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Biomedical subjects

C W Brown

Publications and source records attributed to C W Brown.

At least 55 records · Page 3Linked to original sources
PubMed1992

Neuropathic (Charcot) arthropathy of the spine after traumatic spinal paraplegia.

Neuropathic (Charcot) arthropathy of the spine is a relatively rare problem that, nonetheless, must be considered in the differential diagnosis of any patient with degeneration of one or more levels of the spine associated with diminished or absent protective sensation. This study presents 15 patients in whom Charcot arthropathy of the spine developed after traumatic paraplegia. Eight were successfully treated with surgical fusion, and the remaining seven were treated nonoperatively. By the use of combined anterior and posterior fusion with extensive debridement, autogenous grafting, and posterior instrumentation, successful fusion can be achieved in patients with Charcot arthropathy of the spine. However, the surgical technique is demanding, the rehabilitation must be carefully supervised, and the postoperative complication rate remains high. The possibility of developing secondary levels of arthropathy below a previously successful fusion must be considered.

Adult↗
PubMed1991

Analysis of factors related to truncal decompensation following Cotrel-Dubousset instrumentation.

Spinal imbalance following Cotrel-Dubousset (CD) instrumentation for adolescent idiopathic scoliosis is a problem that is recognized with increasing frequency. We reviewed the clinical records and radiographs of 41 consecutive patients treated with CD instrumentation and attempted to identify factors related to postoperative worsening of spinal balance. Spinal balance was determined by the perpendicular distance of C7 to the center sacral line. Twenty-five were decompensated postoperatively. Sixteen patients had balance that was worse relative to the preoperative films. Eleven of 16 patients with worsened balance postoperative were King type III curves. Of 16 patients with worsened balance postoperatively, 13 had been fused to or below the lower neutral vertebra. Overcorrection of either the primary curve or the composite curve (sum of the measurable curves) relative to the preoperative bending films was not related to postoperative worsening of spinal balance. Fusion to the neutral or stable vertebra with CD instrumentation runs a high risk for postoperative worsening of spinal balance when the derotation maneuver is used. Consideration should be given to avoiding the derotation maneuver in larger type II curves in order to preserve spinal balance and avoid extension of instrumentation into the middle or lower lumbar spine.

Adolescent↗
PubMed1991

Relationship between vertebral intraosseous pressure, pH, PO2, pCO2, and magnetic resonance imaging signal inhomogeneity in patients with back pain. An in vivo study.

The cause of back pain in many patients in unknown. The pain experienced by patients with osteoarthritis of large joints has been associated with intraosseous abnormalities of elevated pressure, venous dilatations, and abnormalities of pH, pCO2, and pO2. Magnetic resonance imaging demonstrates an abnormal signal in the vertebral bodies of some patients with degenerative disc disease. The intraosseous pressure as well as the intraosseous pH, pO2, and pCO2 in a group of patients undergoing anterior spine surgery was studied, and the results were correlated to the preoperative magnetic resonance imaging appearance. Vertebral bodies with an abnormal magnetic resonance imaging signal had pressures 55% higher than vertebral bodies with a homogeneous signal; they also had significantly decreased pH and increased pCO2. Bodies with Type I changes had pressures 73% higher than those with a normal signal. No differences in pO2 were identified. These findings suggest that abnormalities of intraosseous pressure or blood gas concentrations may be related to mechanisms of pain production in some patients with back pain. These abnormalities can be identified by magnetic resonance imaging. Further investigation is needed to determine if therapeutic manipulation of these variables can be effective in relieving axial spinal pain.

Back Pain↗
PubMed1986

The rate of pseudarthrosis (surgical nonunion) in patients who are smokers and patients who are nonsmokers: a comparison study.

To investigate the relationship of smoking with the rate of pseudarthrosis (surgical nonunion), 50 patients, who were smokers, and 50 patients, who were not, and who had had a two-level laminectomy and fusion during 1977 and 1978 were randomly selected for this study. Most of those participating had sustained job-related injuries whereas the others had no common etiology for their back dysfunction. Most of the patients were from the southeastern United States. Ages ranged from 23 to 62 years, with a mean age of 42.4 years for smokers and 42.7 years for nonsmokers. There was an equal representation of males and females, with minorities represented according to their general percentage in the population. Examination 1 to 2 years after surgery revealed that 40% (20) of the smokers had developed a pseudarthrosis, whereas among nonsmokers, the rate was 8% (4). This finding appears to be independent of age, sex, or race and was statistically significant (chi 2 = 14.035, P = .001). It was hypothesized that the higher incidence of surgical nonunion among smokers may be related to blood gas levels. Nonsmokers showed no significant deficiencies, whereas smokers showed a mean PO2 level of 78.5% (normal = 95-97) and a mean O2 saturation level of 92.9% (normal = 95 or above). Implications and suggestions for further research are also discussed.

Adult↗
PubMed1985

Chronicity of infection with Treponema paraluis-cuniculi in New Zealand white rabbits.

Popliteal lymph nodes from eight New Zealand white rabbits with clinical or serological evidence of naturally acquired infection with Treponema paraluis-cuniculi were transferred to rabbits that had not been exposed to this infection. Lymph nodes from two rabbits successfully transmitted infection. The nodes from one of these rabbits transmitted infection during both the acute and chronic stages of infection. Recipients that were successfully infected showed concomitant antibody responses in the Venereal Disease Research Laboratory (VDRL), rapid plasma reagin (RPR), and fluorescent treponemal antibody-absorption (FTA-ABS) tests six to 10 weeks after inoculation; recipients of uninfected nodes showed no change in serological state. Antibody responses were followed by the development of dark field positive genital lesions 14 to 15 weeks after inoculation.

Animals↗
PubMed1984

Clinical course and treatment of venereal spirochaetosis in New Zealand white rabbits.

Ten sporadic cases of venereal spirochaetosis, caused by Treponema paraluis-cuniculi, were seen in New Zealand white rabbits in two years. An equal number of males and females were affected. Females tended to have milder clinical signs than males. Lesions were usually found on the prepuce in males and the vulva in females, although the anus and skin of the perineum were also affected. Facial lesions were rare. Lesions healed in seven to 28 days in rabbits treated with penicillin. Eight rabbits had antibodies reactive in the Venereal Disease Research Laboratory (VDRL), rapid plasma reagin (RPR), and fluorescent treponemal antibody absorbed (FTA-ABS) tests when the disease was first diagnosed. In several rabbits followed longitudinally, RPR test results became negative two to four months after antimicrobial treatment, VDRL antibody titres diminished but usually persisted at low levels, while FTA-ABS antibodies declined slowly and were still evident 12 months after treatment.

Animal Diseases↗
PubMed1983

Femoral intraarterial digital angiography: an outpatient procedure.

Selective intraarterial digital angiography was performed in 50 patients with known or suspected peripheral vascular disease. Excellent anatomic detail was provided by low-volume injection of 80 mgl/ml contrast medium. The procedure was performed with a 20- to 21-gauge needle or short 3 French catheter as an outpatient procedure. No complications were observed. Thirty-five patients underwent subsequent surgical repair of abnormalities demonstrated by this direct intraarterial technique.

Adult↗
PubMed1978

Prevalence of neoplasia in 10 New England populations of the soft-shell clam (Mya arenaria).

Neoplasia was a prevalent disease of the soft-shell clam and was found in widely geographically distinct sites in New England. Two types of neoplasms were recognized. Most were of hematopoietic origin, except in clams from Maine, which also had gonadal neoplasms. Both types were apparently malignant neoplasms, based on their characteristic anaplastic appearance, invasiveness, metastasis, mitotic activity, associated tissue necrosis, and mortality. Diagnosis of neoplasia in the living mollusk was achieved rapidly and accurately by cytologic examination of circulating blood. The etiology of the neoplasms was not identified. In general, nonneoplastic lesions, such as epithelial hyperplasia and accumulations of a orange-brown bodies, were more common in clams from polluted areas.

Animals↗
PubMed1977

Genital exhibitionism in women.

Historically, genital exhibitionism has usually been regarded as an exclusively male phenomenon. The authors present a case study of a female exhibitionist which is at variance with that contention. They offer a formulation of the psychodymanics of female exhibitionism, focusing on its pregenital, attention-seeking purpose. The findings from this case justify a critical reexamination of the traditional definitions of exhibitionism.

Adult↗