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Biomedical subjects

E J Fine

Publications and source records attributed to E J Fine.

At least 37 records · Page 2Linked to original sources
PubMed1994

The importance of Spratling.

William P. Spratling made important contributions to American epileptology at the beginning of this century. He was the first medical superintendent of Craig Colony for Epileptics from 1893 to 1908, cofounder and president of the National Association for the Study of Epilepsy, and first editor of its scholarly journal, Transactions. During his tenure at Craig Colony, Spratling established standards for safe and humane public care of epileptics. He started the first American residency training program emphasizing epileptology. Spratling conducted the first American multicenter research on the causes of death in epilepsy. The dosage of bromide therapy, which he empirically determined, remains correct. In his book Epilepsy and Its Treatment, Spratling substantiated the cortical origin theory of epilepsy developed by Jackson and Gowers. He was the first American to postulate and investigate a biochemical etiology of generalized seizures in the absence of anatomic lesions. Despite signal accomplishments, his untimely, tragic death may explain why he remains obscure.

Epilepsy↗
PubMed1993

William P. Letchworth: philanthropist and pioneer epileptologist.

Although neither a physician nor a scientist, William Pryor Letchworth significantly improved the care and treatment of epileptics at the beginning of this century. As commissioner of the New York State Board of Charities and later president, he established Craig Colony, America's first comprehensive epilepsy facility. In Care and Treatment of Epileptics, he summarized contemporary medical and social knowledge of epilepsy. As cofounder and president of the National Association for the Study of Epilepsy, he introduced from Europe his improvements of the colony plan of construction and financed Transactions, the society's scholarly journal. He combined a sensitivity to the needs of the unfortunate with the resolve of a successful businessman. Although William Pryor Letchworth is remembered for his philanthropy and the park in western New York that bears his name, his signal contributions to modern concepts of epilepsy are unknown to most physicians. This article will acquaint readers with the life and accomplishments of this philanthropist and pioneer epileptologist.

Epilepsy↗
PubMed1992

Nuclear medicine evaluation of hypertension.

Noninvasive diagnosis of renovascular hypertension using nuclear medicine techniques has evolved in the past 30 years through improvements in imaging equipment, radiotracers, and, most recently, captopril intervention. Characteristic patterns of normal and abnormal renograms using typical radiotracers are demonstrated, including renal artery stenosis. Comparison with other tests, both invasive and noninvasive, are made with the aim toward identifying anatomic as well as physiologic definitions of renovascular hypertension. Pitfalls in the methodology are also described. The main advantage of captopril renography is enhancement of the sensitivity, and particularly the specificity, of the radionuclide diagnosis of renovascular hypertension. Available investigations have identified captopril renography as the likely procedure of choice in the noninvasive identification of renovascular hypertension.

Captopril↗
PubMed1992

Early studies on the biological effects of high-intensity magnetic fields.

In 1892, Frederick Peterson described the experiences of humans exposed to magnetic fields of strength comparable to those currently used in magnetic resonance imaging. These investigations were conducted in the Edison Laboratory. None of the subjects exposed to constant and to time-variable magnetic fields suffered any ill effects. Peterson concluded that the human organism was in no way appreciably affected by the most powerful magnets known to nineteenth-century science. Peterson can be credited with the first truly scientific assessment of the biological effects of high-intensity magnetic fields. His experiments on humans, done one century ago with great cogency and skill, provide a source of inspiration to modern studies on magnetic resonance imaging.

Diagnostic Imaging↗
PubMed1991

Interventions in renal scintigraphy.

Physiological and pharmacological intervention for the purpose of determining organ functional reserve is a familiar concept in medical testing and in nuclear medicine. Nephrourologic applications include established procedures such as diuretic scintigraphy for determination of urinary outflow obstruction and captopril scintigraphy for determination of renovascular hypertension. Subtle renal dysfunction may exist among some individuals with essential hypertension, induced by provocative exercise renography, and not observed at rest. The strength of nuclear medicine resides in its ability to assess disorders of organ function for the diagnostic, prognostic, or pathophysiological information provided. Nephrourologic interventions are reviewed with an emphasis on the functional changes caused by the intervention.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1991

The Einstein/Cornell collaborative protocol to assess efficacy and methodology in captopril scintirenography. Early results in patients with essential hypertension. Report of the Einstein/Cornell Collaborative Hypertension Group.

We have established an ongoing prospective investigation of hypertensive patients to examine the rates of false results in captopril scintirenography. This study is being conducted at the Albert Einstein College of Medicine and the Cornell University Medical Center. Two large populations will allow an accurate assessment of both false positive and false negative results. We report here the results from the first 30 patients, results which will be useful in defining the bounds for future studies.

Adult↗
PubMed1991

Myths about vitamin B12 deficiency.

Neurologic manifestations of vitamin B12 deficiency are protean, including neuropathy, depression, and dementia. We present evidence to dispel confounding myths about vitamin B12 deficiency. Hematologic indices are normal in up to 30% of patients with vitamin B12 deficiency, and results of the Schilling test may be normal in patients with symptoms of deficiency. Isolated neuropathy or myelopathy may occur independently, but often appear concurrently. The neuropathy is primarily axonal and predominantly sensory. Myelopathy is caused by demyelinated areas in posterior and lateral columns. After therapy, recovery from neuropathy is incomplete or may extend for several years. Vitamin B12 replacement should not be withheld from patients with borderline vitamin B12 levels, since the consequences of allowing myelopathy, neuropathy, dementia, and mental disorders to worsen clearly outweigh any disadvantage of therapy.

Adult↗
PubMed1990

Tremor studies in 1886 through 1889.

From biblical times to 1886, tremors were partially characterized by patterns of activation and associated disease states. William Richard Gowers and Frederick Peterson devised methods to determine the frequencies of the tremors of Parkinson's disease, alcoholism, hysteria, and other diseases. Their values concur closely with the contemporary ranges of 4.0 to 7.0 Hz in Parkinson's disease and 8.1 to 11.0 Hz in chronic alcoholism. This review properly credits these authors' pioneer investigations made with simple instruments a century ago.

England↗
PubMed1990

The neurophysiological profile of vitamin B12 deficiency.

Reports of the incidence and severity of physiological abnormalities of vitamin B12 deficiency sharply differ. To resolve these controversies we performed evoked response and nerve conduction studies in 10 males with vitamin B12 deficiency. The minimum criteria for this diagnosis were diminished position and vibration sensation and vitamin B12 levels less than 220 pg/ml. We found normal BAERs in 9/10 patients. The central interpeak latencies of the median and peroneal SERs were abnormal in 4/10 and 8/8 patients, respectively. The VERs were abnormal in 7/10 patients. We found absent or diminished amplitudes of sural sensory and peroneal motor action potentials in 8/10 patients. Abnormal peroneal F response chronodispersion was present in 7/10 patients. Nerve conduction velocities (NCV) were normal in 9/10 patients. EMG demonstrated abnormalities consistent with denervation in lower extremity muscles in 8/10 patients. These studies present a profile of vitamin B12 deficiency: essentially normal BAERs, mildly abnormal VERs and median SERs, and markedly abnormal peroneal SERs. NCV studies are consistent with sensory-motor axonopathy.

Adult↗
PubMed1989

Differential diagnosis and management of renovascular hypertension through nuclear medicine techniques.

Identification of patients with renovascular hypertension (RVH) among the larger group of patients with essential hypertension has been aided by a wide variety of in vitro and in vivo nuclear medicine procedures. The most valuable in vitro procedure remains the radioimmunoassay (RIA) for renin activity obtained from individual renal vein catheterization studies. Lateralizing renin activity provides valuable prognostic information about the likelihood for surgical cure of RVH. Older in vivo procedures for the diagnosis of RVH included rectilinear scanning and probe renography, which suffered from poor resolution and specificity, respectively. These tests have been replaced by computer-interfaced gamma camera scintirenography using 131I- or 123I-labeled orthoiodohippurate (OIH), or scintiangiography using 99mTc-DTPA. False-positive (FP) results for RVH persist due to a wide variety of relatively common conditions that can cause asymmetric renal size and function, including outflow obstruction and parenchymal renal disease. Newer approaches promise to improve the specificity of nuclear medicine procedures for identification of RVH. In particular, the number of FP exams appears to improve when scintirenography is performed before and after the administration of oral angiotensin converting enzyme (ACE) inhibitors, using either 99mTc-DTPA or OIH. The incentive for improved diagnostic testing has increased with the availability of percutaneous transluminal angioplasty (PCTA) for treatment of renal artery stenosis (RAS). Follow up of PCTA with scintirenography is of great value in assessing its effect on renal function and in evaluating the subsequent clinical course of the patient.

Diagnosis, Differential↗
PubMed1988

Fraley's syndrome: case report and update on current diagnostic methods.

A 38-year-old woman presented with fever, right flank pain, and a clinical diagnosis of pyelonephritis. Work-up revealed the presence of a crossing arterial branch causing obstruction of the superior infundibulum of the right kidney, which is an uncommon cause of nephralgia and urinary infection initially described by Fraley in 1966. Intravenous urography, retrograde pyelography, and angiography remain the mainstay of diagnosis, much as in the initial descriptions of this entity. [131I]Hippuran imaging, with analysis of the upper and lower pole regions of interest, provides a simple yet powerful method of evaluating functional and excretory changes in the superior infundibulum, and has proved more efficacious than previously reported whole-kidney renograms. Renal scintigraphy represents a relatively noninvasive method of serial functional examination in this disorder. Ultrasound imaging, by monitoring upper-pole dilatation, may provide complementary morphologic information important for long-term follow-up.

Adult↗
PubMed1987

Parathyroid imaging: its current status and future role.

The management of autonomous (primary or tertiary) hyperparathyroidism is controversial for two important reasons: (1) Diagnosis of primary or tertiary hyperparathyroidism (as distinct from reactive or secondary hyperparathyroidism) has been revolutionized in the past 20 years as a result of routine inclusion of serum calcium concentration assays in serum multiautomated analysis, now obtained routinely for both hospitalized as well as ambulatory patients. The prevalence of primary hyperparathyroidism in the general population has appeared to rise as a consequence of this assay and the enhanced detection of this disease. This situation has confused the management of hyperparathyroidism since most patients now present with asymptomatic disease, and the need for surgical treatment is controversial in asymptomatic individuals. (2) Primary hyperparathyroidism usually is caused by hypersecretion of parathyroid hormone by an autonomously functioning parathyroid adenoma. In a small percentage of cases, multigland hyperplasia is present. In experienced hands, surgical removal of an adenoma within the thyroid bed cures the hyperparathyroidism 90% to 95% of the time, without performance of a preoperative procedure to localize the adenoma. Approximately 10% of parathyroid tissue is ectopic in location, however. Furthermore, approximately two thirds of "missed" adenomas are within the thyroid bed. Reexploration in the event of a failed operation therefore is not an uncommon occurrence. Parathyroid localization procedures clearly are indicated in patients with primary hyperparathyroidism who have evidence of persistent disease after a failed attempt at surgical cure. In patients first presenting with primary hyperparathyroidism, the need for a localization procedure is less clear, since surgery appears to be successful much of the time without it. Regardless of the nature of the above controversies, surgery for autonomous hyperparathyroidism continues, and localization procedures become more popular. Preoperative localization procedures such as angiography and venography with venous sampling for parathormone are cumbersome and invasive. Noninvasive tests to localize the parathyroid glands have emerged in the past 10 years, including dual tracer radionuclide scintigraphy with 201-thallous chloride and 99m-technetium pertechnetate, high-resolution computer tomography, and fine parts ultrasonography. Dual tracer scintigraphy with thallium and technetium is reported to have a localization sensitivity of 70%-90%. False-negative studies occur primarily in patients with small adenomatous or hyperplastic glands.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗