or longer. Two patients had a mild recurrence of their hemifacial spasm after a cessation of their spasm for eighteen months and two years following surgery. Contrary to the experience of other authors a definite vascular abnormality was found in only four cases. In the other twelve cases circumferential fibrosis about the nerve is again proposed as a mechanism for the effectiveness of the procedure.

Adult↗
PubMed1981

Predicting outcome in patients with intracranial aneurysms with the help of microsurgery.

A follow-up study of 265 patients treated by microsurgical techniques for ruptured intracranial aneurysms at the Department of Neurological Surgery of the Radcliffe Infirmary, Oxford from 1972 to 1977 showed that prediction of results in terms of mortality, and various measures of morbidity could be achieved by considering before operation several variables in combination. Age, systemic blood pressure on admission and before operation were the most important factors in determining outcome. Inclusion of a variable following operation-arterial spasm-was found to improve prediction somewhat. In addition, spasm was found to be the single most important factor in predicting both mortality and morbidity.

Adolescent↗
PubMed1980

Surgical mortality in an aneurysm population: effects of age, blood pressure and preoperative neurological state.

The mortality of 256 patients surgically treated for ruptured intracranial aneurysms was assessed with regard to age, systemic blood pressure on admission and preoperative neurological state. Increasing age, hypertension, and a poor neurological state (both singly and in combination) were found to influence surgical results dramatically. It is suggested that preoperative treatment of hypertension, and delay of operation in those patients aged over 50 years or hypertensive, as well as waiting for the neurological state to improve prior to operation, may lead to better results.

Adolescent↗
PubMed1980

The treatment of raised intracranial pressure following aneurysm surgery.

The effect of intravenous mannitol infusion and withdrawal of cerebrospinal fluid on the intracranial pressure and clinical state was studied in 26 patients with raised intracranial pressure after direct surgery for ruptured aneurysm. Each method decreased the mean intracranial pressure by about 60% of the pre-treatment level. The maximal decrease following mannitol occurred after 60-90 minutes and generally lasted between three and four hours. The effects of mannitol did not decrease when repeated infusions were necessary. Rebound increases in the intracranial pressure following infusion were not observed. Withdrawal of cerebrospinal fluid lowered the intracranial pressure immediately and the effect persisted for approximately 60 minutes. This could be repeated as often as necessary and was without systemic disturbance, although a patent intraventricular catheter was necessary. The two methods could be used simultaneously.

Cerebrospinal Fluid Shunts↗
PubMed1979

Intracranial compliance during the post-operative period after surgery for intracranial aneurysms.

Generalised post-operative cerebral vasospasm is a major factor in delineating poor operative results following direct ruptured intracranial aneurysms. Continuous monitoring of intracranial pressure seems to be particularly helpful on such occasions, and intracranial compliance determination as well. High intracranial compliance values suggest that even small intracranial volume increases may induce rapid intracranial pressure and situations likely to produce neurological deterioration.

Humans↗
PubMed1978

Tumours of the cauda equina.

A retrospective study of 70 consecutive patients with a cauda equina tumour who were admitted to Neurosurgical Department at the Radcliffe Infirmary, Oxford is presented. The diagnosis of these tumours is often difficult and delayed. The quality of life largely depends upon the neurological disability at presentation. The diagnostic features and investigations are discussed together with the treatment and prognosis.

Adolescent↗
PubMed1978

Hemifacial spasm: treatment by posterior fossa surgery.

Nine cases of hemifacial spasm have been treated by posterior fossa exploration without mortality or significant morbidity. In only three was definite pathology found, but the hemifacial spasm was abolished in eight patients and markedly diminished in the remaining patient. The condition has reccurred in one patient. Microsurgical techniques make the operation safe and accurate. We suggest that this procedure is the best approach for hemifacial spasm requiring treatment. Where no definite pathology is found, the effectiveness of the procedure is probably due to fibrosis and hence mild trauma to the facial nerve induced by the sponge wrapped around the nerve.

Adult↗
PubMed1978

An investigation with serial angiography into the evolution of cerebral arterial spasm following aneurysm surgery.

Serial postoperative angiograms were performed in 28 patients with intracranial aneurysms, 26 of whom had presented with a subarachnoid hemorrhage. The clinical state and intracranial pressure (ICP) were also measured. Angiograms were performed in the ward using a cannula, which was passed into the proximal external carotid artery via the superficial temporal artery. Measurements of the vessel diameters were made, with the preoperative angiogram as a baseline. Patients could be placed into one of five groups depending on the presence or absence of significant arterial spasm, the clinical state of the patient, and the normality or otherwise of the ICP. No patient's condition deteriorated without an elevated ICP and/or significant arterial spasm. The study shows that this spasm is usually associated with a poor clinical state if it reaches a maximum 8 to 12 hours after the operation, although the clinical deterioration is not apparent for a further 6 to 12 hours. Knowledge of the natural history of postoperative arterial spasm may allow earlier treatment of the spasm, which may be more successful than delaying treatment until clinical deterioration has occurred. The worth of the varied drugs proposed for the treatment of spasm may be assessed using this type of protocol.

Adolescent↗