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Biomedical subjects

M M LaBan

Publications and source records attributed to M M LaBan.

4 recordsLinked to original sources

Breast pain: a symptom of cervical radiculopathy.

Eighteen women, all of whom had extensive but noninformative breast evaluations, including 10 mammograms and 4 biopies, were successfully treated by cervical traction for chronic breast pain. Each patient had distinct clinical or electromyographic evidence of cervical root compromise. Fifteen had roentgenographic evidence of cervical spondylosis, primarily at levels C6 and C7. Cervical angina, as a symptom constellation produced by cervical radiculopathy and mimicking coronary ischemic disease, is a well-defined entity. Less well recognized is persistent breast pain as a primary presenting symptom of cervical root compromise. In both instances, the early identification of the cervical radicular origin of the pain, with its quite different prognosis and associated therapeutic implications, can promptly help to allay the patient's physical and psychologic discomfort. The pathologic mechanism of pain production and the anatomic pattern of referral are described.

Adult

Symphyseal and sacroiliac joint pain associated with pubic symphysis instability.

Fifty patients presenting with lumbosacral and inguinal pain were examined by routine clinical radiographic and electromyographic evaluations. All were without antecedent history of major pelvic trauma or spinal surgery but demonstrated evidence of pubic symphysis instability. Slip between the pubic rami in excess of 2 mm could be demonstrated in each with alternate leg weight bearing. Asymmetry of hip mobility on the symptomatic side with a reduction in abduction and external rotation was present in 20 patients. An approach to treatment of pain associated with pubic symphyseal and associated sacroiliac joint instability is described, combining both intraarticular steroids, lumbosacral supports and physical therapy modalities.

Adolescent

Metastatic disease of the paraspinal muscles: electromyographic and histopathologic correlation in early detection.

Electromyographic examination may demonstrate severe segmental compromise of the posterior primary ramus and relative sparing of the anterior ramus as the earliest objective evidences of spinal and paraspinal metastases. Antecedent studies, including roentgenographic, radioisotopic and neurologic investigations, are often initially normal, failing to reveal the underlying cause of the progressive back pain. The present report demonstrates metastatic spread both through the paravertebral venous plexus and by direct extension in contiguous muscle. In this special instance, segmental 4+ fibrillations in the paraspinal muscles are electrophysiologic manifestations of a local, active process of denervation rather than a remote effect of the malignant disease, as has been suggested by others.

Adenocarcinoma

Carotid bruits: their significance in the cervical radicular syndrome.

Routine physical examination of 600 patients referred with complaints of neck or shoulder pain included auscultation of both carotid and subclavian arteries. A treatment regimen including consideration of therapeutic cervical traction was precluded in 11 patients when unilateral carotid bruits were heard. Subsequent testing including radioisotopic carotid blood flow studies, and arteriography demonstrated 1 thoracic outlet syndrome, 1 arteriovenous malformation, 1 scarring secondary to radical neck dissection, 1 extrinsic pressure from an epidermoid carcinoma, 5 partial carotid occlusions secondary to intra-arterial plaque formation, and 2 normal carotid contrast studies. Successful surgery in all five of the stenotic patients and in the case of arteriovenous malformation aborted what might have otherwise been a less satisfactory outcome.

Adult