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Biomedical subjects

J R Keane

Publications and source records attributed to J R Keane.

At least 19 recordsLinked to original sources
PubMed2000

Dueling doctors.

Formal "duels of honor" ruled upper-class conduct for centuries. That social pressure could compel a choice of "death before dishonor" seems nearly incomprehensible today. Physicians might have been expected to disdain dueling as contrary to professional ethics, but a few rather colorful physicians did enter the lists. Details of some of the most famous physician duels are summarized in this article.

Europe↗
PubMed1996

Twelfth-nerve palsy. Analysis of 100 cases.

OBJECTIVE: To describe the causes and characteristics of hypoglossal nerve palsy. DESIGN: A review of 26 years of personal experience in a large public hospital. RESULTS: Twelfth-nerve palsies usually appear as signs rather than symptoms. Tumors, predominantly malignant, produced nearly half of the palsies (49 cases), while gunshot wounds made trauma (12) the second most common cause. Stroke (6), hysteria (6), multiple sclerosis (6), surgery (5), Guillain-Barré neuropathy (4), and infection (4) together accounted for about one third of the patients. CONCLUSION: Twelfth-nerve palsy proved to be an ominous sign, with only 15% of patients experiencing complete or nearly complete recovery.

Adolescent↗
PubMed1996

Cavernous sinus syndrome. Analysis of 151 cases.

OBJECTIVE: To characterize lesions causing cavernous sinus syndrome. DESIGN: Review of 26 years of personal experience in a large city hospital. RESULTS: Among 151 patients, tumors (45 patients, 30%) were the most frequent cause of cavernous sinus syndrome. However, when surgical causes (17 patients, 11%) were included, trauma (36 patients, 24%) became most common. Self-limited inflammation was the third frequent cause (34 patients, 23%), while carotid aneurysms and fistulas, infection, and other causes composed the remaining 12%. The age at onset varied with the cause, and patients with aneurysms (average age, 52 years) and patients with tumors (average age, 47 years) were older than those with self-limited inflammation (average age, 35 years) and trauma (average age, 29 years). Spontaneous remissions defined "self-limited inflammation" but were also seen following an acute onset of symptoms due to aneurysms and pituitary apoplexy. CONCLUSIONS: In an unselected series from a city hospital, tumor, trauma, and self-limited inflammation were the predominant causes of cavernous sinus syndrome, and classic causes such as aneurysm, meningioma, and bacterial infection were uncommon. Contrast-enhanced magnetic resonance imaging and watchful waiting proved the most effective diagnostic procedures.

Adolescent↗
PubMed1995

Eye movement abnormalities in systemic lupus erythematosus.

OBJECTIVE: To describe eye movement abnormalities in patients with systemic lupus erythematosus (SLE). DESIGN: Between January 1, 1970, and June 30, 1995, 113 patients with a clinical diagnosis of SLE were examined. Of these, 33 had ocular motor abnormalities and a diagnosis of SLE as defined by the revised criteria of the American College of Rheumatology. SETTING: Patients hospitalized on the wards of the Los Angeles County-University of Southern California Medical Center, Los Angeles. SUBJECTS: Thirty-three patients, 82% women, ranging in age from 19 to 58 years (mean, 33.5 years). The average duration of SLE was 3.5 years, and 10 patients had been symptomatic for 5 years or longer. RESULTS: Of 55 ocular motor signs, 33 involved limitation of eye movements or abnormal eye position at rest; abnormal spontaneous eye movements occurred 12 times; ptosis was seen in eight patients and psychogenic signs in two. Sixteen patients (48%) had brain-stem infarcts; 11 had other known causes, including three with meningitis, two with hysteria, and one each with ocular myositis, pseudotumor cerebri, both ocular myositis and pseudotumor cerebri, Guillain-Barré syndrome, hyperosmolality, and hypoxic encephalopathy. In four patients with isolated sixth nerve palsies and two with isolated ptosis, the cause remained unknown. CONCLUSIONS: Ocular motor signs in SLE are uncommon and often transitory. When present, they help to ascertain the location, and often the cause, of neurologic involvement.

Adult↗
PubMed1995

Tremor as the result of shunt obstruction: four patients with cysticercosis and secondary parkinsonism: report of four cases.

In four patients, shunt obstruction was accompanied by severe resting tremor involving principally the head, the jaw, the tongue, and the right upper extremity. Shunt revision resulted in improvement in each patient. Five similar patients have been reported. Although rare, the occurrence of parkinsonian tremor in a previously shunted patient suggests obstruction and requires prompt evaluation.

Adult↗
PubMed1994

The neurological complications of spermatorrhoea.

The age-old belief that loss of sperm could be dangerous to health became a major medical concern throughout the Western world following Claude-Francois Lallemand's inflammatory warnings about the dangers of spermatorrhoea. This article investigates the leading role played by American neurologic authorities of the mid and late 1800s in their fight against the cerebral and spinal complications of spermic depletion.

Ejaculation↗
PubMed1994

Bilateral seventh nerve palsy: analysis of 43 cases and review of the literature.

Among inpatients with facial diplegia, one-half (22 patients) had benign, self-limited causes, including Bell's palsy (10), Guillain-Barré syndrome (5), multiple idiopathic cranial neuropathies (3), brainstem encephalitis (2), Miller Fisher syndrome (1), and association with benign intracranial hypertension (1). Nine patients had tumors: four meningeal, three prepontine, and two intrapontine. Syphilis (2 patients), Hansen's disease (1), cryptococcal meningitis with acquired immunodeficiency syndrome (1), and tuberculous meningitis (1) constituted those with an infectious etiology, while miscellaneous causes included one patient each with diabetes, sarcoidosis, head trauma, pontine tegmental hemorrhage, undiagnosed Möbius syndrome in an adult, systemic lupus erythematosus with severe neuropathy, and slowly progressive degeneration--possibly bulbospinal neuronopathy. Bilaterality makes facial neuropathy a more ominous sign with widely varying causes that requires prompt investigation.

Adolescent↗
PubMed1993

Fourth nerve palsy: historical review and study of 215 inpatients.

A review of inpatient trochlear nerve pareses diagnosed over 23 years revealed head trauma as the principal cause, with surgical injury, inflammation, and brain tumors seen occasionally. Ischemic (microvascular) neuropathies were rare. About one-half of the patients (52%) had no other neuro-ophthalmologic signs, but only 5% were truly isolated, without other neurologic or ophthalmologic signs or symptoms. Fourth nerve palsies are underdiagnosed on hospital services, where stuporous patients encounter unsuspecting physicians.

Adolescent↗
PubMed1993

Third-nerve palsy due to penetrating trauma.

Penetrating trauma is an unusual etiology of third-nerve palsy. Of 815 hospitalized patients with third-nerve palsies, 20 had such an etiology, with gunshot wounds being the usual cause.

Adult↗