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Biomedical subjects

L B Kline

Publications and source records attributed to L B Kline.

At least 55 records · Page 3Linked to original sources
PubMed1983

Comparison of dopamine agonists in the treatment of hyperprolactinemic syndromes: a multicenter study.

Thirty-one patients with hyperprolactinemia were admitted for protocol study. Twenty-one of these patients had no findings of prolactinoma by computerized axial tomography (CAT) scanning; 10 had documented tumor by CAT scan. The patients were assigned to either Parlodel or Pergolide treatment on the basis of random numbers tables. They were treated for 6 months continuously and followed during this time with radiologic survey, hormonal evaluation, and blood chemistry determinations. Patients in both groups showed a decrease in prolactin levels, whether they were treated with Parlodel or Pergolide. The response was similar whether patients had hyperplasia or pituitary tumors. Patients with pituitary tumors tended to have a diminution in the size of their lesions regardless of the dopamine agonist used. The types of side effects experienced by various groups were similar regardless of the treatment. It is concluded that both Pergolide and Parlodel are useful in the treatment of hyperprolactinemic syndromes, although neither one appears to be superior to the other.

Adolescent↗
PubMed1983

Periodic alternating nystagmus associated with periodic alternating skew deviation.

A 34-year-old man had both periodic alternating nystagmus and periodic alternating skew deviation. Neurologic examination and cranial computed tomography supported the diagnosis of cerebellar degeneration. Pathophysiologic mechanisms of these motility disturbances are discussed briefly. To our knowledge these two unusual eye movement abnormalities have not been reported previously in the same patient.

Adult↗
PubMed1982

Bilateral choroidal osteomas associated with fatal systemic illness.

An 11-year-old black boy complained of intermittent occipital headaches with nausea and projectile vomiting. Previous skin and lung biopsy specimens were interpreted as histiocytosis X. Cranial computed tomographic scanning disclosed a mass lesion in the region of the choroid plexus of the left lateral ventricle. This was surgically removed but proved nondiagnostic despite extensive histologic examination. An ophthalmologic evaluation showed discrete, elevated, yellow-white choroidal tumors in both maculas. The ophthalmoscopic appearance, as well as ultrasonography and computed tomography, led to the diagnosis of choroidal osteomas.

Brain Neoplasms↗
PubMed1982

Computed tomographic evaluation of the cavernous sinus.

In evaluating over 300 patients with sellar and parasellar lesions, the computed tomographic (CT) appearance of the cavernous sinus was studied. Optimal visualization of the cavernous sinus was obtained with continuous contrast enhancement of both axial and coronal tomograms. The coronal projection and reformatted views provided imaging of the cranial nerves within the cavernous sinus. In addition to the physiologic CT appearance of the cavernous sinus, a variety of pathologic conditions are illustrated. CT criteria suggesting an abnormal cavernous sinus are: (1) asymmetry of size; (2) asymmetry of shape, particularly the lateral wall; and (3) focal areas of abnormal density within the sinus.

Adult↗
PubMed1982

Visual evoked response in transient monocular visual loss.

The pattern-reversal visual evoked response (VER) was recorded in 2 patients during transient monocular visual reduction. In both cases the VER was initially abolished. With recovery of vision there was gradual return of amplitude over a 3- to 8-minute period, while latencies remained unchanged from preattack values. These findings are discussed with regard to current understanding of the origins of the VER and relevant aspects of retinal electrophysiology.

Adult↗
PubMed1981

Retinopathy in toxemia of pregnancy.

Two cases of toxemia of pregnancy are presented, with color photographic documentation of the accompanying retinopathy. Although both pregnancies resulted in delivery of a viable infant and resolution of other systemic manifestations of toxemia, both patients were left with severe visual impairment. The retinopathy of toxemia is emphasized as a potential source of permanent morbidity in this complication of pregnancy.

Adolescent↗
PubMed1981

Television-induced formed visual hallucinations and cerebral diplopia.

A 65-year-old man with ischaemic encephalomalacia following surgery for an aortic arch aneurysm experienced episodes of stereotyped formed visual hallucinations uniquely provoked by television viewing. In addition he noted vertical diplopia of cerebral origin. These symptoms are discussed in the light of what is known about visual hallucinations, television-induced epilepsy, and cerebral polyopia.

Aged↗
PubMed1981

Dorsal midbrain syndrome in multiple sclerosis.

Complaining only of vertical diplopia, a 34-year-old woman had pupillary light-near dissociation, upward gaze paresis, convergence-retraction nystagmus, and skew deviation. Cranial computerized tomography excluded a space-occupying lesion. Additional history and examination established the diagnosis of clinically definite multiple sclerosis. Dorsal midbrain syndrome due to multiple sclerosis rare.

Adult↗
PubMed1981

Parasellar epidermoid tumor presenting as painful ophthalmoplegia.

In 1964, a 51-year-old man experienced a right abducens nerve palsy, which resolved spontaneously. In 1978, he developed painful ophthalmoplegia on the right with paresis of the right oculomotor and trigeminal nerves. Neuroradiographic evaluation was reported unremarkable, and the painful ophthalmoplegia was attributed to the Tolosa-Hunt syndrome. High-dose corticosteroids were administered with transient improvement of signs and symptoms. In 1979, cranial computerized tomography demonstrated a low-density lesion adjacent to the right cavernous sinus, which at operation proved to be an epidermoid tumor.

Brain Neoplasms↗
PubMed1981

Computed tomographic sellar and perisellar evaluation. Use of high-dose continuous contrast infusion.

Contrast enhancement provides valuable information in cranial computed tomography. We report the use of high-dose continuous contrast infusion as a means of consistently demonstrating major perisellar cerebral vasculature. This method was utilized in examining 73 patients, and three illustrative cases are presented. We propose that this technique be performed as the initial radiographic procedure in evaluating sellar and perisellar lesions. Results of clinical, laboratory, and CT examinations may necessitate additional studies including sellar complex motion polytomography, cerebral angiography, metrizamide CT cisternography, or pneumoencephalography. However, employing the CT techniques described, the role of invasive neuroradiographic procedures in the preoperative evaluation of the sellar and perisellar region requires reconsideration.

Adenoma↗
PubMed1981

Bilateral abducens nerve palsies from clivus chordoma.

An 87-year-old male complaining of horizontal diplopia of five months duration was found to have bilateral abducens nerve palsies. The remainder of the neurologic examination was unremarkable, but neuroradiologic investigation disclosed a lesion involving the sella and sphenoid sinus, with erosion of the upper aspect of the clivus. A large chordoma was found at trans-sphenoidal surgery. This presentation is unique in that the chordoma produced bilateral sixth-nerve palsies with no other neurologic defects.

Abducens Nerve↗
PubMed1980

Complement sensitivity of paroxysmal nocturnal hemoglobinuria bone marrow cells.

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired disorder in which erythrocytes, granulocytes, and platelets are defective, as shown by increased susceptibility of RBCs, WBCs, and platelets to complement-mediated lysis in vitro. The purpose of this study is to determine the sensitivity to complement lysis of PNH and non-PNH erythroid and myeloid precursors using the release of 59Fe and myeloperoxidase as specific markers to monitor the lytic action of complement on erythroid and myeloid cell precursors, respectively. Erythroid cell precursors in four of four PNH patients demonstrated increased sensitivity to complement-mediated lysis. Myeloid cell precursors in four of five PNH patients also exhibited increased sensitivity to complement and antibody. In addition, CFU-c growth was below normal in the marrow of seven PNH patients. These findings support the hypothesis that the defect in PNH occurs at the level of the hematopoietic stem cell.

Adult↗
PubMed1980

Internuclear ophthalmoplegia: recovery and plasticity.

We studied refixational eye movements of a patient during the gradual resolution of an internuclear ophthalmoplegia (secondary to head trauma) in an attempt to determine the relative contributions of both medial longitudinal fasciculus (MLF) recovery and secondary central plastic changes. Adduction-refixational eye movements in the affected eye consisted of an initial fast (saccadic) portion followed by a slow drift toward the new intended eye position. The fast and slow components of the movements reflected, respectively, the pulse and step increases in neural innervation. Shortly after the traumatic insult, the affected eye exhibited low adduction gain (pulse gain 0.34; step gain 0.37) and slow saccades with peak velocities of 55% and durations of 278%, normalized for achieved, rather than intended, amplitudes. Several months later the pulse and step gains, peak velocities, and durations of the saccades improved to 0.81, 0.92, 87%, and 145%, respectively. The increased gains and faster velocity were accomplished by increases in the firing frequency of the pulse and step, reflecting recovery of MLF axons, rather than saccadic system plasticity, which would have resulted in increased duration of the saccadic pulse.

Adolescent↗