PubMed Health⌕ Search

Biomedical subjects

J Tompkins

Publications and source records attributed to J Tompkins.

11 recordsLinked to original sources
PubMed2001

Transcostovertebral approach for thoracic disc herniations.

OBJECT: The authors describe a new posterolateral transcostovertebral approach for the removal of herniated thoracic discs. METHODS: From January 1994 to January 2000, 28 thoracic discs in 22 patients were excised via a new transcostovertebral surgical approach. Seventeen patients (77%) presented with axial pain, 14 (64%) with radicular pain, 13 (59%) with myelopathy, eight (36%) with sensory loss, and 10 (45%) with genitourinary (GU) symptoms such as urinary hesitancy or incontinence. The affected discs were approached using a midline incision to gain access of the costovertebral junction. The surgical corridor was posterolateral; the costovertebral joint and lateral edge of the vertebral endplates were drilled to expose the lateral annulus. The ribs were preserved, obviating the need for insertion of a chest tube postoperatively. The average operating time per level was 200.5 minutes (range 90-360 minutes). The average blood loss was 231 ml (50-750 ml). The average length of stay was 3.8 days. Most patients were discharged home on postoperative Day 2 or 3. No patients were worse postoperatively. Improvement was demonstrated in 13 (76%) of 17 patients with axial pain, 11 (79%) of 14 patients with radicular pain, 11 (85%) of 13 patients with myelopathy, seven (88%) of eight patients with sensory loss, and six (60%) of 10 patients with GU symptoms. CONCLUSIONS: This procedure is well suited for any thoracic disc level and offers several advantages over the traditional costotransversectomy or transthoracic approaches: shorter operating time, less blood loss, less extensive soft-tissue and bone dissection, reduced postoperative pain, and shorter hospital stays.

Adult↗
PubMed2000

Immunoneutralization of endogenous opioid peptides prevents the suckling-induced prolactin increase and the inhibition of tuberoinfundibular dopaminergic neurons.

Previous studies have shown that the endogenous opioid peptides, acting at specific opiate receptor subtypes, are involved in the suckling-induced prolactin secretory response. The prolactin increase elicited by suckling is due, at least in part, to an inhibition of tuberoinfundibular dopaminergic (TIDA) neurons in the hypothalamus. We investigated the effects of immunoneutralization of dynorphin, leu-enkephalin and met-enkephalin on the suckling-induced prolactin increase and on the activity of the TIDA neurons in lactating female rats between days 7 and 12 postpartum. Rats were injected into the right lateral ventricle with antiserum specific for one of these three peptides. Control rats were administered equal amounts of immunoglobulin proteins. Suckling produced a profound and significant increase in prolactin levels, as well as a decrease in DOPA accumulation in the median eminence of lactating rats. Administration of immunoglobulin concentrations of up to 3.6 microg did not inhibit the prolactin secretory response to the suckling stimulus and did not prevent the suckling-induced inhibition of TIDA neurons. Antisera to all three endogenous opioid peptides abolished the suckling-induced prolactin increase and prevented the inhibition in DOPA accumulation in the median eminence. Thus, the endogenous opioid peptides, dynorphin, leu-enkephalin and met-enkephalin, are essential for the prolactin secretory response to suckling and inhibition of TIDA neuronal activity is at least one of the mechanisms of action utilized by these peptides.

Animals↗
PubMed1995

The use of patient symptoms to screen for serious back problems.

Even when a patient is referred by a physician, the physical therapist must remain alert to the possibility that the patient may require medical care outside the realm of physical therapy. Physical therapists must be able to screen low back pain patients to identify those who have serious low back problems which require additional diagnostic evaluation and treatment by a physician. It is important for physical therapists to know which symptoms and signs or combination of symptoms and signs best indicate the likelihood of a serious problem. The purpose of this study was to test the sensitivity and specificity of low back pain symptoms in distinguishing individuals with a benign low back problem from those requiring surgical or medical intervention. Demographic and clinical data were collected retrospectively from a standardized low back pain questionnaire located in the medical records of 174 low back pain patients. Patients were classified as having a benign low back problem (N = 41) or a serious low back problem (N = 133) based on surgical findings or long term follow-up. Some individual symptoms had high specificity, but none had high sensitivity. To improve sensitivity while attempting to maintain moderate specificity, a number of symptoms were considered in parallel. The highest combination of sensitivity (.87) and specificity (.50) was obtained by combining in parallel the symptoms of unable to sleep, awakened and unable to fall back to sleep, medication required to sleep, and pain worsened by walking.

Adult↗
PubMed1995

The role of striate cortex in visual function of the cat.

We examined the contribution of area 17 to visual function in two cats whose fixation was monitored by means of scleral search coils. Ibotenic acid lesions were made within the physiologically identified representation of the lower left visual field of area 17. In a detection task in which the cats simply indicated the presence or absence of a vertical grating, contrast sensitivity loss was greatest at middle spatial frequencies with no loss in spatial resolution. However, when cats were required to discriminate between vertical and horizontal gratings, sensitivity loss was profound at both middle and high spatial frequencies with an octave loss of spatial resolution. This greater loss was not due to disrupted orientation discrimination since sensitivity to the orientation of coarse gratings was unaffected in the lesioned hemifield. We also found deficits in the ability to discriminate the direction of grating motion, but only at higher spatial and lower temporal frequencies. The role of area 17 in perceiving the global motion of complex patterns was also studied with high contrast, dynamic random dots drifting at high speeds. Paradoxically, area 17 lesion improved the perception of global motion. This improvement was eliminated by spatially filtering the dot patterns to remove high spatial frequencies, suggesting that the lesion has enhanced performance by interfering with masking by high spatial frequencies. Our results demonstrate that the performance of traditional detection tasks may be insensitive to the effects of area 17 lesions. Discrimination tasks, on the other hand, revealed that area 17 neurons play a major role in the perception of higher spatial frequency stimuli as long as they move or flicker at low rates, but contribute little to these functions when the stimuli are coarse and move at high speeds.

Animals↗
PubMed1993

Effect of warm and cold applications on the resolution of i.v. infiltrations.

Differences in pain intensity, surface area measurements of induration and erythema, and interstitial fluid volume when warm versus cold applications were randomly made to an intentional intravenous infiltrate of 5 mL of a designated solution were examined. Three solutions were used: 1/2 saline (154 mOsm), normal saline (308 mOsm), and 3% saline (1027 mOsm). Differences in volume were determined by magnetic resonance imaging (MRI) at three intervals postinfiltration. The sample was 18 healthy adults between 20 and 45 years. There was no difference in remaining infiltrate when 1/2 saline or normal saline were used, but a significant (p < .001) difference was found with 3% saline. For all solutions there was a significant (p < .001) difference in the volume of infiltrate remaining when warmth was applied and this effect held across MRI readings and solutions. Pain intensity did not differ by treatment but a significant (p < .005) difference was found by solution, with 3% saline producing the greatest difference. Erythema was absent with all solutions. Surface induration was affected by solution and decreased over time (p = .001). There was no effect of warmth or cold on surface area induration.

Adult↗
PubMed1993

Initial-impression diagnosis using low-back pain patient pain drawings.

Patient pain drawings were blindly selected from five lumbar spine disorder categories. The drawings were classified by low-back physicians, discriminant analysis, and several computerized artificial neural network configurations. The purpose was to determine the reliability of the patient pain drawing when diagnosing low-back disorders and to delineate the pain mark patterns particular to each disorder by comparing physicians with computerized methods. The physicians averaged 51% accuracy with individual preferences for certain disorder groups. The computerized methods demonstrated comparable accuracy (48%) and more agreement in classification. Associations were found between the predicted pain patterns for each diagnostic group made by an expert and the patterns generated by computerized methods. Variances in these associations are instructive to clinicians for making accurate predictions of diagnosis from pain drawings.

Diagnosis, Computer-Assisted↗
PubMed1989

Kochia (Kochia scoparia) toxicosis in cattle: results of four experimental grazing trials.

Four kochia grazing trials were completed over a period of 3 years. Yearling steers were allowed to graze pure stands of irrigated and fertilized kochia (Kochia scoparia) for periods of 14 to 105 days. A total of 116 steers were given kochia as their sole forage. Twenty control steers were allowed to graze native grass pasture, and 20 steers were allowed to graze both native grass and kochia pastures. Steers grazing only kochia lost weight or gained poorly compared with control steers grazing native grass. Steers that grazed both kochia and native grass had intermediate rates of gain. Signs of toxicosis were observed only in steers grazing kochia alone. Considerable variability in the degree of toxicosis was observed from one year to another. Morbidity in the steers grazing only kochia varied from 0% (Trial 4) to 28% (Trial 1), and mortality varied from 0% (Trials 3 and 4) to 10% (Trial 2). The most common signs observed in clinically affected steers were depression, dehydration, weight loss, muscular weakness, photosensitization, ocular discharge, and crusty muzzle. In all 4 trials, significant elevations in serum glutamic oxaloacetic transaminase (GOT) and serum gamma glutamyl transpeptidase (GGT) were observed in steers grazing kochia. In 3 of the 4 trials, significant elevations in serum bilirubin, serum calcium, and serum protein were also observed in kochia-fed steers. Necropsies were performed on 6 of 9 steers that died or were euthanized. The primary pathologic findings were severe chronic nephrosis (5 steers) and degenerative hepatopathy (5 steers).(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Feed↗
PubMed1988

A good sign.

Explore the source record for details and available documents.

Humans↗