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Biomedical subjects

N Schuman

Publications and source records attributed to N Schuman.

7 recordsLinked to original sources

A4V superoxide dismutase mutation in apparently sporadic ALS resembling neuralgic amyotrophy.

We report a case of apparently sporadic amyotrophic lateral sclerosis (ALS) in a young pregnant woman presenting subacutely with severe left shoulder pain followed by progressive weakness and wasting of the left arm, mimicking neuralgic amyotrophy. She was later found electrophysiologically to have widespread denervation involving more than just the arm and an alanine for valine substitution in codon 4 (A4V) in the gene for Cu/Zn superoxide dismutase 1 (SOD1). Her case illustrates that pain on initial presentation, though uncommon, does not exclude a diagnosis of ALS.

Adult↗

Prefabricated post-and-core systems: an overview.

Restorative dentists should have a working knowledge of more than one post-and-core system. This review is designed to encourage them to consider systems they might not have considered otherwise. Many restorative dentists learn to use one prefabricated post-and core system, and they have only one system on hand. When the system on hand is the solution, there is no need for an alternative. However, no single prefabricated post-and-core system can fit all endodontic restorative requirements. The best way to pick an optimum system design is to compare alternatives. The vast assortment of available system components, many supported solely by experimental data without direct clinical corroboration, makes comparison and selection a challenging process.

Dental Cements↗

Restoration of endodontically treated teeth: a guide for the restorative dentist.

This article provides a decision flow chart that can serve as a guide to selecting the optimum restorations for endodontically treated teeth. The process begins with an assessment of the endodontically treated tooth to determine its restorability. The restorable tooth is then evaluated for the amount of remaining coronal tooth structure. Anterior teeth with minimal or moderate coronal damage do not require complete coverage or a post and core. However, anterior teeth with significant coronal damage will require complete coverage plus a post and core. Posterior teeth with minimal coronal damage may be treated conservatively with partial-coverage restorations. For posterior teeth with moderate damage and those with curved roots, amalgam or resin composite foundations are used to support complete-coverage restorations. Posterior teeth with significant coronal damage require a post and core and a complete-coverage restoration.

Decision Trees↗

Color vision and dentistry.

Color vision is a critical component of restorative and esthetic dentistry, but dentists, as a group, do not have their color vision tested at any time during their careers. A study was undertaken to ascertain the color-vision status of practicing dental personnel at the University of Tennessee, College of Dentistry. One hundred fifty individuals, 75 men and 75 women, were screened. The results corroborated the existing medical data for the general population. It was found that 9.3% of the men and none of the women exhibited color-vision defect. Since most dentists are male, this study demonstrates an area of potential weakness for some practitioners. Once a color-vision problem is found, it is simple to remedy by employing a team approach to shade matching or mechanical means of matching shades (by the practitioner). No ethnic or racial distinctions were detected, although these have been reported in other studies.

Adult↗

Results of surgical lysis of lumbar adhesive arachnoiditis.

From a series of 681 patients with lumbar disc disease treated between 1966 and 1978, 17 patients required surgical lysis of lumbar adhesive arachnoiditis, 8 having initially been operated upon by another surgeon. All patients had severe pain as a predominant feature, with pain being bilateral in 9 patients. Pain was the only major symptom in 3; the other 14 exhibited varying combinations of progressive neurological dysfunction. Three patients developed late symptoms after trauma, 8 to 21 years after back surgery. At operation, multisegmental arachnoiditis was found in 5 patients and anular or subtotal adhesions were found in 12. Complete lysis could not be obtained in 4 patients. Fourteen patients were treated with steroids at the time of operation. Follow-up after lysis was less than 1 year for 5 patients but averaged 4.8 years for the remaining 12. During the 1st year after operation, 76% experienced improvement in pain (35%, good to excellent), 71% experienced improvement in neurological status. Follow-up after at least 1 year revealed 50% still enjoying pain relief (25%, good to excellent) and 45% experiencing neurological improvement. Pain relief persisted in 4 of 5 patients followed 5 years or more. The etiological role of myelograpy and lumbar disc surgery in arachnoiditis has probably been over-rated. Arachnoiditis may be symptomatic or asymptomatic and may mask other, treatable lumbar lesions. More frequent intradural exploration for discrepancies between operative and myelographic findings might reveal, and benefit, more cases of spontaneous arachnoiditis mimicking lumbar disc disease.

Adult↗

Nonvolumetric methods of detecting impaired intracranial compliance or reactivity: pulse width and wave form analysis.

The authors have attempted to find a clinically reliable method of measuring intracranial pressure (ICP) compliance or reactivity that does not require volumetric manipulation. An analysis was undertaken of ICP, pulse widths and of the presence or absence of B waves, both experimentally in dogs and clinically in postoperative human patients. In both dogs and humans, ICP pulse width generally increased with increasing ICP and with increasing intracranial mass, and definitely increased with systolic arterial blood pressure. Nonetheless, ICP pulse width commonly failed to increase with increasing cerebral reactivity, and low ICP pulse width measurements were at times recorded in distinctly pathological situations. From the clinical study it was found that B waves were encountered more commonly in patients with increased ICP or increased ICP pulse width. However, the correlation between B waves alone or in combination with increased ICP or ICP pulse width and quantitative measurements of ICP reactivity was not significant. Mean reactivity and the range of reactivity measurements were almost identical in patient groups with and without B waves. For the time being the "ICP reserve test" remains the most accurate, the safest, and the most clinically useful method of quantitating ICP reserve.

Animals↗

Intradiscal corticosteroids in the treatment of lumbar and cervical disc problems.

Forty-two intradiscal injections were performed in 29 patients having lumbar disc disease, 19 of whom had nonradiating back pain and 20 of whom had back and leg pain. Discograms were abnormal for 27 patients, but myelograms were abnormal for only four. Twenty-two injections (52%) gave relief of pain for a minimum of one month, but only 14 (33%) for at least three months. Of the 29 patients, six (21%) have obtained relief lasting six months to several years and have not required surgery. Twenty injections were performed in 14 patients having cervical disc disease, 11 of whom had neck and arm pain and three of whom had discogenic neck pain. Contrast and anesthesia discograms were abnormal for all patients, but myelograms were abnormal for only four. Thirteen injections (65%) gave relief of pain for a minimum of one month, but only three (15%) for at least three months. Of the 14 patients, three (21%) have obtained relief lasting six months to several years and have not required surgery.

Adolescent↗