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Biomedical subjects

J Zisfein

Publications and source records attributed to J Zisfein.

13 recordsLinked to original sources
PubMed1993

Selective deep peroneal nerve injury associated with arthroscopic knee surgery.

We report 3 cases of isolated deep peroneal nerve injury as a complication of arthroscopic knee surgery. At the level of the knee joint, the deep and superficial peroneal nerves are usually joined as the common peroneal nerve. However, because of the fascicular structure, a partial nerve injury can result in an isolated injury to the deep peroneal nerve fibers. Due to the intraneural topography of the peroneal nerve, electrodiagnostic studies in a partial nerve injury may erroneously indicate a more distal lesion.

Action Potentials↗
PubMed1991

Use of CT in epilepsy: does it matter how long you wait?

Computer tomography (CT) of the brain is of value for finding potentially correctable lesions in adult patients with new onset seizures. The value of CT is unknown, however, for finding such lesions in adult chronic epileptic patients without prior CT. We compared a group of 177 adult patients who had CT within a year from the onset of seizures to a group of 93 patients who had a history of seizures for more than a year before CT was performed. In the first group, 33 potentially correctable lesions (19%) were found including 17 tumors. The group with chronic epilepsy had 4 (4%) potentially correctable lesions: 3 arteriovenous malformations and 1 meningioma. It seems that CT is of value in discovering potentially removable lesions in chronic epileptic patients, but the likelihood is relatively small. The incidence of stable structural lesions seems to be similar in the two groups.

Adult↗
PubMed1990

Silent myocardial ischemia. Is the person or the event silent?

The symptoms of organic disease vary widely among patients with the same tissue abnormality, because the experience of a symptom is shaped by the patient's perceptual and cognitive style. Thus, the relationship between myocardial ischemia and chest pain is variable in that many patients experience pain without ischemia and many others exhibit ischemia without pain-termed "silent" or "asymptomatic ischemia." Although the nature of the ischemic event may be important in determining the degree of associated pain, we suggest more study of the individual who perceives the event. Myocardial ischemia may not generate a spontaneous report of chest pain because the patient is generally hyposensitive to visceral sensation; because he or she is coping with the threat of heart disease by denying the evidence of it--ie, denying the pain to deny the disease; or because the patient misunderstands the cause and significance of a vague or ambiguous cardiac sensation, normalizing the symptom and misattributing it to a nonpathologic cause.

Coronary Disease↗
PubMed1990

Apneic oxygenation in apnea tests for brain death. A controlled trial.

We performed a prospective controlled study of apneic oxygenation on 15 patients undergoing apnea tests for brain death. All patients were preoxygenated with 100% oxygen at existing respirator settings. During the 10-minute apnea tests, nine patients were given continuous apneic oxygenation by tracheal cannula. The other six patients had tracheal tubes open to room air. The patients given apneic oxygenation had little or no hypoxia by the end of the test. The patients given room air during the test became hypoxic. Many neurologists perform apnea tests with no oxygenation or with preoxygenation alone. This is the first prospective controlled study (to our knowledge) of apneic oxygenation; it shows that preoxygenation alone does not prevent hypoxia during apnea tests for brain death. We recommend that all apnea tests be performed with apneic oxygenation.

Arteries↗
PubMed1987

Single-dose oral phenytoin loading.

A single 18 mg/kg dose of oral phenytoin capsules or suspension (mean dose, 1.3 g) was given to 44 patients with recent seizures and no detectable serum phenytoin level. Mean serum phenytoin levels after loading for patients receiving capsules were 6.8 micrograms/mL at two hours, 9.7 micrograms/mL at three to five hours, 12.3 micrograms/mL at six to ten hours, and 15.1 micrograms/mL at 16 to 24 hours. Mean levels for patients receiving suspension were slightly, but not significantly, lower than for patients receiving capsules. No seizures occurred during an eight-hour observation period after loading. Drug toxicity was minimal. Single-dose, 18 mg/kg oral phenytoin loading provides rapid therapeutic levels and is well tolerated.

Administration, Oral↗
PubMed1986

Brain death in perspective.

Advances in lifesaving medical therapy over the past two decades have forced us to redefine death. Cessation of the heartbeat cannot be synonymous with death if the heart can be permanently removed and replaced with a plastic pump. We now can substitute for the function of all organs in the body, save one--the brain. When brain function is irreversibly lost, the person served by that brain has ceased to exist as a person and is medically and legally dead. This article focuses on the criteria currently used to diagnose irreversible brain failure.

Brain Death↗
PubMed1983

Isaacs' syndrome with muscle hypertrophy reversed by phenytoin therapy.

A 16-year-old boy was seen for severe episodic muscle cramps and generalized myokymia, consistent with Isaacs's syndrome. Bilateral calf hypertrophy (46-cm calf circumference) and ankle areflexia were noted. He was treated with phenytoin sodium, 300 mg/day. Within three months there was marked decrease in myokymia, total relief of cramps, return of ankle reflexes, and 6-cm reduction in calf circumference. We suggest that the excess muscle activity in Isaacs's syndrome may be responsible for the associated phenomena of muscle hypertrophy and areflexia.

Adolescent↗
PubMedDate not supplied

Molecular studies of the atrial natriuretic factor gene.

The molecular biology of human atrial natriuretic factor was studied. A cloned rat cDNA probe was used to analyze tissue for the synthesis of atrial natriuretic factor, and the human gene was identified and sequenced. Nucleotide sequence comparison of human and rodent atrial natriuretic factor genes suggests regions that are critical for regulated expression of this cardiac hormone.

Amino Acid Sequence↗