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Biomedical subjects

H Grossman

Publications and source records attributed to H Grossman.

At least 19 recordsLinked to original sources
PubMed2006

Age, gender, and education norms on the CERAD neuropsychological battery in the oldest old.

OBJECTIVE: To evaluate the performance of nondemented subjects 85 years and older on the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery, and to assess its relationship with sociodemographic variables. METHODS: We studied 196 subjects enrolled in an Alzheimer's Disease Research Center study who had a complete CERAD neuropsychological assessment. We used multiple regression analysis to predict performance on the neuropsychological tests from age, education, and sex. Eight representative hypothetical individuals were created (for example, an 87-year-old man, with high education). For each test, estimates of performance at the 10th, 25th, 50th, and 75th percentiles were reported for the eight representative hypothetical individuals. RESULTS: Mean age was 89.2 years (SD = 3.2), mean years of education was 14.9 (SD = 3.2), and 66% of the sample were women. For 11 of the 14 neuropsychological tests, there was a significant multiple regression model using education, age, and sex as predictors. Neither the models nor the predictors used individually were significant for Delayed Recall, Savings, or correct Recognition. Among the significant results, seven had education as the strongest predictor. Lower age and higher education were associated with better performance. Women performed better than men in three of four tests with significant results for sex. CONCLUSIONS: In a sample of oldest old whose primary language is English, neuropsychological testing is influenced mainly by education and age. Cutoff scores based on younger populations and applied to the oldest old might lead to increased false-positive misclassifications.

Aged, 80 and over↗
PubMed1997

Early-onset substance abuse and community violence by outpatients with chronic mental illness.

OBJECTIVE: This study examined the relationship between violence and substance abuse among patients with chronic mental illness living in the community. METHODS: All referrals over a one-year period to an urban assertive community treatment team were evaluated systematically with a standardized intake protocol. Thirty-seven patients with a history of violence in the community were compared with 27 patients without such a history on a variety of clinical and demographic variables. RESULTS: More than half of the patients (58 percent) had a history of violence in the community. The only significant differences between those with a history of violence and those without involved alcohol or drug use. The single best predictor of violence was the onset of alcohol or drug abuse in late childhood or early adolescence. CONCLUSIONS: In this sample, very early onset of substance abuse among people who developed mental illness was associated with the greatest risk of community violence. Thus at least some of the causal determinants of violence in this sample may precede the onset of adult mental illness.

Activities of Daily Living↗
PubMed1996

Cognitive performance and regional brain volume in human immunodeficiency virus type 1 infection.

BACKGROUND: Brain atrophy has been reported to occur in advancing human immunodeficiency virus (HIV) infection, particularly in patients with HIV-related dementia. Atrophy of the caudate region, as assessed by magnetic resonance imaging measures, has been reported to correlate with cognitive impairment in patients with HIV infection; however, differences in the severity of HIV-induced immunosuppression may have contributed to these findings. OBJECTIVE: To determine the relationship between regional brain volumes and cognitive performance in individuals with HIV infection. PATIENTS AND METHODS: We evaluated 11 patients with advanced HIV disease by using neuropsychologic tests and quantitative magnetic resonance imaging volume analysis. SETTING: University hospital, involving patients from a clinical trial. RESULTS: Caudate volume, expressed as a ratio of total intracranial volume, correlated with performance on the Trails A and Grooved Pegboard tests, but not with other tests of memory, motor speed, or mood (adjusted for age and education). Hippocampal volume did not correlate with any of the neuropsychologic tests. CONCLUSIONS: Caudate volume in patients with advanced HIV disease is associated with poor performance on neuropsychologic tests of complex motor and sequencing skills. Hippocampal volume does not appear to be related to impairment on neuropsychologic tests. These findings are independent of the degree of immunosuppression and the overall extent of brain atrophy; however, these results must be interpreted with some caution, given the limited sample size.

Adult↗
PubMed1990

Liver preservation with UW solution. I. Evidence that hydroxyethyl starch is not essential.

Preservation of rat livers by simple ice-storage has been demonstrated after 24 hr using the University of Wisconsin (UW) solution. Equally good preservation could be obtained by substituting hydroxyethyl starch (HES) from another source or by omission of HES from the UW formulation. Survival, early and late function, and morphology at the end of a 3-month follow-up period were essentially similar for all three test groups. It is concluded that HES is not required for optimum preservation of the rat liver in this treatment model.

Adenosine↗
PubMed1989

Vertex epidural hematomas.

Four cases of vertex epidural hematomas are presented to illustrate the unique management problems which set them apart from their more common counterparts located over the temporal convexity. Diagnosis requires a high degree of suspicion as vertex epidural hematomas are often missed by conventional horizontal scanning. Coronal computed tomographic scanning should be undertaken in all suspected cases. Clinical symptoms exceeding the small volume of clot may be present due to venous obstruction and disruption of cerebrospinal fluid absorption. Evacuation of the clot usually leads to clinical improvement.

Adult↗
PubMed1989

The importance of the hepatic artery in rat liver transplantation.

The hepatic artery is important in preventing biliary ischemia and obstruction after bile duct reconstruction or orthotopic liver transplantation in the rat. A technique of orthotopic liver transplantation in the rat with reestablishment of the arterial inflow is described, suitable for studies in immunology and preservation. Reestablishment of both venous and arterial inflow is required to minimize biliary complications. General survival, hepatic cellular function, and biliary drainage are all improved by rearterialization. In all these features, the rat illustrates characteristics applicable to human liver transplantation. The vital requirement of the adequacy of blood supply to the bile duct in liver transplantation surgery in all species is highlighted by these findings, which indicate clearly the importance of an arterial blood supply in rat liver transplantation and bile duct surgery.

Animals↗
PubMed1989

Tardive dyskinesia: a five year follow-up.

A group of chronic schizophrenic patients receiving prolonged treatment with neuroleptics was assessed in 1978 at an outpatient clinic to determine the prevalence of Tardive Dyskinesia. Those with TD were reassessed after two and five years with regard to change in TD severity. The Smith scale was used every time and, on the last assessment, the AIMS scale and videotaped interviews were added. Because of the high attrition rate, results, though interesting, cannot be generalized.

Adult↗
PubMed1989

Preoperative embolization in the treatment of osseous metastases from renal cell carcinoma.

Metastatic lesions due to renal cell carcinoma are frequently hypervascular. This study reports the results of preoperative embolization of skeletal metastases from hypernephroma. Reported for the first time in the English literature is the use of this technique for preoperative devascularization of metastatic lesions to the spine in eight patients. Effective devascularization was achieved in all peripheral lesions. Blood loss for peripheral lesions averaged 940 cc and compared favorably to 20 nonembolized cases, in whom average blood loss was 1975 cc. Spinal embolization requires careful identification and preservation of any segmental arteries that supply the anterior spinal artery. Effective spinal devascularization was achieved in six of eight patients. In two patients significant bleeding occurred as a result of incomplete embolization. This series supports the growing evidence for the efficacy and safety of selective arterial embolization in the preoperative control of hemostasis in patients with metastatic hypernephroma. Embolization of spinal metastases, although technically demanding, has been effective in devascularizing these lesions without serious neurologic complications.

Bone Neoplasms↗
PubMed1988

Formation of double-walled microtubules and multilayered tubulin sheets by basic proteins.

Some basic proteins enable microtubule protein to form special assembly products in vitro, known as double-walled microtubules. Using histones (H1, core histones) as well as the human encephalitogenic protein to induce the formation of double-walled microtubules, we made the following electron microscopic observations: (1) Double-walled microtubules consist of an "inner" microtubule which is covered by electron-dense material, apparently formed from the basic protein, and by a second tubulin wall. (2) The tubulin of the second wall seems to be arranged as protofilaments, surrounding the inner microtubule in a helical or ring-like manner. (3) The surface of double-walled microtubules lacks the projections of microtubule-associated proteins, usually found on microtubules. (4) In the case of protofilament ribbons (incomplete microtubules), H1 binds exclusively to their convex sides that correspond to the surface of microtubules. Zn2+-induced tubulin sheets, consisting in contrast to microtubules of alternately arranged protofilaments, are covered by H1 on both surfaces. Furthermore, multilayered sheet aggregates appeared. The results indicate that the basic proteins used interact only with that protofilament side which represents the microtubule surface. In accordance with this general principle, models on the structure of double-walled microtubules and multilayered tubulin sheets were derived.

Animals↗
PubMed1988

Pathogenetic role of HIV infection in Kaposi's sarcoma of equatorial East Africa.

Thirty residents of north-central Tanzania with various forms of Kaposi's sarcoma (KS) were evaluated. The absolute number of peripheral blood OKT4 lymphocytes in patients and Tanzanian control subjects tended to be low (in comparison with healthy young American adults), and many had inverted T4/T8 ratios. Plasma polyclonal beta- and gamma-globulin concentrations were increased in many patients with KS and in control patients in Tanzania with chronic dermatopathies, but not in African hospital employees and patients undergoing elective surgery. Three of nine patients with locally aggressive KS possessed antibodies to human T-cell lymphotropic virus type III/lyphadenopathy-associated virus (HIV), but none had evidence of the acquired immunodeficiency syndrome (AIDS) or the AIDS-related complex. Three patients with disseminated, rapidly progressive KS and high HIV-antibody titers had an immunologic and clinical picture consistent with AIDS. Two of 13 patients with the classic plaque/nodular form of KS had low plasma titers of HIV antibody, but the significance of these serologic findings is not known. The evidence suggests that HIV plays a role in the pathogenesis of some cases of KS in East Africa, but most patients with KS in East Africa have no evidence of overt immunologic deficiency or HIV infection.

AIDS-Related Complex↗
PubMed1986

Imaging of neuroblastoma: an overview.

This review article briefly describes the pathology, clinical features, prognosis, and treatment of neuroblastoma. The emphasis is on applications of newer diagnostic modalities (sonography, nuclear scintigraphy, computed tomography) for imaging and staging. The potential role of magnetic resonance imaging and spectroscopy is discussed.

Abdominal Neoplasms↗
PubMed1986

Diagnostic imaging in pediatrics: the state of the art.

The results of the study panels, both at national and international levels, have shown that much can be done to increase the efficiency and efficacy of diagnostic imaging in all areas of medical practice including pediatrics. Much remains to be done, however. The work that has been done must be expanded into a thorough investigation of the safety, yield, and cost of diagnostic imaging. It is the responsibility of all physicians to continue efforts toward more rational use of diagnostic imaging at all levels of society and to make sure that established guidelines are implemented. Flexibility in attitudes, cooperation between clinician and radiologist, and a willingness to learn and keep up with advances are essential to this process--not only to improve the benefits from diagnostic imaging, but to preserve the ability of society to pay for it. Those who would proclaim that this or that recommendation is the "last word" must realize that half of what is said today may well be proven false 10 years from now, and, further that we have no way of knowing what techniques and imaging approaches will comprise that half, nor should the imaging "standards" be self-serving. Guidelines drawn up in an academic vacuum where all imaging techniques are readily available may have little practical application in pediatric practice and impact on health care in areas of the world where diagnostic imaging, if available at all, will consist only of basic radiographic imaging. At the same time, experience gained in countries using all advanced imaging modalities must be shared with less fortunate nations: such knowledge may have important implications for even the most basic radiographic studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1985

Acute median nerve compression by haemorrhage from acute myelomonocytic leukaemia.

A 61-year-old male receiving treatment for acute myelomonocytic leukaemia (AMML) developed weakness and sensory loss in the thumb, index and middle finger and half of the ring finger of the left hand as a result of a spontaneous haemorrhage into the carpal tunnel and forearm, an unusual cause of median nerve compression. These findings were confirmed by CT scanning and post-mortem examination. This is the first report of spontaneous haemorrhage occurring in a patient with AMML.

Acute Disease↗