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Biomedical subjects

S J Goodman

Publications and source records attributed to S J Goodman.

At least 37 records · Page 2Linked to original sources
PubMed1979

Dorsal spinal cord stimulation in the treatment of multiple sclerosis.

Previously published work indicated significant improvement in the symptoms of multiple sclerosis with dorsal spinal cord stimulation. In this study 23 patients with multiple sclerosis documented by history, examination, laboratory studies, and clinical course were treated with dorsal spinal cord stimulation and followed for 19 to 45 months (mean, 32 months). Pre- and postoperative clinical assessment was carried out using the Kurtzke Scale. Walking velocity, upper limb coordination, sphincter function, and sensory function were also evaluated quantitatively. No statistically significant objective improvement in any of these measures was demonstrated. Fifty per cent of the patients initially reported subjective symptomatic improvement, but this declined to 30% at last follow-up. Fifteen of 23 patients experienced complications related mainly to the hardware used and required a total of 21 subsequent operative procedures for correction of these complications. These results do not support the continued clinical use of dorsal spinal cord stimulation in the symptomatic treatment of multiple sclerosis.

Electric Stimulation Therapy↗
PubMed1977

Release of antidiuretic hormone during mass-induced elevation of intracranial pressure.

There are complex osmotic and non-osmotic factors regulating release of antidiuretic hormone (ADH). A wide variety of intracranial pathological processes may trigger ADH release sufficient to produce clinically recognizable hyponatremia, or the "inappropriate ADH syndrome." We systematically studied one non-osmotic trigger, namely mass-induced elevated intracranial pressure (ICP). Initial experiments established baseline data in normal rhesus monkeys: anesthetized animals displayed appropriate rises and falls in immunoreactive urinary ADH in response to intravenously administered hypertonic and hypotonic infusions. Next, ballon catherters were implanted subdurally over temporal lobes and the animals were allowed to recover. The final experiment consisted of anethetizing the animals, monitoring arterial blood pressure and blood gases, and retrieving timed urinary specimens while continuously recording ICP during infusion-pump expansion of the subdural ballon. A nonlethal and a lethal series of ballon-expansion experiments were done. Control values of urinary ADH were 783 +/- 125 muU/15 min, and ICP was less than 10 mm Hg. During nonlethal mass expansion ADH output rose of 3433 +/- 269 millimicronU/15 min while ICP averaged 65 mm Hg (measured at completion of mass expansion). While the mass was maintained, hypotonic infusion produced unchanged urinary ADH output of 3452 +/- 277 muU/15 min. During lethal experiments, urinary ADH rose still higher to 4339 +/- 1887 muU/15 min associated with ICP averaging 100 mm Hg. We concluded that there is a direct relationship between the magnitude of ICP and the amount of ADH release, and that during elevated ICP the ADH release is not suppressed by hypotonic infusion.

Animals↗
PubMed1977

The craniotubular bone modeling disorders: a neurosurgical introduction to rare skeletal dysplasias with cranial nerve compression.

The craniotubular bone modeling disorders are a group of skeletal dysplasias which involve predominantly the skull and long bones. The cranial involvement includes both external facial deformities and internal bony overgrowth about the cranial foramina and fissures. The latter commonly leads to cranial nerve compression, particularly of the optic nerve. Craniotomy and cranial nerve decompression can give substantial benefit to selected patients with these diseases but the severe bony abnormalities create technical problems which prevent surgery in some extreme cases. These disorders are genetically determined but the basic pathophysiologic mechanism has been delineated for only a few types and non-surgical treatment remains supportive.

Bone Diseases, Developmental↗
PubMed1976

Neurologic complications of gas myelography by the lumbar route.

Gas myelography is not a new technique, but its acceptance in neuroradiologic diagnosis has been relatively recent. Previously reported series have emphasized the benign nature of this technique and the lack of significant accompanying complications. From a series of 174 gas myelograms performed during a four-year period, two reports are presented wherein transient exacerbation of neurologic deficit followed exchange of cerebrospinal fluid and gas under pressure by the lumbar route. One patient with cervical spondylotic myelopathy experienced an increase in paresis, while another was found to have marked fasciculations. Speculation regarding possible mechanisms involved with these complications is presented. It is suggested that exchange of cerebrospinal fluid and gas under pressure via the lumbar route be used with caution in those patients with compromised cervical spinal cords.

Female↗
PubMed1976

Validity of the 24-hr. recall. Analysis of data obtained from elderly subjects.

Tests of the validity of the 24-hr. dietary recall were done by comparing actual with recalled intakes for eight nutrients and the MAR (mean adequacy ratio) for a sample of seventy-six subjects age sixty years or older. Validity was tested by using paired-t tests and regression analysis. In the paired-t test, no significant difference was found between the mean recalled and the mean actual intake of nutrients, with the exception of calories. Using regression analysis, results indicated that for three of the eight nutrients considered (calories, protein, and vitamin A), small intakes tend to be over-reported and large intakes under-reported (p less than .05). Thus, for these three nutrients, the recall seems to be statistically conservative for group comparisons; it would seldom, if ever, indicate a difference in intake where no difference exists. But, it could yield a false negative, i.e., an indication of no significant difference, when, in fact, a difference does exist. Clearly, more research is needed, both to replicate this study and to develop techniques with greater internal validity for comparing the dietary intakes of groups.

Aged↗
PubMed1975

Large optic nerve glioma with normal vision.

When the diagnosis of optic glioma is made, the visual loss is most often mildly or profoundly impaired. We report the details of the unusual situation where central visual acuity, visual fields, and color vision were normal at the time a large optic nerve glioma was demonstrated in a young boy. To our knowledge, this is the first case report containing ophthalmologic, neuroradiologic, surgical, and histologic details illustrating the rare association of normal vision and an optic glioma.

Child↗
PubMed1975

Cervical spine injuries in infants. Problems in management.

The authors point out the unique anatomical and therapeutic considerations involved in injuries of the cervical spine and cord in infants. The special problems encountered in the treatment of such patients are illustrated by three cases, a "Hangman's" fracture, a C6-7 fracture-dislocation, and an acute quadriparesis associated with dysgenesis of the posterior elements of C1-3.

Accidents↗
PubMed1975

Combined subarachnoid and subdural spinal hematoma following spinal puncture.

A case of combined subarachnoid and subdural spinal hematomas secondary to lumbar puncture during myelography is described. Contributing factors to this particular syndrome are discussed and the separate clinical syndromes of epidural and subarachnoid spinal hematomas are described. The incidence of all spinal hematomas appears to be increasing, due to the combined factors of spinal trauma and anticoagulant therapy. Spinal hematomas typically present with severe and localized back pain, rapidly progressive myelopathy and a poor prognosis for functional recovery unless immediate decompression is performed.

Female↗