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Biomedical subjects

S J Myers

Publications and source records attributed to S J Myers.

12 recordsLinked to original sources

Spinal cord arteriovenous malformation in a person with congenital lymphatic abnormalities.

Spinal cord arteriovenous malformations have been described in association with a variety of congenital diseases affecting the vasculature, including Klippel-Trenaunay-Weber syndrome, Rendu-Osler-Weber syndrome and others, but rarely in association with lymphatic abnormalities. We report the case of a young man with congenital lymphedema and arteriovenous malformations of one lower extremity and a spinal cord arteriovenous malformation. Awareness of the possible presence of a central nervous system arteriovenous malformation in individuals with pre-existing arteriovenous and lymphatic abnormalities may be helpful in their diagnosis and management.

Abnormalities, Multiple

Dural spinal cord arteriovenous malformation.

After multiple hospital admissions and an inpatient rehabilitation stay, a 68-year-old woman was transferred to our rehabilitation facility with a paraparesis of unknown etiology. Previous studies included four CT scans and three MRIs which did not demonstrate the lesion. A myelogram was noncharacteristic. The correct diagnosis, confirmed by selective angiography, was ultimately contingent upon recognition of the clinical features and natural history of dural spinal cord arteriovenous malformations (SCAVM). The unusual combination of this multitude of nondiagnostic imaging studies in the uncommon dural SCAVM served to delay diagnosis and treatment. Such delay may have great functional consequences. This report illustrates the importance of suspecting SCAVM and recognizing its features. Emphasis is placed on the physiatrist's role in assuring proper diagnosis to expedite a timely treatment and to obtain the best functional outcome. A brief review of the classification, clinical features, pathophysiology, diagnosis, and prognosis of SCAVM is presented.

Aged

Molecular biology of mammalian amino acid receptors.

The amino acid receptor proteins are ubiquitous transducers of most excitatory and inhibitory synaptic transmission in the brain. In July 1987 two reports appeared describing the molecular cloning of a pair of subunits of the GABAA receptor (7) and one subunit of the glycine receptor (13). These papers sparked wide interest and led quickly to the concept of a ligand-gated receptor-ion channel superfamily that includes nicotinic acetylcholine receptors as well as certain amino acid receptors. The identification of additional subunits of each receptor followed; with the recent cloning of a kainate receptor subunit (14), only the NMDA receptor remains elusive. Several disciplines have been brought to bear on these receptor clones, including in situ hybridization and functional expression in Xenopus laevis oocytes and mammalian cell lines. In this review we compare cloning strategies that have been used for amino acid receptors and discuss structural similarities among the receptor subunits. Two findings that have arisen from molecular cloning and expression of these receptors receive special attention. First, the molecular heterogeneity of GABAA receptors is larger than expected from pharmacological studies of native receptors. Second, although the native receptors are thought to be heterooligomers, much like the model proposed for the nicotinic receptors, some individual amino acid receptor subunits can form functional receptor channels, presumably in a homomeric configuration. This review focuses, therefore, on what we have learned from cloning efforts about amino acid receptors and what might lie ahead in this field.

Amino Acid Sequence

Unlicensed midwifery practice in Washington state.

We examined the role of unlicensed midwives in Washington State by questioning mothers of infants born out-of-hospital with an unlicensed person in attendance. Only a small proportion of the state's births (0.11 percent) were attended by unlicensed midwives. Unlicensed midwives attended 7 percent of home births, licensed midwives and certified nurse-midwives attended 69 percent. Mothers chose unlicensed midwives because they had religious beliefs in common, or because they were the only providers available who would attend a home birth.

Adolescent

Past history and degree of depression in paraplegic individuals.

The purpose of this study was to attempt to collect sufficient data to substantiate the clinical impression that the degree of depression in the paraplegic and his past history are correlated. It was hypothesised that the poorer the past history, the greater the degree of depression in paraplegic individuals. This study was conducted on ten paraplegic subjects from the Spinal Cord Clinic at Columbia Presbyterian Medical Center, Department of Rehabilitation Medicine, based on data obtained from the administration and scoring of the Depression Scale (D-scale) of the Minnesota Multiphasic Personality Inventory (MMPI) and by the clinical observation by the consulting psychiatrist with the Spinal Injury Clinic. Past history was assumed measurable as 'favourable' to 'poor' by the use of an original questionnaire. The results of this investigation suggested a relationship between a paraplegic individual's past history and the degree of depression. The study was deemed significant in presentation of an original past history questionnaire and in the prediction of future difficulties in the rehabilitation of paraplegics so that preventive measures could be instituted.

Achievement

Paraplegia following trauma in a patient with kyphosis.

The reported incidence of paraplegia following acute spinal trauma in patients with kyphosis is very low. One such case is presented here and discussed. Although deterioration of spinal cord function in patients with kyphosis who have not sustained trauma is treated by surgical decompression and stabilization of the spine, a more conservative approach may be beneficial in those patients with a history of trauma. Thus, the treatment appears to follow that now recommended for acute spinal injuries in patients with a premorbidly normal spine.

Humans

Causalgia.

Causalgia is a distressing syndrome which should be diagnosed and treated promptly. A presumptive diagnosis can be made on the basis of the existence of burning pain, autonomic dysfunction and atrophic changes. Confirmation of diagnosis can be obtained by assessing the results of a sympathetic block. Some patients with causalgia may be mistaken for "hysterics" or "malingerers." Treatment may require physical and occupational therapy, analgesics, tranquilizers, sympathetic block or sympathectomy. The merits of adrenergic blocking agents, percutaneous electrical stimulation, dorsal column stimulation and acupuncture are still to be evaluated.

Adult

Effect of electronic cooking on fatty acids in meats.

This study was conducted to investigate the effects of microwave energy and conventional heating on the fatty acid composition of meats and poultry. Data on weight loss and cooking time with both heat treatments are reported. Gas-liquid chromatographic data of the methyl esters of myristic, palmitic, stearic, oleic, linoleic, and linolenic acids revealed no significant difference between fatty acid composition as a result of heat treatment. Decreases in fatty acids appeared to be mainly due to a change in oleic acid. Poultry appeared to be the species most affected by heat treatment. Cooking times were much shorter for the electronic method and varied among species. No significant difference was found in weight loss as a result of treatment of beef or pork. Poultry weight losses were greater for the conventional method.

Animals

Sensory conduction in peroneal and posterior tibial nerves using averaging techniques.

A method of obtaining pure sensory nerve conduction velocities in the lower extremities is described. This involves the use of electronic summation (signal averaging). Potentials were obtained and velocities calculated from all normal subjects examined. In patients with peripheral neuropathies it was often possible to obtain nerve velocities with signal amplitudes as low as 0·1 μV and these were often slower than those obtained from the normal subjects. The advantages and disadvantages of this method are discussed. It is of significant clinical value in that pure sensory nerve conduction velocities can be measured in the legs when this may be the only valuable parameter in the absence of motor involvement. In addition, investigation of neuropathies at an earlier stage of development and recovery may be facilitated. It is hoped that in the future this technique of obtaining low amplitude responses with an analogue averager can be incorporated with the more routine aspects of nerve conduction testing when clinically indicated.

Action Potentials