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Biomedical subjects

J F Cusick

Publications and source records attributed to J F Cusick.

At least 55 records · Page 3Linked to original sources
PubMed1983

Distraction rod stabilization in the treatment of metastatic carcinoma.

Stabilization of the spinal column with Harrington distraction rods and acrylic fusion was the primary form of treatment in a select group of patients with metastatic carcinoma of the spinal column. Clinical criteria included patients in poor general medical condition with intractable pain originating from metastatic tumor involvement in the ventral components of the thoracic or upper lumbar spinal column and minimal evidence or absence of spinal cord compression. After stabilization, pain relief was almost total and sustained, and neurological status generally remained unchanged from preoperative findings without any evidence of improvement of preexisting abnormalities or occasions of rapid neurological deterioration. This form of spinal stabilization may offer significant relief of debilitating pain, lessen the risk of pathological fracture-dislocation of the thoracic or upper lumbar vertebral column, and reduction in the local compressive effects on the spinal cord caused by ventrally situated metastatic tumor.

Aged↗
PubMed1982

Altered neural conduction with epidural bupivacaine.

The sites and magnitude of evoked potential response alterations induced by varying masses and concentrations of epidurally administered bupivacaine were assessed from electrodes positioned along the conducting pathways of the monkey. The mass of bupivacaine was the major factor in determining the level and degree of response alterations. At the lower levels of total drug mass, effects were limited to the dorsal root entry zone, whereas higher levels of mass not only increased the response attenuation at the gray matter level but resulted in additional changes in those responses recorded from the spinal cord white matter tracts. With all other factors stable, increasing concentration was associated with a greater degree of response attenuation, especially at the lower levels of total mass. These findings indicate that the mass of the drug is the major factor in determining the magnitude and level of bupivacaine-induced epidural analgesia. Increased concentration influences the local anesthetic's penetration at the dorsal root entry zone and, to a lesser degree, at the white tracts of the spinal cord.

Anesthesia, Epidural↗
PubMed1982

Effects of vertebral column distraction in the monkey.

Experiments were performed to assess the effects of vertebral column distraction on evoked potential responses from multiple recording sites along the conducting pathway in the monkey, and on concurrent blood flows, measured with the radioactive microsphere technique, along the axis of the central nervous system. Linear distractive loads were applied until the amplitude of the evoked response was significantly reduced. In four monkeys, the loads (100 to 150 lb) were sustained, whereas in two monkeys the forces (80 to 110 lb) were relaxed. The earliest response changes were most marked in recordings dependent upon the integrity of the upper cervical dorsal columns or brain stem-lemniscal pathway. The responses returned to control levels with load relaxation, but maintenance of the tractive load produced generalized and progressive response attenuation. At selected periods of significant changes in the evoked potential response, blood flow remained stable except for the late onset of regional ischemia in the middle cervical through upper thoracic spinal cord levels in the animals undergoing sustained loads. These findings indicate that brain-stem or spinal cord dysfunction occurring with both acute and gradual elongation of the spinal canal are the result of excess tensile stress acting on fiber tracts, and the delayed onset of spinal cord ischemia is the probable result of a similar mechanical process acting upon intrinsic spinal cord blood vessels.

Animals↗
PubMed1981

Experimental electrical injury studies.

Voltages from 10 to 14,000 volts demonstrated currents up to 70 amperes with resistances of approximately 200 ohms in studies in hogs. Below 1,000 volts, a current reduction is observed following arcing and skin necrosis. At the higher voltages, this phenomenon was not observed. The energy required for tissue damage was dependent upon the voltage and time of application. The tissue electrode resistance with stainless steel disc was proportional to the diameter. Skin buring commenced at the periphery of the electrodes and moved inwards. For application of currents between the hindlimbs of the hog, the current per tissue cross-section was greatest in artery and nerve, followed by muscle, fat, bone marrow, and bone cortex.

Animals↗
PubMed1981

Differential diagnosis of intrasellar tumors by computed tomography.

The specificity of the computed tomography (CT) diagnosis of intrasellar adenoma has not been studied. We compared the CT findings in intrasellar meningiomas, craniopharyngiomas, aneurysms, and metastases with those of pituitary adenomas. Calcification was a features of intrasellar meningiomas, aneurysms, and craniopharyngioma,s but not a typical feature of adenomas. Low-density regions representing necrosis or cyst were found in most types of intrasellar tumors. Eccentricity, hyperostosis, and bone destruction were useful signs of aneurysm, meningioma, and metastasis, respectively. Since adenoma cannot always be distinguished from another intrasellar mass, angiography to demonstrate tumor angioarchitecture may be needed to characterize some neoplasms or to confirm an intrasellar aneurysm.

Adenoma↗
PubMed1981

Spontaneous reversal of internal carotid artery occlusion: case report.

Spontaneous dissection of the internal carotid arteries, including those dissections resulting in total occlusion, may be a spontaneously reversible process. A patient who had angiographic evidence of bilateral complete internal carotid artery occlusions of different ages of onset illustrates this process. This case suggests certain considerations regarding the pathogenesis of these dissections.

Arterial Occlusive Diseases↗
PubMed1981

Failure of naloxone to reverse analgesia from transcutaneous electrical stimulation in patients with chronic pain.

To investigate the possible role of endogenous opiates in the mediation of analgesia produced by low intensity, high frequency transcutaneous electrical stimulation in the presence of chronic pain, an attempt was made to reverse stimulation-induced analgesia with naloxone. Fifteen patients with chronic pain who were consistently relieved of pain by low intensity, high frequency transcutaneous stimulation were studied. During stimulation at 58 Hz, patients were given double-blind intravenous injections of either naloxone (0.4 or 1.2 mg) or saline. Subjective pain ratings were recorded before stimulation, after stimulation, and after naloxone and saline injections. No reversal of analgesia was seen after naloxone or saline. These results suggest that transcutaneous stimulation at low intensity and high frequency may provide analgesia that is not associated with release of endogenous opiates in patients with chronic pain.

Adult↗
PubMed1980

Differential neural effects of epidural anesthetics.

The purpose of this investigation was to clarify in a laboratory model the sites of action of epidurally administered local anesthetics. This report describes such a a model, which is capable of monitoring sites of altered electrophysiologic activity induced by epidural anesthetic agents. Evoked potential response alterations measured from electrodes positioned along the conducting pathways were assessed in six monkeys following epidural injections of 0.5 per cent bupivacaine, 3 per cent chloroprocaine, and 1 per cent etidocaine. Bupivacaine in ten studies was found to cause its major effects at the dorsal root entry zone and the long tracts of the spinal cord white matter, associated with variable peripheral nerve alterations. Chloroprocaine effects in six studies were limited to alteration of responses recorded from the dorsal root zone and peripheral nerve. In contrast, etidocaine in eight studies caused marked attenuation of the responses recorded from the long tracts of the spinal cord white matter, associated with only minimal corresponding changes at the dorsal entry zone or peripheral nerve levels. These findings illustrate the capability of this experimental model to demonstrate relatively selective effects along the sensory and motor pathways for epidurally injected local anesthetic agents.

Anesthesia, Epidural↗
PubMed1980

Radiological assessment of intrasellar prolactin-secreting tumors.

In this study, the value of high resolution computed tomography (CT) in defining prolactin-secreting intrasellar tumors was compared to the value of conventional hypocycloidal polytomography. In all cases, contrast-enhanced coronal CT images were capable of defining these tumors by the demonstration of abnormal dimensions, upward convexity, or regional low density areas in the pituitary gland. The focal regions of decreased density and contrast enhancement correlated consistently with the prolactin-secreting microadenoma location found during surgical removal. Polytomography was not as effective as CT in the diagnostic differentiation of these adenomas.

Adenoma↗
PubMed1979

Spinal cord evaluation by cortical evoked responses.

In ten monkeys, selective segmental lesions of the dorsal columns at the upper thoracic and middle cervical levels resulted in almost total attenuation of the cortical evoked potential responses to peripheral nerve stimulation. Conversely isolated segmental dorsal column preservation showed intact transmission of the evoked responses at rostral spinal cord, nucleus ventralis posterior lateralis, and cortical levels. Responses recorded from the intralaminar thalamic nuclei in the region of nucleus centrum medianum were unaffected by dorsal column ablation, but were markedly attenuated following bilateral ventral column ablation.

Animals↗
PubMed1979

The computed tomographic appearance of the normal pituitary gland and pituitary microadenomas.

With the use of axial and coronal computed tomography (CT), the authors compared the density, contrast enhancement, and dimensions of normal pituitary glands and pituitary microadenomas. The normal gland appears homogeneous, nearly isodense with brain tissue, and it enhances uniformly. Its upper surface is concave downward or flat and its height 2-7 mm. The cavernous sinuses, the third, fourth, and sixth cranial nerves, the infundibulum, and the adjacent carotid arteries are well demonstrated by CT. Abnormal height and upward convexity of the gland are reliable signs of prolactinoma; abnormal density and enhancement are suggestive signs. CT findings in prolactin- and ACTH-secreting tumors may differ. CT is more sensitive and more specific than polytomography in the diagnosis of pituitary adenoma.

Adenoma↗
PubMed1978

Ultrastructural identification of afferent fibers of cardiac origin in thoracic sympathetic nerves in the dog.

While cardiac afferent nerve activity has been recorded from the ventrolateral (VLCN) and ventromedial (VMCN) cardiac nerves, left dorsal and ventral ansae subclaviae, and left upper thoracic white rami communicantes, little anatomical evidence for the existence of afferent fibers in these nerves has been reported. This study was designed to characterize the normal ultrastructure of the above nerves and to identify afferent fibers in them through Wallerian degeneration produced by dorsal root ganglionectomy. Laminectomies followed by dorsal root ganglionectomies were performed on left thoracic roots T1-T4 in six mongrel dogs. The nerves to be examined were removed from two animals at 1, 2, and 3 weeks following ganglionectomy and prepared for electron microscopy. Control nerves were obtained from two normal dogs. Degenerating nonmyelinated fibers were characterized by watery axoplasm containing clumps of electron-dense material. Degenerating myelinated fibers were distinguished by the separation of their myelin lamellae, producing characteristic whorls. After three weeks, afferent nonmyelinated axons had degenerated in all nerves, leaving only layered processes of Schwann cells in these areas. Approximately 5-15% of the fibers in each nerve degenerated, indicating their afferent nature. Of these fibers, 85-90% were nonmyelinated C fibers and the remainder myelinated Adelta fibers. These results indicate participation of both Adelta fibers and a large population of C fibers in transmission of cardiac afferent activity.

Animals↗