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Biomedical subjects

R M Woolsey

Publications and source records attributed to R M Woolsey.

At least 19 recordsLinked to original sources
PubMed1995

Cisapride for constipation in spinal cord injured patients: a preliminary report.

Chronic constipation in patients with spinal cord injury (SCI) has significant impact on quality of life. To measure baseline clinical functioning, colonic transit time and anorectal manometry and the effect of cisapride on these clinical and physiological parameters, we studied 12 SCI patients. Patients initially received baseline clinical scoring, measurement of colonic transit time and anorectal manometry. Patients then received cisapride 20 mg orally three times each day. After one and three months of cisapride therapy, all measurements were repeated. The mean duration cisapride treatment was 5.2 months. Six of 12 (50 percent) reported that symptoms of constipation improved. No patient had worsening of symptoms. Prior to cisapride treatment, 23 percent of patients passed colonic transit markers by day five and 57 percent by day seven; baseline anal manometry revealed variable resting and squeeze pressures. After treatment, 33 percent of patients passed their colonic transit markers by day five and 71 percent by day seven. Six of 12 (50 percent) demonstrated a 10 percent or more increase in resting anal canal pressures. We conclude that about 50 percent of SCI patients have subjective improvement in constipation after cisapride therapy. Cisapride appears to improve both colonic and anorectal function.

Cisapride↗
PubMed1991

Acute myelopathy following intravenous heroin: a case report.

A 43-year-old woman developed acute paraplegia and a Korsakoff syndrome following intravenous administration of heroin. Thirteen previously reported cases are similar to the one presented here. Based on those similarities, we conclude that these myelopathies are probably due to spinal cord infarction resulting from systemic hypoxemia and hypotension.

Adult↗
PubMed1991

The clinical diagnosis of disorders of the spinal cord.

Disease of the spinal cord or cauda equina may cause pain, motor abnormalities, sensory disturbance, alteration of reflexes and muscle tone, and bladder dysfunction. These five neurologic abnormalities occur in various combinations, evolve rapidly or slowly, and result in one of eight possible spinal cord syndromes. When a particular syndrome is defined by neurologic history and examination, differential diagnosis is limited to only a few possible disorders. An appropriate neuroradiologic or electrophysiologic procedure done at this point will usually provide the correct diagnosis.

Humans↗
PubMed1991

The cause, prevention, and treatment of pressure sores.

Pressure sores are a common, expensive, and preventable complication of paralysis. They are the result of ischemia produced when tissue is compressed and distorted by pressure exerted between a bone and an external hard surface for an extended period of time. Prevention involves control of the two variables of pressure and time. Pressure can be minimized by using various pressure-reductive devices in the form of mattresses and cushions. Control of time involves scheduled position changes. If pressure sores occur, treatment consists of keeping the sore completely pressure free and clean. Grades I and II sores usually need no further treatment. Grades III and IV sores heal faster and more effectively when treated surgically.

Humans↗
PubMed1988

Mycobacterial meningomyelitis associated with human immunodeficiency virus infection.

A homosexual man, seropositive for human immunodeficiency virus, developed back and leg pain that evolved, over three weeks, into a T-10 anesthetic, areflexic paraplegia. Spinal fluid examination showed lymphocytosis, markedly elevated spinal fluid protein, and hypoglycorrhachia. A spinal cord biopsy specimen disclosed an intramedullary granuloma containing acid-fast bacilli. The patient was treated with antituberculous drugs and had no progression of neurologic deficit. He died, eight months after first becoming ill, of Klebsiella pyelonephritis and septicemia. Mycobacterial meningomyelitis is presently the only known acquired immunodeficiency syndrome-related myelopathy responsive to specific treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Modern concepts of therapy and management of spinal cord injuries.

Trauma is the most common cause of spinal cord-related disability. There are approximately 52 new spinal cord injuries per million population per year in the U.S., and about 200,000 persons with post-traumatic paraplegia or quadriplegia require continuing medical care in this country at the present time. Management of the spinal cord-injured patient commences at the moment of injury and continues throughout the entire lifetime of the patient. While there is considerable consensus regarding the management of some problems related to traumatic myelopathy, other treatment concerns, mainly related to spinal fractures, are highly controversial, with a plethora of strongly held opinions, frequently supported by meager factual evidence or none at all. It is not generally recognized that whatever treatment the patient receives during the first days or weeks following injury is of considerably less importance, from a lifelong perspective, than that which occurs over subsequent months. Skillful physical rehabilitation to maximize the functional usefulness of remaining neurological function permits the return of most spinal cord-injured patients to their family and community able to function as an independent person. Paraplegic and quadriplegic patients acquire health risks unique to their condition, mainly related to pressure sore liability and altered bladder function, which requires continual, meticulous attention from the patient and his physician. The sudden transition from being an unimpaired to a permanently paralyzed person is a cataclysmic emotional experience. Unless psychic rehabilitation is undertaken in tandem with physical rehabilitation, a spinal cord-injured patient is likely to become an unhappy social recluse or denizen of a chronic care facility, rather than an independent productive member of his community. Centers dedicated to comprehensive spinal cord care have become generally available and provide optimal care for traumatic myelopathy.

Humans↗
PubMed1986

Aortic laceration after anterior spinal fusion.

Six weeks after anterior spinal fusion and instrumentation for a burst fracture of the second lumbar vertebra, a patient developed a nearly fatal retroperitoneal hemorrhage from a laceration of the aorta produced by the metallic implant. This experience suggests that placement of fusion hardware in close proximity to large arteries should be avoided if possible or, if such placement is necessary, the device should be removed as soon as fusion has taken place.

Adult↗
PubMed1985

Rehabilitation outcome following spinal cord injury.

The rehabilitation outcome of 100 consecutive patients with a recent spinal cord injury was reviewed. On admission, 80% were predicted to become functionally independent; 70% had achieved this goal at discharge. Factors relating to success or failure of the rehabilitation effort were identified. Appropriate intervention to neutralized negative influences may increase the number of successfully rehabilitated patients who have spinal cord injuries.

Activities of Daily Living↗
PubMed1982

Autonomic hyperreflexia following passive stretching to the hip joint.

Autonomic hyperreflexia may occur in patients with severe upper thoracic and cervical spinal cord lesions. This syndrome, consisting of episodic hypertension, bradycardia, diaphoresis, and headaches, is an autonomic reflex evoked by a variety of stimuli applied below the level of injury. This article describes three cases in which autonomic hyperreflexia was provoked by passive hip joint stretching.

Adult↗
PubMed1979

Fatal basilar artery occlusion following cervical spine injury.

A patient rendered acutely quadriplegic in an automobile accident was shown by angiography to have occlusion of the left vertebral artery. One month later, he abruptly became unconscious, apneic and died. Autopsy showed an organised thrombus in the left vertebral artery and a fresh thrombus occluding the entire basilar artery. This case differs from previously reported cases of traumatic vertebral artery thrombosis wherein symptoms of brain stem infarction were more immediately evident.

Adult↗
PubMed1976

Dilute ethyl alcohol: effect on the sciatic nerve of the mouse.

The histological changes produced in peripheral nerve by topical ethyl alcohol have been infrequently studied in spite of widespread use of this neurotoxic agent in the management of pain and spasticity. In the present study the sciatic nerves of a series of albino mice were exposed to ethanol in concentrations of from 10% to 50% for from 15 to 60 seconds. An immediate physiochemical reaction took place, resulting in splitting of myelin sheaths and swelling of cellular organelles and cytoplasm. Nerves subsequently underwent Wallerian degeneration. A central core of fibers appeared to be normal. The longer exposure times or higher alcohol concentrations increased the extent to which the peripheral rim of altered tissue extended centrally into the nerve. Within altered tissue, all fiber types and sizes were found to be affected to an equal degree. To study the physical properties of alcohol in solution, absolute alcohol was slowly placed at the bottom of a cylinder filled with artificial or normal human spinal fluid and sequential levels of the solution were sampled 30 and 60 seconds after injection. Though hypobaric, alcohol dispersed rapidly so that specimens taken from the bottom of the cylinder were 65% as concentrated as specimens taken from the surface.

Animals↗
PubMed1975

Asymptomatic destruction of the fornix in man.

In the five previous reports dealing with the effects of interruption of the formix in man, two noted that a severe disturbance of recent memory resulted, and three indicated that no symptoms were evident. The brain was examined in only one of the cases cited. This report describes a patient, without any apparent neurological or psychological disturbances, in whom a malignant tumor had destroyed the formix bilaterally.

Adenocarcinoma↗