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Biomedical subjects

L H Phillips

Publications and source records attributed to L H Phillips.

68 records · Page 4Linked to original sources
PubMed1986

The evaluation of suspected ulnar neuropathy at the elbow. Normal conduction study values.

Local compression of the ulnar nerve occurs at several points, with the elbow region being the most common. Nerve conduction studies can be useful in identifying and localizing such lesions; however, the specifics of the technique, including normal values, have not been firmly established. We evaluated the effect of elbow position on segmental conduction velocities (CVs), the influence of elbow, nerve segment length on CV calculations, the change in compound action potential amplitude at sites along the nerve, and the use of performing segmental sensory CVs. Conductions done with the elbow flexed produced less segment-to-segment CV variation than those obtained with the elbow extended. The influence of using overlapping nerve segments compared with short adjacent ones for segmental CV comparison is discussed.

Action Potentials↗
PubMed1986

Familial autoimmune myasthenia gravis and thymoma: occurrence in two brothers.

At ages 31 and 42 years, two brothers presented with clinical, pharmacologic, electrophysiologic, and immunologic characteristics of autoimmune myasthenia gravis. At thymectomy, both had histologic findings of epithelial thymoma. HLA analysis revealed A2, A3, B7, and B39 antigens in one patient and A3, A24, B7, and B40 antigens in the other. Familial myasthenia gravis with thymoma has not been described previously. Familial thymoma has been rarely reported, but never with myasthenia gravis.

Adult↗
PubMed1986

Familial long thoracic nerve palsy: a manifestation of brachial plexus neuropathy.

Long thoracic nerve palsy causes weakness of the serratus anterior muscle and winging of the scapula. It is usually traumatic in origin. Isolated long thoracic nerve palsy has not been recognized as the major manifestation of familial brachial plexus neuropathy, but I have studied the syndrome in four members of three generations of one family. One individual suffered an episode of facial paresis. The inheritance pattern was autosomal dominant.

Adolescent↗
PubMed1985

Hereditary motor-sensory neuropathy (HMSN): possible X-linked dominant inheritance.

The inheritance of the hereditary motor and sensory neuropathies (HMSN) is usually autosomal dominant. We studied a kinship with a pattern of X-linked dominant inheritance. The phenotype was similar to HMSN of the "intermediate" type. Men were more severely affected than women, and hypertrophic nerves were not found. Nerve conduction was very slow in men, but it was mildly slow or normal in women. No male-to-male transmission was found in six generations.

Adolescent↗
PubMed1982

Aneurysmal subarachnoid hemorrhage: timing of surgery and mortality.

In contrast to the incidence of other types of stroke, the incidence of aneurysmal subarachnoid hemorrhage has not changed. It is highest in the oldest age groups, and this indicates that it is not due to a congenital lesion. The primary factors that affect survival after aneurysmal subarachnoid hemorrhage are the clinical grade of the patient and the duration of time from onset to the time the patient is seen for medical attention. Because of the very high early mortality from aneurysmal subarachnoid hemorrhage, surgeons generally wait until 10 to 14 days before undertaking surgery. This delay results in a lower surgical mortality but makes it difficult to show an effect on overall mortality. Increasing attention is being given to early surgery after aneurysmal subarachnoid hemorrhage.

Age Factors↗
PubMed1981

Changes in peripheral and central nerve conduction with aging.

An electrophysiological study was made of 30 normal subjects aged 20 to 70 years. Routine methods were used to measure peripheral motor and sensory functions of the posterior tibial nerve. This nerve was then stimulated at the ankle and recordings made simultaneously over the thoraco-lumbar spine, cervical spine and central sensory cortex. Peripheral and central potentials were reproducibly recorded at each site in all subjects. Peripheral nerve motor and sensory potential amplitudes fell significantly with age, as did the amplitude of the thoraco-lumbar potential. Cervical and central potential amplitudes did not change significantly with age. The peak latencies of thoraco-lumbar, cervical and central potentials all showed a significant increase with age. In addition, when 'central conduction time' was calculated by subtracting thoraco-lumbar or cervical latency from the latency of the cortical potential, a significant prolongation with increasing age was still seen, especially in more rostral pathways.

Adult↗
PubMed1980

The unchanging pattern of subarachnoid hemorrhage in a community.

The average annual incidence of subarachnoid hemorrhage (SAH) from aneurysm rupture in Rochester, Minnesota, has remained remarkably constant at about 11 per 100,000 population. Age-specific incidence increased with age. Survival after SAH depended on: (1) clinical grade, (2) time after onset of SAH, and (3) presence of intracerebral hematoma. Among those who survived to receive medical attention, 48% were clinical grade 1 or 2, 20% were grade 3, and 32% were grade 4 or 5. Proved rebleeding occurred within 10 days of the first SAH in 20% of patients who survived until hospital admission.

Adolescent↗
PubMed1980

Lumbosacral spinal evoked potentials in humans.

Evoked potentials in response to submaximal electrical stimuli to the peroneal or tibial nerves were recorded from the lumbosacral region in 18 normal subjects. Averaging of 128 responses from recording electrodes over spinous processes S1 to T11, with a reference electrode on the contralateral iliac crest, demonstrated potentials of 0.5 to 1.8 microV, with two well-defined negative peaks having latencies proportional to the distance between the stimulating and recording electrodes. The first peak originated from a traveling wave of depolarization in afferent fibers in the cauda equina, and the second peak originated in the spinal cord. F waves, H reflexes, microreflexes, and volume-conducted muscle responses did not contribute to these potentials.

Adolescent↗
PubMed1979

The declining incidence of stroke.

A major decline in the incidence of stroke occurred in the population of Rochester, Minnesota, during the period 1945 to 1974. For every 100 first episodes of stroke that occurred per unit of population during the period 1945--49, only 55 occurred in the period 1970--74. Although the decline was present in both sexes and in all age groups, the reduction in rates was more pronounced in the elderly. There was no major change in age at onset. Analysis of cohorts born during successive five-year periods from 1865 to 1915 confirmed the decreasing incidence rate in all age groups.

Age Factors↗
PubMedDate not supplied

The time course of creatine kinase elevation following concentric needle EMG.

The electromyographic (EMG) exam and creatine kinase (CK) are commonly used to evaluate patients with neuromuscular diseases. Prior studies have demonstrated minimal elevation of CK following monopolar needle examination, indicating that a false positive elevation does not occur in normal individuals. We studied the magnitude and time course of CK change resulting from concentric (CNEMG) and monopolar (MNEMG) needle EMG examination on healthy volunteers. CK increased in all subjects following CNEMG and MNEMG. Statistically significant mean CK elevations over baseline were observed at 4, 8, 12, and 24 hours for CNEMG and at 12 and 24 hours for MNEMG. Maximum elevation occurred at 12 and 24 hours for both CNEMG (mean, 178% of baseline) and MNEMG (mean, 134% of baseline). CK returned to baseline by 48 to 72 hours. In 25-30% of subjects CK elevation significantly exceeded the normal range. The magnitude of CK elevation is greater and the time course more prolonged than previously reported. CK measurements should be avoided 4 to 48 hours following CNEMG because of the potential for false positive results. Measurements immediately after and at 72 hours are not affected by the CNEMG or MNEMG. The time course for CK change following MNEMG is similar to CNEMG, but the magnitude is less.

Adult↗
PubMedDate not supplied

Sudden death from stroke.

Sudden death is defined as any death that occurs less than 24 hours after the onset of first symptoms. Strokes account for 10 to 20% of all sudden deaths. The records of all residents of Rochester, Minn., who had their first stroke during the period 1955 through 1969 were analyzed. Among 255 deaths caused by the first stroke, 52 were sudden. Twenty-six of the deaths were due to primary intracerebral hemorrhage, and 20 to primary subarachnoid hemorrhage. Only two of the sudden deaths were caused by infarction: one by pontine and cerebellar infarct and the second by a cortical infarct, which resulted in death from status epilepticus. Among the nine patients who died within 2 hours of the onset of symptoms, six had primary subarachnoid hemorrhage. Hypertension was noted in 23 of the 26 patients (88%) who died of primary intracerebral hemorrhage; 8 patients with primary intracerebral hemorrhage were on long-term oral anticoagulant therapy, and all 8 were hypertensive.

Adult↗