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Biomedical subjects

C F Miller

Publications and source records attributed to C F Miller.

35 records · Page 2Linked to original sources
PubMed1981

Bone marrow acid phosphatase by radioimmunoassay: 3 years of experience.

Clinical followup of 112 patients staged by the immunochemical determination of prostatic acid phosphatase from bone marrow aspirates is presented. This represents a 94 per cent (112 of 118) retrieval rate of a group studied more than 2 years previously. Of the 11 patients judged to be at high risk 4 (36 per cent) have suffered bony metastases, whereas only 3 of 86 patients (3 per cent) with normal bone marrow acid phosphatase by radioimmunoassay have done so. An additional 184 patients with carcinoma and 77 controls have been studied. Although radioimmunoassay greatly improves specificity in bone marrow aspirates a few falsely positive results can occur. This finding may be secondary to cross reaction from leukocyte acid phosphatase and/or interference from lipid.

Acid Phosphatase↗
PubMed1980

The syndrome of acute central cervical spinal cord injury revisited.

Seven patients with acute central cervical spinal cord injury were operated upon during the subacute stages following injury, when their condition had improved and become stable for seven to ten days. Myelography in each case showed significant anterior compression of the spinal cord. The rapid improvement in function following the operation in these patients was gratifying and emphasizes the pathophysiological importance of spinal compression in this condition.

Adult↗
PubMed1979

Acquired middle cranial fossa fistulas: normal pressure and nontraumatic in origin.

To the accepted classification of three types of normal pressure, nontraumatic cerebrospinal fluid (CSF) fistulas, we would add "acquired." This type of CSF fistula tends to occur from the middle cranial fossa because of the enlargement of "pitholes" that are normally present in its anterior medial aspect. The enlargement of these bony defects is due to normal intracranial pressure variations that, not uncommonly, create meningoceles and meningoencephaloceles. A portion of the floor of this area is aerated in up to 10% of the normal population by the lateral recess of the sphenoid sinus, the pterygoid recess. Thus, this area has the potential to act as a pathway between the middle fossa and the paranasal sinuses, allowing cerebrospinal fluid to pass into the sinuses. Isotope and computerized tomographic studies are helpful in the localization of such a CSF leak. Tomography of the base of the skull, however, is essential for the ideal definition of possible routes of fistulization. If there is any question of the presence of a middle fossa fistula, these studies can show whether the floor of this area is pneumatized and whether there are any defects in the floor. The treatment of such a fistula should include generalized reinforcement of the floor of the anterior middle fossa by a middle fossa approach. If any doubt exists as to the site of leakage (anterior or middle fossa), the minimal surgical procedure should include exploration of both areas via a frontotemporal craniotomy.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1979

Spontaneous ventriculo-cisternostomy.

A case in which obstructive hydrocephalus was relieved by spontaneous ventriculo-cisternostomy is presented and the pertinent literature reviewed. Management of acquired obstructive hydrocephalus by percutaneous stereotactic or endoscopic third ventriculo-cisternostomy is discussed.

Cerebral Ventricles↗
PubMed1977

Sequential treatment with quinine and mefloquine or quinine and pyrimethamine-sulfadoxine for falciparum malaria.

Patients with falciparum malaria were studied in Thailand, an area of known chloroquine resistance. The patients were unselected and some had severe malaria, and they were randomly assigned to one of two sequential regimes. A short course of quinine (average 4 doses, equivalent to 2 g base) followed by a single dose of pyrimethamine-sulfadoxine (Fansidar) cured 92% of patients (36 out of 39), while a short course of quinine followed by a single 1-5-dose of mefloquine cured all of the 35 patients who could be followed up. Gastrointestinal side effects were minimal if at least 12 hours elapsed between the last dose of quinine and the mefloquine. Sequential quinine and mefloquine is the most effective treatment for patients with chloroquine-resistant falciparum malaria, including those with severe or complicated disease. Mefloquine, however, is not commercially available, and the similar regimen using Fansidar is almost as effective.

Adolescent↗
PubMed1977

The danger of intracranial wood.

Peri-orbital puncture wounds by sharp wooden objects are not rare, but can be dangerous when there is intracranial penetration by and retention of the wooden foreign body. Days to years after an apparently trivial initial wounding, serious intracranial complications can occur. The authors have reviewed 42 case reports from the literature. Morbidity-defined as permanent neurologic sequelae-occurred in 74% of the cases. Intracranial suppuration was the major complication, with brain abscess having occurred in nearly one-half of the cases. Mortality occurred in 25% of 28 cases occurring in the post-antibiotic era. The qualities of wood which make it especially hazardous as a wounding agent and foreign body are discussed. The role of orbital anatomy in affording easy access to the cranial contents is described. Surgical exploration in all those cases in which there is a reasonable suspicion of intracranial injury is recommended.

Adolescent↗
PubMed1970

Bronchiolar carcinoma.

Explore the source record for details and available documents.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMedDate not supplied

Vaginal birth after cesarean.

Recent studies prompted by the high cesarean birth rates have looked at the issue of vaginal birth after cesarean. The risk of attempting a vaginal birth after cesarean appears to be minimal for selected clients. As more and more obstetricians begin to offer vaginal birth after cesarean to their patients, nurses will need to be fully informed about this option. A review of the pertinent literature relating to vaginal birth after cesarean and nursing implications are presented.

Cesarean Section↗
PubMedDate not supplied

Epidural morphine decreases postoperative hypertension by attenuating sympathetic nervous system hyperactivity.

Twenty-four adults who were undergoing operations on the abdominal aorta were enrolled in a randomized, double-blind, placebo-controlled study in which epidural morphine sulfate (6 mg) was employed to attenuate the sympathoadrenal response to surgery to evaluate the possible contribution of sympathetic nervous system hyperactivity to postoperative hypertension. Patients who received epidural morphine required less parenteral morphine in the 24 hours following surgery, had lower analogue pain scores, and had markedly lower plasma norepinephrine levels when compared with patients in the control group who received an identical volume of saline in the epidural space. Epidural morphine had no effect on plasma epinephrine or arginine vasopressin levels. Fewer patients in the morphine group (4 of 12 vs 9 of 12 patients in the saline group) required treatment for hypertension (mean arterial blood pressure, greater than or equal to 110 mm Hg) in the 24 hours following surgery. In addition, patients in the morphine group had lower blood pressures in the 24 hours following surgery. These data suggest that sympathetic nervous system activity and not adrenal epinephrine or pituitary secretion of arginine vasopressin is responsible for the development of hypertension following aortic surgery. Furthermore, epidural narcotics appear to provide a means of attenuating this response.

Adult↗