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Biomedical subjects

R L Saunders

Publications and source records attributed to R L Saunders.

16 recordsLinked to original sources
PubMed1992

Continuous infusion of intrathecal morphine to control acquired immunodeficiency syndrome-associated bladder pain.

A 36-year-old man with acquired immunodeficiency syndrome had incapacitating dysuria and vesical pain secondary to interstitial cystitis. When medical management and suprapubic urinary diversion failed to control the symptoms the patient was started on subarachnoid morphine sulfate. Bupivacaine was added 1 year later via an implanted Therex M-3000 implantable continuous infusion pump, which has continued successfully for more than 18 months. We believe that subarachnoid narcotics and other analgesic agents, such as clonidine, bupivacaine hydrochloride and baclofen, may prove equally valuable in the treatment of bladder spasm and pain. Furthermore, implanted intrathecal ports and pumps may have less associated risk of infection than the percutaneous vascular access catheters presently used for the continuous delivery of medications in immunosuppressed patients.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Geniculate ganglion: anatomic study with surgical implications.

The geniculate ganglion and adjacent segments of the facial nerve were dissected in 11 human temporal bones to study the extent and distribution of ganglion cells. A histologic basis for the use of geniculate ganglionectomy as the treatment for geniculate neuralgia was sought. In 9 of 11 specimens (81.8%), the ganglion cell bodies appeared to be aggregated at the apex of the genu close to the origin of the greater superficial petrosal nerve. The mean ratio of the width of the ganglion cell cluster to the width of the facial nerve trunk at the level of the genu was 0.4. In two specimens, significant anatomic variation was present. One specimen showed extension of cell bodies into the labyrinthine segment of the facial nerve; another specimen showed a single ganglion cell in the region of the genu. These findings lead us to postulate that geniculate ganglionectomy may be ineffective as the sole treatment for certain cases of geniculate neuralgia, and that nervus intermedius section may also be required to achieve a more complete deafferentation.

Facial Nerve↗
PubMed1979

External ventricular drainage. A technical note.

The disadvantages of external ventricular drainage are the threat of sepsis and the nuisance of dislodging a precarious system in routine care. The experience of the authors with nearly 200 cases using a long ventricular catheter demonstrates that a subgaleal tunnel can be easily made for the ventricular catheter using a sharp trocar. The resulting system is secured by the tunnel, easily dressed, and has a minimal likelihood of sepsis. Although external drainage has been maintained for longer than 3 weeks in some cases, the average duration is 6 days; and in the last 68 cases, there has been no incidence of sepsis and but one case of patient removal of the catheter. The device has been used for both monitoring, as well as ventricular decompression in a broad range of patients.

Catheterization↗
PubMed1979

Considerations of a method of analyzing diallel crosses of atlantic salmon.

Inferences derived from a proposed mixed model analysis of a diallel cross involving four stocks of Atlantic salmon (Salmo salar) are illustrated with growth data on weight and length. Variation between stocks was more apparent when samples represented dams as opposed to sires, thus stressing the relative importance of maternal effects. However, the ranking of stocks was not altered when either the means of sire sources or the means of dam sources were considered. No heterotic effects were found for the growth traits studied.

Analysis of Variance↗
PubMed1978

Sternberg-Reed-like cells in a pleural effusion secondary to pulmonary emboli with infarction: a cytological observation.

Cells resembling Sternberg-Reed cells were observed in a pleural effusion that was caused by pulmonary embolus with infarction. Although Hodgkin's disease was suggested on the basis of abnormal pleural fluid cytological preparations, the subsequent evaluation and clinical course did not support that diagnosis. We conclude that first, the cytological diagnosis of Hodgkin's disease should only be made when Sternberg-Reed-like cells are seen in association with a compatible clinical and cytological picture, and second, the cytological diagnosis of Hodgkin's disease or other malignancy should be made with caution in cases in which pulmonary infarction is present.

Adult↗
PubMed1977

Alexia without agraphia, hemianopia, or color-naming defect: a disconnection syndrome.

A patient with alexia without agraphia, hemianopia, or color-naming defect was found at operation to have a meningioma arising from the tentorium cerebelli that compressed the inferior aspect of the left temporal-occipital junction. It is presumed to have involved only the left ventral visual association cortex and its inferior outflow tracts to the angular gyrus. The input from the right occipital area also was disconnected from the visual language verbal association area by involvement of the ventral outflow of the splenium of the corpus callosum. Preservation of color naming and matching suggests that these functions are dependent on the integrity of more dorsal occipital association systems.

Brain Neoplasms↗
PubMed1977

Appearance of a gastric ulcer during diphosphonate therapy in a woman with CRST syndrome.

A 46-year-old woman with the CRST variant of scleroderma (calcinosis, Raynaud's phenomenon, sclerodactyly, and telangiectasis) was treated with a diphosphonate (disodium etidronate) in an effort to reduce her dystrophic calcifications or retard their progression. After 18 months of therapy, no improvement in her calcinosis was noted. In addition, she developed bloody diarrhea, epigastric burning, and weight loss during the last two months of Therapy. Upper gastrointestinal series revealed a gastric ulcer. Endoscopy with biopsy proved it to be benign. Gastric ulcerations has been seen in animals given disodium etidronate but only at much higher doses than are currently recommended for humans. Although a cause and effect relationship cannot be established with certainty in this patient, it is suggested since she was not receiving other ulcerogenic drugs chronically. This information may be important to other investigators of disodium etidronate.

Calcinosis↗
PubMed1976

Shunt system patency testing by lumbar infusion.

A simple and reliable bedside infusion test is described to evaluate shunt-system patency in adult patients with treated "normal" pressure hydrocephalus. Fifteen consecutive patients with ventriculoperitoneal shunts were tested by a two-part infusion test between 2 days and 32 months after shunt surgery. When we used the criteria presented, shunt patency could be established with certainty, and shunt malfunction could be established with relative certainty. Shunt malfunction was verified surgically.

Adult↗
PubMed1976

Lumbar intradural arachnoid diverticulum with cauda equina compression.

An unusual case is reported of an intradural lumbar arachnoid diverticulum causing mild compression of the cauda equina and producing debilitating symptoms which were relieved by inadvertent drainage. A survey of the literature indicates that lumbar arachnoid diverticula are very rare. Only one other report of an intradural lesion of this type has been found. These lesions cause back pain or radicular pain and sensory disturbances when the patient is upright of bending forward. These symptoms are relieved by lying down. Percussion tenderness over the level of the diverticulum is a consistent finding. The key to the diagnosis is supine myelography.

Adult↗
PubMedDate not supplied

Omental transposition to brain of stroke patients.

The intact omentum was transposed to the surface of the brain in three aphasic patients who had stabilized following a dominant hemisphere ischemic stroke. The procedure was found to be safe, causing little physical disfigurement. Subjective and objective improvement in these patients, who are on a strict experimental protocol, has provided encouragement to continue this study in a deliberate and critical manner.

Adult↗