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Biomedical subjects

J P Conomy

Publications and source records attributed to J P Conomy.

At least 37 records · Page 2Linked to original sources
PubMed1978

Baclofen for spasticity in multiple sclerosis. Double-blind crossover and three-year study.

Baclofen is a safe and effective means for treating spasticity associated with multiple sclerosis. We found no toxic effects on hepatologic, hematopoietic, or renal function, acutely or for over 3 years of follow-up. A statistically significant reduction was noted in frequency of spasms, and clonus, and there was improved range of joint movement, which enabled patients to maintain functional status for prolonged periods. For the more disabled patients, treatment with baclofen gave symptomatic relief of painful spasms and made immobility more tolerable. Optimum effect was achieved when baclofen was administered in the early stages of disease, before major disabilities became permanent.

Activities of Daily Living↗
PubMed1978

Long-term use of the major anticonvulsant drugs.

The specific type of epilepsy must be identified. The history and the EEG provide the evidence. Drug selection is then based on the classification of the patient's epilepsy. Major drugs used in the management of epilepsy are phenytoin, phenobarbital, primidone, carbamazepine, ethosuximide and valproic acid. The physician should know their kinetics, interactions and side effects, and the value of monitoring blood levels of these anticonvulsant agents.

Abnormalities, Drug-Induced↗
PubMed1977

Airborne rabies encephalitis: demonstration of rabies virus in the human central nervous system.

A veterinarian contracted rabies in the course of laboratory work with homogenates of rabid goat brain. Epidemiologic study determined a respiratory mode of transmission. After a fulminant encephalitic illness, formed rabies virions were identified in the synaptic zones of the olfactory glomeruli. Identification, isolation, experimental disease production, and tissue cytopathic effects of virus recovered from the brain fulfilled Koch's postulates in this unusual instance of virus disease of the nervous system.

Adult↗
PubMed1977

Central nervous system involvement in mycosis fungoides: pre mortem diagnosis by light and electron microsocopic study of the spinal fluid.

Involvement of the brain, spinal cord, peripheral nerves, meninges, and cerebrospinal pathways in mycosis fungoides manifests itself, clinically, as an obscure neurologic disturbance, occurring in patients with cutaneous manifestations of that disorder. Neurologic expressions of this particular cutaneous lymphoma are infrequently reported, in spite of the fact that many patients dying in the course of mycosis fungoides have pathologically demonstrable central nervous system, peripheral nervous system, and meningeal involvement. We report here a patient who incurred devastating neurologic illness as one of the initial features of the course of systemic dissemination of mycosis fungoides. Death occurred nine years after the onset of cutaneous illness. In this instance, cerebrospinal fluid cytologic studies established the diagnosis of nervous system involvement. Mycosis fungoides cells shed into the cerebrospinal fluid were studied by special techniques of light and electron microscopy. Brain scan abnormalities were present, which were clinically correlative with foci of brain involvement. The initial response of patient's nervous system illness to therapy was gratifying but unsustained, and she went on to fatal brain and multiple organ involvement with disseminated mycosis fungoides. The techniques of spinal fluid cytologic diagnosis, confirmatory of the etiology of disease in this case, may have practical appications in the diagnosis of otherwise obscure neurologic disorders.

Adult↗
PubMed1976

Quantitative assessment of cutaneous sensory function in subjects with neurologic disease.

Based upon techniques devised for the behavioral study of cutaneous sensation in monkeys, a method has been developed which studies quantitatively cutaneous sensation in man. The techniques is analogous to the von Békésy method of audiometry and employs a subject-operated stimulus and signalling divice. In tests utilizing electrical stimulation of the skin surfaces the subject serves as his own control for comparison of one cutaneous zone with another and from one trial session to another. A permanent, written record of stimulus and nonverbal perceptual response is produced in this instrumental method which permits statistical analysis of responses. The analysis includes determination of cutaneous sensory thresholds, limits of stimulus intensity during detection, duration of perception, detection cycle rates, and persistence indices. This instrumental method of cutaneous sensory assessment is quantifiable, free of verbal bias, and repeatable in terms of defined stimulus strengths. In applied clinical studies, patients with peripheral nerve lesions show elevations of perceptual thresholds, reduced numbers of detection-disappearance cycles per unit time, prolonged, contorted decay slopes, and occasionally persistence of perception in the absence of stimulation. Patients with central lesions have variable threshold abnormalities, but little slowing of cycle rate or perceptual persistence. These quantitative sensation parameters can be evaluated longitudinally during the course of an illness and its treatment. The method has potential use in the investigation of basic aspects of sensation and its interactions with behavior.

Adolescent↗
PubMed1976

Computed tomography in progressive multifocal leukoencephalopathy.

An area of decreased density found with computed tomography corresponded to confluent demyelinative lesions in the brain of a patient with progressive multifocal leukoencephalopathy. Failure of the CT scan to enhance with contrast material together with the clinical picture may enable clinicians to diagnose this subacutely progressive viral demyelinative brain disorder.

Adult↗
PubMed1975

Delayed cerebrovascular consequences of therapeutic radiation. A clinicopathologic study of a stroke associated with radiation-related carotid arteriopathy.

A young woman, successfully treated for Hodgkin's disease with radiation and MOPP chemotherapy, incurred a devastating stroke months after radiation therapy to the neck and other areas. There was no premonitory clinical history of cerebrovascular attacks. Autopsy showed unilateral thrombotic occlusion of the internal carotid artery unassociated with neoplastic or fibrotic annular constriction of the vessel. There was medial thickening and fibroblastic proliferation within the carotid artery. Areas of focal elastic membrane degeneration involved the cervical portions of the carotid. Thrombus was organized to the damaged vessel wall and was propagated into the intracranial vessels. Aneurysm formation and arterial hemorrhages were absent. These vascular changes occurred in an area of extensive radiation (7200 rads). Pathoanatomical studies in this patient indicate that radiation-induced vascular changes were associated with a "delayed" stroke.

Adult↗
PubMed1975

Spontaneous infarction in pituitary tumors: neurologic and therapeutic aspects.

In addition to progressive endocrine dysfunction and progressive visual loss, pituitary neoplasms may annouce their presence by the more catastrophic alternative of spontaneous tumor infarction. In two patients reported, illness due to the spontaneous infraction of pituitary tumors was heralded by sudden onset of focal headache associated with diplopia. Stupor, confusion, and evidence of increased intracranial pressure occurred without subarachnoid hemorrhage or massive extrasellar extension of tumor. One patient developed inappropriate antidiuretic hormone secretion with spontaneous infarction in a large but clinically silent chromophobe adenoma. In both patients, skull x-rays suggested a long-standing intrasella mass. Both underwent prompt treatment with endocrinologic replacement therapy and subsequent successful transsphenoidal removal of voluminous, infarcted, pituitary masses.

Adenoma, Chromophobe↗