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Biomedical subjects

D Crockett

Publications and source records attributed to D Crockett.

At least 19 recordsLinked to original sources
PubMed1996

Cervical thymic cyst: case reports and review of the literature.

Due to its rarity, cervical thymic cyst is seldom included in the differential diagnosis of a neck mass. Approximately 80 cases have been reported thus far, and most of these cases have occurred asymptomatically in children and adults. Only 5 cases have involved patients younger than 1 year of age. The authors report four new patients with thymic cyst in the neck. Two of the patients were newborns in whom the cyst caused airway obstruction and dysphagia. All four patients underwent successful resection of the lesions, with complete resolution of symptoms. The embryology, histopathology, and differential diagnosis of cervical thymic cysts are also reviewed. The authors recommend that despite its infrequent occurrence cervical thymic cyst should be considered in the evaluation of neck masses in children.

Child, Preschool↗
PubMed1996

False aneurysm of the thyrocervical trunk.

False aneurysm of the thyrocervical trunk as a complication of central venous catheterization is rare. We report a case of this complication in a 63-year-old white man and review the history, diagnosis, pathophysiology, and treatment of these aneurysms.

Aneurysm, False↗
PubMed1994

Risk of respiratory failure after repair of thoracoabdominal aortic aneurysms.

BACKGROUND: Multiple complications occur after repair of a thoracoabdominal aortic aneurysm, the most common of which is respiratory failure. METHODS: One hundred consecutive thoracoabdominal aneurysm repairs were studied retrospectively using univariate, bivariate, and multiple logarithmic regression analyses to identify factors associated with respiratory failure. RESULTS: The mean of days of intubation was 5.8 +/- 0.8 (mean +/- SEM), with a median of 2 days. Patients who developed respiratory failure (21%) had a 42% mortality compared with a 6% mortality in patients who did not develop respiratory failure (P < 0.001). Statistical analysis demonstrated a significant (P < 0.01) age difference between those with respiratory failure (71.9 +/- 1.6 years) and those without (65.5 +/- 1.3 years). Type II aneurysms occurred in 32% of patients, a 3.2-fold increase in relative risk compared with all other types of aneurysm. Seventy-nine percent of patients had a significant smoking history. Low forced vital capacity and forced expiratory volume were both significant variables in predicting respiratory failure, but neither chronic obstructive pulmonary disease nor emphysema was a predictive variable. Intraoperative blood transfusion (mean 10.5 +/- 0.8 units) was associated with respiratory failure (P = 0.05). Postoperative complications associated with respiratory failure were creatinine elevation and pneumonia. CONCLUSION: We conclude that the independent variables affecting respiratory failure after thoracoabdominal aneurysm repair are age, type of aneurysm, excessive intraoperative blood transfusions, creatinine elevation, and postoperative pneumonia.

Age Factors↗
PubMed1992

A comparison of the matching of emotional information by depressive and organic patients.

The ability to match complex emotional stimuli was assessed in depressed and organic neuropsychiatric patients. Subjects were 13 nonorganic-depressed, 13 organic-depressed, 10 organic-nondepressed, and 10 nonorganic-nondepressed right-handed adults. They were required to match pictures, sentences, and faces on the basis of emotional content in order to determine whether depression resulted in difficulties in analyzing emotional information consistent with those seen in organic patients. Depression produced an error pattern for the matching of complex emotional information that was suggestive of right hemisphere dysfunction. It was unclear if this was due to emotional processing defects or a more generalized deficit in conceptual processes.

Journal Article↗
PubMed1990

18Fluorodeoxyglucose positron emission tomography studies in presumed Alzheimer cases, including 13 serial scans.

Positron emission tomographic (PET) data on local cerebral metabolic rates for glucose (LCMR) are reported for 32 regions of interest (ROI)s in cross-sectional studies on 57 patients with clinically diagnosed Alzheimer's disease (AD) and 20 neurologically normal controls, and in serial studies on 13 of the AD cases, including a familial, young-onset case where the diagnosis has been confirmed at autopsy. Extensive psychological testing was done on all the AD cases. Almost all cortical regions showed a significant decline in LCMR with age in the control subjects. There were the expected cortical metabolic deficits in AD and the serial studies showed a general increase in such deficits over time in 12 of the 13 cases. The regions showing the greatest declines with time in serial studies are the same as those showing the most severe deficiencies in cross-sectional studies. The young-onset case did not show a greater rate of metabolic decline than many of the older cases studied. Results on individual psychological tests tended to correlate with metabolic rates in multiple, rather than single, cortical regions, suggesting intact neuronal networks are required for good performance. The correlations with cortical metabolic activity found were of a sign indicating that the higher the metabolic rates and the better the left:right asymmetry index, the better was the performance.

Aged↗
PubMed1989

Cued recall and memory disorders in dementia.

Memory functioning of normal elderly subjects and patients with suspected malignant memory disorders were examined using a cued recall memory assessment procedure. Levels of psychosocial functioning were rated by a multidisciplinary team. Ability to engage in free and cued recall was studied to determine the relationship between problems of acquisition and retrieval. Normal and impaired elderly showed strong differences on free recall and total recall resulting in 90.58% and 79.06% rates of accuracy of prediction of group membership. There were significant multivariate and univariate differences among the memory-impaired groups defined in terms of their psychosocial functioning. These findings indicate that differences in acquisition and retrieval are associated with increasing impairment of psychosocial functioning. Patients whose psychosocial functioning was rated as falling within the questionable range exhibited only deficits in retrieval. Patients whose psychosocial functioning was rated as more severely impaired, exhibited problems of retrieval and acquisition.

Aged↗
PubMed1988

Neuropsychological performance in psychiatric patients with or without documented brain dysfunction.

The current study examined neuropsychological performance of schizophrenic and depressed patients with and without structural or EEG signs of brain dysfunctioning. The neuropsychological test battery was designed to sample intellectual functioning, psychomotor skills, nonverbal memory, and novel problem solving ability. Patients were classified into four groups: schizophrenics without signs of brain dysfunctioning, schizophrenics with signs of brain dysfunctioning, depressed without signs of brain dysfunctioning, and depressed with signs of brain dysfunctioning. The Trail Making Test--Parts A & B, the difference between these two components of the Trail Making Test, the World Fluency Test and a Laterality Index based on the age scale scores of the WAIS significantly discriminated between patients with and without brain dysfunction. Using these variables and a Linear Discriminant Function Analysis, we found that 84.5% of our subjects could be correctly classified. Substantially fewer patients could be correctly classified with respect to their psychiatric diagnosis (i.e., 66.7% correct classification). In fact, only the PIQ from the WAIS-R showed significant differences between the depressed and schizophrenic subjects. Poor neuropsychological performance was interpreted as showing more than the behavioral disorganization associated with psychiatric states and was felt to be related to the presence of objective signs of brain dysfunctioning.

Adolescent↗
PubMed1987

Central cholinergic deficiency WAIS profiles in a nondemented aged sample.

Fuld (1984) described a WAIS profile associated with drug-induced cholinergic deficiency in young adults and dementia of the Alzheimer's type. The frequency of occurrence of this profile was examined in a group of healthy elderly persons who were administered the WAIS. The results of this study suggest that the profile occurs rarely in independently functioning elderly persons, thus lending support to Fuld's findings that the profile may be relatively specific to dementia of the Alzheimer's type. Hypotheses as to the significance of this index of pathology are discussed.

Aged↗
PubMed1986

Clinical utility of three measures of frontal lobe dysfunction in neuropsychiatric samples.

The utility of the Word Fluency Test, Wisconsin Card-Sorting Test, and a shorter form of the Categories Test as screening instruments for detecting frontal lobe dysfunction in a neuropsychiatric setting was examined. On the basis of clinical and neurological examination, patients were assigned to one of three groups: frontal lobe injured, brain impaired excluding the frontal areas, and psychiatric with no evidence of brain dysfunctioning. It was possible to assign correctly 66.3% of the patients to their respective groups. The Word Fluency Test made the strongest contribution to the prediction of the presence of frontal lobe pathology, even when the effects of age and postmorbid intellectual functioning were controlled. The results were consistent with the interpretation of lowered verbal fluency and deficits in the capacity to suppress habitual behaviour as a major feature of frontal lobe dysfunctioning.

Brain Damage, Chronic↗
PubMed1984

Bringing the feet in from the cold: thermal biofeedback training of foot-warming in Raynaud's syndrome.

The biofeedback-assisted treatment of a case of Raynaud's syndrome was examined in order to determine the relationship between learning of the hand-warming response and the subsequent ability to produce foot-warming responses. It was found that fluctuations in dermal hand and foot temperatures were not significantly related, either within or across treatment sessions. The obtained hand-warming response was of high magnitude and rapidly learned, while the foot-warming response was more modest and took substantially more trials to learn. These results indicate that an easy generalization of the hand-warming response cannot be assumed.

Adult↗
PubMed1983

Cluster analysis of the WAIS on brain-damaged patients.

In recognition of increased usage of cluster analytic techniques, the current study attempted to examine sampling bounds for tests and subjects on one cluster-analytic procedure. Specifically, the WAIS subtest scores from a heterogeneous group of subjects with CNS involvement were first, factor analyzed and then clustered by means of Ward's hierarchical procedure. This methodology had been previously applied to two different samples of aphasics and aphasia batteries. In both these aphasic studies, an underlying severity dimension of language dysfunction was found. In contrast, in the current study, salient feature groups were found. Moreover, these groups were distributed in a sequential or hierarchical model in terms of specific cognitive deficits. From these data, it is argued that two major parameters in determining the resulting cluster structures are the homogeneity/heterogeneity of the sample and test battery employed. Although such a statement is obvious, the theoretical ramifications are large, in that the cluster structure may be a function of test weighting or sample diversity, not the phenomenon of interest. However, the cluster structures found in the current study were consistent with historical models of cognitive dysfunction and also lend support to hierarchical models of sequential cognitive impairment. These findings are discussed in terms of their clinical and experimental ramifications with respect to grouping subjects in terms of WAIS profiles.

Adult↗
PubMed1982

Shortening the Speech Sounds Perception Test.

Statistical means of shortening the Speech Sounds Perception Test were examined. Stepwise multiple regression analyses indicated that a 30-item version correlated quite highly with the 60-item version. Group means for representative clinical groups were presented, but no strong differences emerged using either version. Inclusion of length of stay and number of previous admissions as covariates did little to enhance the predictive validity of either form. Finally, the correlation of the 30-item test with demographic variables showed that age correlated most, followed by occupational status. these results were interpreted as indicating that the 30-item version could be used while maintaining the clinical utility of this test.

Adult↗
PubMed1981

Severity of impairment or specific types of aphasia: an empirical investigation.

This study examined empirical means of clustering aphasic patients into relatively homogenous and identifiable groups. The method included: (1) examining the intercorrelations of the subtests of the Neurosensory Comprehensive Examination for Aphasia by the means of factor analysis; (2) allowing the subjects to group themselves in homogenous subgroups by means of hierarchical cluster analysis; and (3) comparing the profiles of these groups on the derived dimensions. Four factors accounting for 79.3% of their total test variance were derived which reflected attention/memory; reading ability; verbal-naming ability; and elementary writing skills. With five groups the hierarchical grouping analysis indicated that only 21.5% of the total variability could be ascribed to within group variability. An analysis of variance of the four factor scores found that 66%, 93%, 81% and 79% of the between group variance of each of the respective factors was associated with group membership and the accuracy of membership prediction was 94.1%. Four groups appeared to be distributed on the basis of a severity model of impairment. One group representing 6.3% of the total sample demonstrated a pattern of specific impairment involving a mild level of impairment on attention/memory tasks, a moderate level of impairment on verbal naming tasks and writing skills, and a profound level of impairment on measures of reading skills. The high inter-factor correlations indicated the general nature of language functioning. The results were discussed in terms of the concept of aphasia as a general cognitive deficit.

Aphasia↗