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Biomedical subjects

C L Branch

Publications and source records attributed to C L Branch.

At least 37 records · Page 2Linked to original sources
PubMed1993

Synthesis and biological activity of 3-(N-substituted pyridinium-4-thiomethyl)-7 alpha-formamido cephalosporins.

The synthesis and antibacterial activity of a series of 3-(1-substituted pyridinium-4-thiomethyl)-7 alpha-formamido cephalosporins is described. All the derivatives showed good potency and stability to bacterial beta-lactamases. The antibacterial efficacy seen with the N-alkyl pyridinium substituents was enhanced by the introduction of a catecholic side chain at C-7 and by preparation of N-(substituted amino)pyridinium derivatives.

Bacteria↗
PubMed1993

Synthesis and biological properties of some 3-[(N-substituted-amino)pyridinium-4-thiomethyl]-7-[2-(2-amino-thiazol- 4-yl)-2-(Z)-(methoxyimino)acetamido]ceph-3-em-4-carboxylates.

The synthesis and antibacterial activity of a series of beta-lactamase stable, broad spectrum 7-[2-(2-amino-thiazol-4-yl)-2-(Z)-(methoxyimino)acetamido]-cephalo sporins, characterised by a C-3-[N-(substituted-amino)pyridinium-4-thiomethyl] group, is described. Gram-positive and Gram-negative bacteria including extended spectrum beta-lactamase-producing strains were most susceptible to the N-amino- and N-methylamino derivatives (3a) and (3b); with the exception of Pseudomonas aeruginosa, (3b) was more active in vitro and in vivo than cefpirome or ceftazidime.

Animals↗
PubMed1992

Thoracic disk herniation.

Symptomatic thoracic disk herniation is unlikely to be encountered with significant frequency in clinical practice. Subtle manifestations required a high index of suspicion if the work-up is to be efficient. In the appropriate candidate, magnetic resonance imaging is the best screening tool, and it may be the only diagnostic study required. In the symptomatic patient with neurologic dysfunction or persistent pain refractory to nonsurgical therapy, surgical diskectomy is a safe and effective treatment with limited morbidity.

Adult↗
PubMed1989

Surgical repair of aneurysms of the posterior inferior cerebellar artery--a clinical series.

Aneurysms of the posterior inferior cerebellar artery are relatively rare. Fourteen such aneurysms (10 vertebral, 4 peripheral) are reported, and their clinical presentation, surgical therapy, and outcome are discussed. All 14 patients had suffered a subarachnoid hemorrhage; 93% (n = 13) underwent direct clipping of the aneurysm while 7% (n = 1) underwent coating of the aneurysm. Two patients died in the perioperative period (one from vasospasm and one from rebleeding). Full activity was achieved by all but one (92%) of the remaining patients in extended follow-up.

Adult↗
PubMed1989

Fixation of fractures of the lower cervical spine using methylmethacrylate and wire: technique and results in 99 patients.

Surgical stabilization of traumatic fracture-dislocations of the lower cervical spine with wire and methylmethacrylate remains a controversial procedure. Yet, the resultant immediate fixation with minimal patient morbidity seems to indicate that this method provides an ideal stabilization construct. We describe and report the outcome of a technique of posterior cervical fixation with methylmethacrylate and wire for stabilization of traumatic fractures of the lower cervical spine. Over a 12-year period, 124 fracture-dislocations of the lower cervical spine in 99 patients (mean age, 32 years; range, 15-76 years) were treated at this institution using a posterior methylmethacrylate and wire technique. Eighty-two patients had a posterior element fracture; 28 had a vertebral compression with posterior ligamentous injury; and 14 had a ligamentous injury alone. Thirty-six patients were neurologically intact upon admission, while the rest had radiculopathy or partial or complete myelopathy. Ninety-one patients were available for follow-up [mean, 18.6 months; range, 1-100 months (8.33 years)]. Eighty-eight patients (97%) had a stable fixation and 77 (85%) had resumed preoperative activity or were working but with a residual deficit. Complications included fixation failure requiring a second operation in 3 patients, nonlethal pulmonary embolism in 2 patients, lethal pulmonary embolism in 1 patient, and a superficial wound infection in 3 patients (none affected the underlying fixation construct). These results indicate that this technique is a safe, simple, and effective method for stabilizing the lower cervical spine that allows rapid patient mobility with minimal morbidity.

Adolescent↗
PubMed1989

Transalar sphenoidal encephaloceles: clinical and radiologic findings.

Two cases of occult basal encephalocele protruding through defects in the greater wing of the sphenoid bone are presented. The cases are unique in that they occurred in adults with non-localizing symptoms and were eloquently imaged by computed tomography (CT) and magnetic resonance (MR). While the theoretical existence of this type of encephalocele has been recognized, no documented cases of transalar sphenoidal encephalocele are known to have been reported in the radiology or surgery literature.

Adult↗
PubMed1988

Cooperative neuro-otologic management of acoustic neuromas and other cerebellopontine angle tumors.

Over a recent 16-month period, 35 cerebellopontine angle tumors were removed at our institution by a surgical team consisting of one neurosurgeon and one otologist. Nineteen tumors were less than 2 cm in diameter and six were greater than 4 cm. There were 26 acoustic neuromas, six meningiomas, two epidermoid tumors, and a glossopharyngeal schwannoma. A suboccipital transmeatal approach was used in the majority of patients. There were no deaths. Thirty-two patients had an excellent outcome. Twenty-four patients had complete tumor removal (92% of the acoustic neuromas). The facial nerve was preserved anatomically in all but one patient, who had nerve grafting intraoperatively and has partial recovery of function. Thirteen of the 24 patients who had auditory function retained some of it postoperatively. With current diagnostic techniques, combined with the neurosurgical and otologic team approach, the majority of patients with acoustic tumors of all sizes may expect a complete resection of the tumor with a good outcome. Certainly, early diagnosis and resection of smaller tumors will increase the likelihood that hearing will be preserved, thus providing impetus for aggressive diagnostic and surgical treatment of patients with these lesions.

Adolescent↗
PubMed1987

Posterior lumbar interbody fusion with the keystone graft: technique and results.

The technique of posterior lumbar interbody fusion reported here consists of the following steps: The confluence of the spinous process and lamina removed en bloc during the exposure is contoured into three keystone plugs; the anterior third of the disc space is packed with bone fragments; the keystone plugs are tapped in posterior to the bone fragments and locked into place; and excess bone fragments are laid over the facets bilaterally and over the transverse processes if necessary to fuse the facet joints and create a posterior fusion. This fusion technique precludes the need for banked bone or for the harvest of autogenous iliac bone, and provides posterior stability with the facet fusion despite the removal of the posterior elements. This technique has been used in 172 patients, with excellent or good results in 129 patients (75%); included in that number were 82 patients expecting compensation and 25 patients with failed-back syndrome.

Adolescent↗
PubMed1987

Metastatic tumors of the sella turcica masquerading as primary pituitary tumors.

Tumors metastatic to the pituitary gland are uncommon, but may mimic a typical pituitary adenoma and are an important part of the differential diagnosis of sellar mass lesions. Pituitary metastases were treated by transsphenoidal microsurgical removal in 14 patients. Most tumors appeared in men in the sixth and seventh decades of life. Half of the patients presented with visual loss, 6 had anterior hypopituitarism, and 4 had diabetes insipidus. Primary cancer had been diagnosed and treated previously in 5 patients. In the remaining 9 patients, the transsphenoidal operation provided the initial diagnosis of cancer, and primary lesions subsequently were detected in all but 2. Transsphenoidal surgery also provided satisfactory decompression of the mass effect related to the tumors, improving the presenting symptoms in the majority of patients, and the surgery was free of mortality or serious complications.

Adenoma↗
PubMed1987

Studies on semi-synthetic 7 alpha-formamidocephalosporins. III. Synthesis and antibacterial activity of some 7 beta-[D-2-(aryl)-2-[(4-ethyl-2,3-dioxopiperazin-1-yl)carbonyl amino] acetamido]-7 alpha-formamidoceph-3-em-4-carboxylate derivatives.

The synthesis and antibacterial activity of 7 beta-[D-2-(aryl)-2-[(4-ethyl-2,3-dioxopiperazin-1-yl) carbonylamino] acetamido]-7 alpha-formamidocephalosporins with various substituents at the C-3 position of the cephalosporin nucleus is described. Inhibition of Gram-positive and Gram-negative bacteria including beta-lactamase producing strains was observed with phenyl as the aryl residue. The 3,4-dihydroxyphenyl group further enhanced the activity against Gram-negative organisms; in this series, the 3-[(1-methyl-1H-tetrazol-5-yl)thiomethyl] and 3-[(1-carboxymethyl-1H-tetrazol-5-yl)thiomethyl] analogues (2 and 12b) exhibited exceptional activity against Gram-negative bacteria, including Pseudomonas aeruginosa.

Cephalosporins↗
PubMed1986

False aneurysm complicating carotid endarterectomy.

We present two cases of false aneurysm after carotid endarterectomy with primary arteriotomy closure. In both cases, infection appeared to be the precipitating cause. Both lesions were repaired with a saphenous vein patch graft, but infection in one patient persisted, and recurrence of a false aneurysm required ligation of the common carotid artery. There were no neurological sequelae in either patient. A review of the English language literature, our experience, and personal communications yielded 57 cases of false aneurysm. The overall incidence of false aneurysm after carotid endarterectomy was 0.30%. There was no significant difference in the incidence after endarterectomy alone and that after endarterectomy and patch grafting. A significant increase in neurological deficit occurred only when carotid ligation was used, with a morbidity/mortality of 50% in eight reported cases. Infection was the major cause of false aneurysm after endarterectomy; it occurred in 50% of cases closed primarily without patch grafting. Repair with a saphenous vein patch graft and monofilament synthetic suture, plus liberal use of antibiotics, should be considered in the treatment of this condition.

Aged↗