Biomedical subjects
Publications and source records attributed to J E Adams.
A 62-year-old man with idiopathic hypoparathyroidism and extensive paravertebral and ligamentous ossification is reported. The clinical and radiological findings of this, and other reported cases, are discussed and compared with other causes of paravertebral ossification.
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The analgesia resulting from electrical stimulation in the periventricular grey matter at the level of the posterior commissure in the human patient has been reversed by naxolone. This finding raises the possibility that such stimulation is effective because morphine receptor cells may be activated.
The authors describe the changing patterns of psychiatric inpatient care in a university hospital. Patients are shortening their hospital stay and are traveling fewer miles from their homes to the hospital. Increasing numbers of blacks, men, and low-income persons are being treated. In addition, the percentage of patients with neuroses and transient situational disturbances has decreased, while the percentage of those with personality and behavior disorders has increased. The authors discuss the implications of these changes, which benefit both patients and the education of students.
Eight acromegalic patients showed a plasma cortisol (11-OHCS) rise after insulin hypoglycemia which was similar to that seen in control patients, with mean peak values (+/-SEM) of 23.2 +/- 3.5 mug/100 ml and 27.2 +/- 3.3 mug/100 ml, respectively. One mg of dexamethasone was given the evening prior to repeat insulin hypoglycemia (DEX-ITT). After dexamethasone, the control subjects showed a mean post hypoglycemic plasma 11-OHCS rise to 18.3 +/- 2.3 mug/100 ml. In contrast, acromegalic patients had a negligible rise is plasma 11-OHCS, despite a comparable degree of hypoglycemia. These data indicate that, in active acromegaly, abnormal hypothalamic-pituitary-adrenal suppressibility can be induced to insulin hypoglycemia after dexamethasone.
Good to excellent relief of phantom pain is reported in 5 of 6 patients by the use of dorsal column stimulation. Follow-up periods are 7 to 25 months. One failure occurred despite excellent pain relief; this patient could not tolerate application of the DCS apparatus to his chest wall. The authors review the physiology involved and some less successful series reported by others.
Dorsal column stimulators (DCS) have been implanted in 130 patients with various chronic pain syndromes at the University of California, San Francisco, between 1969 and 1973. Preoperative psychiatric evaluation and percutaneous dorsal column stimulation testing were of value in rejecting those patients most likely to have unsatisfactory long-term results with DCS. Best results occurred in patients with phantom limb or peripheral nerve pain and worst results in patients with paraplegic pain, documented arachnoiditis, pancreatitis and arthritis. The need is stressed for careful preoperative selection and for close, prolonged postoperative care in a situation permitting access to multidisciplinary facilities for patient care.
Thalamic electrical stimulation by means of chemically implanted electrodes and an externally placed transmitter was effected in patients with central pain. Good response was obtained in four patients with anesthesia dolorosa, four with thalamic syndrome, and one with paraplegic pain. Two patients with medullary syndrome experienced no relief. The mechanism of thalamic stimulation in the relief of pain is discussed and further clinical trials are anticipated.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.