January 1996
Media Contact: John Cramer
Phone: (410) 955-1534

Listed below are story ideas from The Johns Hopkins Medical Institutions. To pursue any of these stories, call the contact person listed.

Hopkins Specialists Guide Naval Surgery Via Satellite

Four U.S. sailors have undergone successful operations aboard Navy ships testing a live satellite system in which Johns Hopkins specialists on land advise Navy general surgeons at sea.

The experimental "telemedicine" system, developed by Johns Hopkins Applied Physics Laboratory researchers, was used in four laparoscopic hernia repair surgeries this summer aboard the USS Abraham Lincoln aircraft carrier battle group. It now is being evaluated aboard the USS George Washington aircraft carrier group by Hopkins and Navy medical and engineering specialists.

The system, using off-the-shelf components, allows civilian and military physicians to interact live via a picture-and-voice connection for diagnosis and treatment. The system is designed to upgrade care, reduce costs and improve Navy readiness by reducing the number of medical evacuations. It may also be used to improve civilian medical care in isolated areas and Third World countries. B-roll of the system, including surgery, is available.

Time Factor Explored With Whiplashes

Researchers may be making progress against whiplash, a complex and often litigated syndrome involving physical and psychological factors.

A recent study in Medicine found that 82 percent of whiplash injuries disappear with little or no treatment within six months. Those patients reporting long-term pain generally were older, had more headaches and osteoarthritis before the accident and reported more neck pain immediately after the accident, according to the study.

While specific injuries cannot yet be identified in these patients, the study suggests that a careful physical exam, patient history and X-rays can predict who will have long-term problems, says Donlin Long, M.D., neurosurgery chairman at Johns Hopkins.

"It's important to remember this is a real condition," says Long. "But for the first six months, the only treatment needed may be simply making the patient comfortable to reduce pain and muscle spasm."

Muscle Exercises Found Beneficial In Multiple Sclerosis

Muscle-strengthening exercises may offer physical and psychological benefits to people with multiple sclerosis, according to two studies by researchers at Johns Hopkins and elsewhere.

Eight patients with mild to severe multiple sclerosis underwent 12 weeks of a weight-training program called progressive resistive exercise to strengthen their arms and legs. All the patients significantly improved their strength, mobility, walking speed, stair climbing and agility, and reported feeling better physically and psychologically after the training sessions, according to the pilot studies presented at a recent meeting of the Consortium of Multiple Sclerosis Centers.

"We concluded that progressive resistive exercise improves the performance of common daily activities in these people," says Barbara de Lateur, M.D., a study co-author and director of physical medicine and rehabilitation at Hopkins. "It has a positive impact on their psychosocial, physical and overall well-being, and the risks are minimal compared to the benefits."

The studies, led by the University of Washington and funded by the National Multiple Sclerosis Society, suggest that further research is warranted, says de Lateur. Multiple sclerosis is a disease that attacks the brain and spinal cord, causing incoordination, paralysis and other symptoms.For media inquiries, call John Cramer at (410) 955-1534.

Experienced Surgeons Credited In Laparoscopy

Another Johns Hopkins study suggests that patients fare better in the hands of more experienced surgeons, especially in complex operations. Laparoscopic surgery can safely repair hernias, but the risk of nerve damage may often be overlooked, according to results of the study, which included two case reports.

"Although it can shorten recovery time when done correctly, laparoscopic hernia repair may also pose some disadvantages over traditional hernia repair," says James Campbell, M.D., the study's senior author and director of Hopkins' Blaustein Pain Treatment Center.

In laparoscopic hernia repair, a prosthetic mesh patch is stapled over the site where the intestine has bulged into the groin through a weak area in the abdominal wall. But this technique may limit the surgeon's view of important nerves in the groin, increasing the risk of nerve damage, and make it harder for the surgeon to manipulate and repair damaged nerves, according to the study, which was recently published in Surgery.

The study evaluated two patients who had severe groin pain and other problems after undergoing laparoscopic hernia repairs at community hospitals. Hopkins surgeons removed the prosthetic patches and staples that had damaged nerves, and the patients improved. These injured nerves are difficult to recognize but may need early reoperation to avoid permanent damage, Campbell says.

"As laparoscopic hernia repair becomes more widely used, there is an increased possibility of problems involving misplaced staples and prosthetic patches," says Charles Yeo, M.D., a co-investigator and an associate professor of surgery. "It's important to remember that severe and constant pain is not normal."

-- JHMI --
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