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Biomedical subjects

R E Maxwell

Publications and source records attributed to R E Maxwell.

At least 37 records · Page 2Linked to original sources
PubMed1986

Intrathecal morphine during lumbar spine operation for postoperative pain control.

The analgesic requirements and bladder function of 5 patients who received 1 mg of intrathecal morphine during lumbar spine operation are compared to those of 10 control patients. No analgesics were used by the treatment group for the first 24 hours postoperatively. The test group subsequently required twice the amount of analgesics during the 2nd through 5th days after operation compared to controls. All 5 patients who received intrathecal morphine developed urinary retention for 24 to 36 hours. The brief duration of analgesia, the increased narcotic use after the effects of the morphine dissipated, and urinary retention after a single intraoperative dose of intrathecal morphine suggest caution in using this technique.

Adult↗
PubMed1985

Klippel-Feil syndrome in children: clinical features and management.

A retrospective analysis of 11 children with the diagnosis of Klippel-Feil syndrome treated at the University of Minnesota Hospital over a period of 20 years is presented. The salient features of the syndrome and its associated anomalies are reviewed. Emphasis is placed on its neurological aspects, particularly the potential risks of injury to the craniocervical junction and cervical spine. Guidelines for the management of these patients are suggested.

Adolescent↗
PubMed1985

Stereotactic removal of a migrating ventricular catheter.

Retained ventricular catheters are usually well tolerated but, when infection is present, their removal becomes imperative because such catheters serve as a nidus for persistent infection. Minimally invasive methods for the removal of retained catheters are desirable. The removal of an infected, retained, subcortical ventricular catheter using stereotactic techniques is described. The authors think that this method is a safe and effective first step in dealing with this difficult problem.

Catheters, Indwelling↗
PubMed1984

Surgical management of torticollis.

Torticollis is a clinical sign of either CNS or musculoskeletal dysfunction. Thorough clinical and neuroradiographic evaluation is indicated for determination of the source, course, and exact nature of the deformity before a considered approach to surgical management is undertaken. Torticollis of neurogenic origin is managed by surgical decompression of the brainstem or cervical spinal cord when indicated, as in the presence of hydrocephalus, the Arnold-Chiari malformation, syringobulbia , syringomyelia, colloid cyst of the third ventricle, or neoplasms in the third ventricle, posterior fossa, or cervicomedullary junction. In progressive and medically refractory cases of spasmodic torticollis, neuroablative procedures, neuroaugmentive procedures, selective muscle excisions, and radical cervical muscle excisions have been used to control the dystonia. Torticollis of musculoskeletal origin is often secondary to or associated with trauma, although congenital craniocervical anomalies may be a predisposing factor. The primary goals of surgery for craniovertebral or upper cervical spine deformity are reduction of the malalignment; decompression of the brainstem, cervical spinal cord, and/or nerve roots if necessary; and stabilization of the upper cervical spine.

Arnold-Chiari Malformation↗
PubMed1984

Identification and management of high-risk patients with Klippel-Feil syndrome.

Patients with Klippel-Feil syndrome are often at high risk for neurological injury. The cervicomedullary junction and cervical spinal cord are especially vulnerable. Twenty-one patients examined and treated over a 20-year period are reviewed. The salient features of the syndrome are identified, and an approach to management is proposed.

Adolescent↗
PubMed1983

Some comparative effects of gemfibrozil, clofibrate, bezafibrate, cholestyramine and compactin on sterol metabolism in rats.

Liver cholesterogenesis in rats was measured by giving [l-14C]octanoate i.p.; 1 h later digitonin-precipitable sterols were isolated and counted. In rats fed normal chow and given 7 daily p.o. doses of compounds and then fasted, at 20 h after the last dose, clofibrate or bezafibrate had no effect at lower doses or inhibited incorporation at higher doses, while compactin or gemfibrozil caused increases; cholestyramine added to the diet also caused marked increases. When rats were fed chow containing 0.1% cholesterol and 5.5% peanut oil, again at 20 h following the last of 7 daily doses, gemfibrozil caused increases of incorporation which diminished at higher levels of dosage, while clofibrate caused only inhibition. A single dose of gemfibrozil caused inhibition at 3 h postdose followed by increases over control at 36 and 48 h; a single dose of compactin caused inhibition at 3 h but not subsequent increase, and a single dose of clofibrate had no effect over the entire period. In rats fed chow containing 1.5% cholesterol and 5.5% peanut oil, gemfibrozil given orally or cholestyramine in the diet prevented the diet-induced decreases of plasma HDL cholesterol and increases of liver cholesterol content, while bezafibrate treatment did not have those effects. The effects of cholestyramine rapidly disappeared when it was withdrawn from the diet, while the effects of gemfibrozil persisted after dosage was stopped. These results suggest that some of the actions of gemfibrozil on rat sterol metabolism are quantitatively different from those of the other agents tested.

Animals↗
PubMed1983

Phenylenebis(oxy)bis[2,2-dimethylpentanoic acid]s: agents that elevate high-density lipoproteins.

A series of phenylenebis(oxy)bis[2,2-dimethylpentanoic acid]s have been synthesized and evaluated as potential hypolipidemic agents. Compound 18 (CI-924) was found to be the most potent compound in this series. In rats, compound 18 not only reduced low-density lipoprotein cholesterol but also increased high-density lipoprotein (HDL) cholesterol. Comparative studies in rats indicated 18 produced an equal elevation of HDL cholesterol at one-third of the dose required of gemfibrozil. Structure-activity relationships are discussed.

Animals↗
PubMed1983

Clinical evaluation of a depth electroencephalography electrode.

Stereo depth electroencephalography (EEG) is of proven benefit in lateralizing and localizing seizure origin in select cases of epilepsy. There are potential hazards and technical considerations inherent with depth EEG, however, that have limited the general applicability of this technique. A new depth EEG electrode with materials and design features that facilitate safe insertion and artifact-free recording has been developed. The design features and technique for inserting the electrode are described. The electrode was evaluated during 2600 hours of implantation and recording in seven patients. With the use of stereotactic techniques, the electrode could be positioned accurately within precise anatomical landmarks such as the amygdaloid nucleus and the hippocampus. After insertion, no hemorrhage or edema was detected along the electrode tracts by third generation computed tomographic scanning. There was no evidence of pyrogenicity or infection. Electrode migration was not observed. A large electrical field could be sampled because of the relatively large surface of the cylindrical depth electrode contacts.

Electrodes, Implanted↗
PubMed1983

Concussion incidences and severity in secondary school varsity football players.

The head coaches and players of 103 secondary school football teams in Minnesota were asked to respond to mail questionnaires. Information about injury incidence and concomitant health care provision was elicited. Responses from 3,063 players (81 per cent) yielded a total injury rate of 78 injuries/100 players; 19/100 players reported a concussion experience characterized by loss of consciousness and/or loss of awareness. Of the players who experienced a loss of consciousness, 69 per cent were returned to play the same day. Persistent concussion symptoms were reported as long as six to nine months following the end of the season; six cases involved permanent disabilities. Continued use of illegal techniques of butt-blocking and face-tackling by as many as 40 per cent of the players was associated with apparent increased risks of concussions and concussion symptoms. Players with a prior history of loss of consciousness had a risk of loss of consciousness four times that of the player without a prior history.

Athletic Injuries↗
PubMed1982

Intramedullary cervical spinal cord abscess. Case report.

A case of spontaneous intramedullary cervical spinal cord abscess is presented. The clinical and laboratory findings in cases of spinal cord abscess vary. Prompt diagnosis and drainage are stressed as critical factors in effectively managing the disease.

Abscess↗
PubMed1982

Surgical control of chronic migrainous neuralgia by trigeminal ganglio-rhizolysis.

Chronic migrainous neuralgia is not diagnosed as often as the periodic or "cluster" form of Horton's syndrome. The distinguishing features of chronic migrainous neuralgia, compared with the periodic variety, are the frequency and persistence of the attacks of hemicraniofacial pain and the intractability to medical management. Eight male patients ranging in age from 22 to 45 years received prompt, although transient, pain relief by blockade of the Gasserian ganglion on the side of their hemifacial pain with a local anesthetic. Prolonged relief was subsequently achieved by percutaneous radiofrequency trigeminal ganglio-rhizolysis. There were no significant complications from this procedure. Review of the literature indicated that other ablative neurosurgical procedures, such as alcohol injection of the Gasserian ganglion and trigeminal rhizotomy by the subtemporal craniectomy approach, have relieved migrainous neuralgia, but with a greater risk and incidence of complications. The characteristic clinical features of migrainous neuralgia and the medical and surgical approaches to therapy are discussed.

Adult↗
PubMed1979

Vasospasm following transcranial removal of large pituitary adenomas. Report of three cases.

The authors report three cases of cerebral vascular spasm following transfrontal removal of large pituitary neoplasms. One patient awakened from surgery hemiparetic, but has since recovered. A second patient developed hemiparesis with confusion on the fifth postoperative day and eventually died. The third patient developed hemiplegia on the tenth postoperative day, but recovered completely. Vascular spasm was documented angiographically in all three cases. Possible mechanisms underlying this unusual complication are discussed.

Adenoma↗
PubMed1977

Aneurysmal tumors of the basifrontal region.

The authors report the cases of three men who presented for evaluation of a rapidly progressing dementia. All were found to have a giant aneurysmal mass in the basifrontal region, and all were successfully treated by surgical excision of the mass. The presenting syndrome included rapidly progressive and severe loss of recent memory associated with confusion, chronic headache, wide-based staggering gait disturbance, urinary urgency, frequency, and incontinence, and a fine tremor of the hands exacerbated by purposeful movements. The clinical presentation, radiological assessment, and surgical treatment are discussed.

Dementia↗