PubMed Health⌕ Search

Biomedical subjects

P J Killian

Publications and source records attributed to P J Killian.

11 recordsLinked to original sources
PubMed1993

Fixed time versus fixed distance protocols for the blood lactate profile in athletes.

Laboratory studies of blood lactate accumulation often use a fixed time protocol to define the onset (4 mM) of blood lactate accumulation (OBLA) or other indices of blood lactate concentration. For practical reasons, field studies with athletes often use a fixed distance protocol to accomplish the same goal. Whether these variations of protocol are comparable has not been established. We studied 10 subjects in the laboratory during fixed time (4 minute) and fixed distance (2 km) exercise protocols on a racing bicycle attached to a wind load simulator. The fixed distance studies required 3-6 minutes to complete. We also studied the subjects during fixed distance (2 km) rides in the field. In the laboratory there were no systematic differences in the velocity (34.3 4.6 vs 34.2 +/- 4.6 km.hr-1), VO2 (2.78 +/- 0.60 vs 2.84 +/- 0.62 liters.min-1), or heart rate (159 +/- 16 vs 155 +/- 14 beats.min-1) at OBLA in the fixed time vs fixed distance protocols. The correlation coefficients for velocity (r = 0.97), VO2 (r = 0.97) and heart rate (r = 0.94) further indicate the similarity of results. In the field study there was a significant difference in velocity (29.9 +/- 4.8 vs 34.2 +/- 4.6 km.hr-1) but not heart rate (155 +/- 18 vs 155 +/- 15 beats.min-1) at OBLA versus the fixed distance laboratory study. The correlations for velocity (r = 0.47) and heart rate (r = 0.93) support these data. The results suggest that the practical modification of the lactate profile technique of using fixed distance versus fixed time exercise stages does not systematically influence the outcome, at least for exercise stage durations approximating 4 minutes.

Female↗
PubMed1991

Temporomandibular joint dysfunction syndrome: a close association with systemic joint laxity (the hypermobile joint syndrome)

Sixty-two patients admitted for elective reconstructive surgery of the temporomandibular joint (TMJ) and eight seen as outpatients with a chief complaint of TMJ dysfunction during the same time interval were evaluated for possible etiologic factors contributing to the disease. All hospitalized patients had severe, end-stage degenerative changes within the TMJ, whereas outpatients had less severe disease and did not require surgery. TMJ dysfunction in some patients was said to be a result of established causes including bruxism, malocclusion, and trauma. No patient in this series had evidence of a systemic inflammatory polyarthritis. Of the 70 patients, 38 (54%) met criteria, based on those of Carter and Wilkinson, as modified by Beighton et al., sufficient to warrant a diagnosis of the hypermobile joint syndrome. Five patients had classic Ehlers-Danlos syndrome and therefore were not patients with "benign hypermobility," and an additional two cases were described as "marfanoid" and as possible Ehlers-Danlos syndrome, respectively. Radiographs showed TMJ hyperextensibility in four hypermobile patients. Long-term surgical outcome was identical in the hypermobile and nonhypermobile groups. The incidence of hypermobility in this series is strikingly higher than the expected incidence in an otherwise population. Magnetic resonance images of the TMJs on separate groups of asymptomatic normal and hypermobile women identified excessive anterior movement in the hypermobile group, together with abnormal anterior disk position in some. We hypothesize that hypermobility within the TMJ may cause accelerated disk destruction and degenerative disease.

Adolescent↗
PubMed1988

Systemic joint laxity (the hypermobile joint syndrome) is associated with temporomandibular joint dysfunction.

A consecutive series of 37 individuals admitted to the hospital for elective temporomandibular joint (TMJ) reconstructive surgery and 3 seen as outpatients with TMJ disease were evaluated for rheumatic disease or for another etiologic factor that might account for this problem. These 40 patients were screened by history, physical examination, and laboratory study. We soon noticed that many patients had generalized joint laxity. Eighteen of the first 40 individuals satisfied established criteria for the hypermobile joint syndrome. An additional 3 were found to have Ehlers-Danlos syndrome or a forme fruste of this disorder. Many were markedly hypermobile and could perform a number of flexible maneuvers. Although excessive joint laxity is known to be associated with a variety of rheumatic conditions, TMJ disease has not been recognized as one of them. No patient in this series had a systemic inflammatory disorder or any other apparent etiologic factor for TMJ disease. We suggest that there is a cause-and-effect relationship between generalized joint laxity and TMJ disease.

Adolescent↗
PubMed1983

Computerized tomography in evaluation of atlantoaxial subluxation in rheumatoid arthritis.

Nineteen patients with rheumatoid C1-C2 subluxation of greater than or equal to 5mm were studied by computerized tomography (CT). CT demonstration of spinal cord compression as defined by loss of posterior subarachnoid space was present in 11/19 (CT+) and absent in 8/19 (CT-). Fourteen patients were examined by a blinded neurologist. Cord compression by CT correlated better with clinical neurologic status than did routine radiographic studies. Absent superficial abdominal reflexes and history of bladder dysfunction correlated highly with cord compression by CT. Two CT+ patients developed neurologic deterioration requiring spinal fusion. Our data suggest that CT is a useful, noninvasive adjunct in management of patients with rheumatoid C1-C2 subluxation.

Aged↗
PubMed1981

Association of myositis and myocarditis in progressive systemic sclerosis.

A retrospective review of 47 patients with progressive systemic sclerosis revealed a highly significant (P less than 0.001) association between myositis and myocarditis. Three patients developed clinically overt myocarditis as an early feature of their disease. These patients had an inflammatory myopathy indistinguishable from polymyositis. Despite an excellent clinical response to steroids, the late occurrence of life-threatening conduction system defects appeared while they were receiving therapy. Consequently, patients with progressive systemic sclerosis and myositis should be evaluated for a coexisting myocarditis. The findings in these patients lend further support to the concept of a generalized myopathic process among the connective tissue diseases.

Adolescent↗
PubMed1980

Coexistence of systemic lupus erythematosus and myasthenia gravis.

The coexistence of myasthenia gravis and systemic lupus erythematosus in a 52-year-old woman is reported. Review of the literature shows that systemic lupus erythematosus occurs much more often in the myasthenia gravis population than in the population in general. Myasthenia gravis should be considered in the differential diagnosis in a patient with weakness and systemic lupus erythematosus.

Diagnosis, Differential↗
PubMed1977

Brown's syndrome. An unusual manifestation of rheumatoid arthritis.

Two patients presented with an ocular complication of rheumatoid arthritis that was extraocular in location. Clinical manifestations include vertical diplopia, an intermittent nature, a clicking sensation, and apparent inferior oblique palsy. A stenosing tenovaginitis of the superior oblique tendon and its sheath is the probable underlying pathologic mechanism.

Adult↗