Biomedical subjects
H R Tyler
Publications and source records attributed to H R Tyler.
Abnormalities in the sensory action potential in patients with amyotrophic lateral sclerosis.
Sensory function in patients with amyotrophic lateral sclerosis (ALS) is thought to be normal; however, there is convincing morphologic evidence that sensory systems are affected in addition to motor systems. In this study, compound sensory action potentials were recorded with near nerve electrodes from 18 patients with ALS. Up to 1024 responses were averaged at high gain to determine minimum conduction velocity; that is, the conduction velocity of the slowest conducting component of the sensory action potential. Nine of 18 patients had abnormally reduced minimum conduction velocity, even when peak-to-peak amplitude and maximum conduction velocity (calculated from the latency to the initial positive peak) were normal. Only 3 of 18 patients showed abnormalities in peak-to-peak amplitude. Thus, subtle abnormalities in the sensory action potential can be detected in many patients with ALS.
Kenneth McKenzie, Harvey Cushing, and the early neurosurgical treatment of spasmodic torticollis.
In 1923, Dr. Kenneth McKenzie trained at the Peter Bent Brigham Hospital under Dr. Harvey Cushing. At that time, a patient with spasmodic torticollis came to Cushing and was treated with an innovative operation for this disorder with good results. This case sparked an interest in Dr. McKenzie, who published the case 1 year later. In reviewing the surgical histories from the Peter Bent Brigham Hospital, we have found the original records of this well-documented case. The record includes postoperative drawings of the intraoperative field by Dr. Cushing, a sketch by Dr. McKenzie illustrating the postoperative sensory examination, and pre- and postoperative photographs of the patient.
Gilbert Horrax the complete surgeon: postoperative drawings.
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Acute aortic thrombosis causing sudden paraplegia in a patient with known thoraco-lumbar spinal metastasis: the diagnostic usefulness of magnetic resonance imaging.
Diagnosis and treatment of acute aortic thrombosis utilizing magnetic resonance imaging is reported. The patient had known thoracolumbar spinal metastases and sudden onset paraplegia. MRI critically shortened the time to emergent surgery and obviated the need for two invasive tests (myelogram and angiogram).
The secret life of James Parkinson (1755-1824): the writings of Old Hubert.
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Trials of ganglioside therapy for amyotrophic lateral sclerosis and diabetic neuropathy.
Double blind placebo controlled trials of dialy intramuscular injections of 40 mg of mixed gangliosides were carried out in ALS and diabetic neuropathy. Forty patients with ALS were treated for six months and monitored with tests of strength and pulmonary function. No effect of gangliosides was found. Forty patients with symptomatic diabetic neuropathy will be treated for three months. Some of the data from the first 25 patients to complete the study were analyzed in a preliminary fashion. While no difference in nerve conduction studies was found in the treated group compared to the control group, there was greater symptomatic improvement in the patients treated with gangliosides.
Ganglioside therapy for amyotrophic lateral sclerosis: a double-blind controlled trial.
A 6-month double-blind study of bovine brain gangliosides was carried out in 40 patients with ALS. Thirty-two patients completed the study; 18 were treated with gangliosides and 14 with placebo. Using 10 different objective tests of muscle strength, we failed to show a significant difference between the two groups in the progression of weakness. Daily intramuscular injections of 40 mg of brain gangliosides for 6 months had no beneficial effect in ALS.
Charles Edouard Brown-Séquard: professor of physiology and pathology of the nervous system at Harvard Medical School.
Brown-Séquard's career as Harvard's first professor of the physiology and pathology of the nervous system is chronicled in a unique and previously unpublished series of his private letters and university archival material. At Harvard, Brown-Séquard tried to modernize the curriculum by adding laboratory exercises and animal experiments in the teaching of physiology. He dreamed of constructing a great physiologic institute to study fundamental problems in neurology, including epilepsy, paralysis, muscular atrophy, nerve injuries, and a wide variety of other problems. His letters reveal Brown-Séquard as a disarmingly "modern" professor who avoided faculty meetings, complained constantly about lecture schedules, his salary, and the improper care of his animals--and threatened to resign regularly!
Nonfamilial amyotrophy with dementia or multisystem degeneration and other neurological disorders.
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Double-blind study of modified neurotoxin in motor neuron disease.
In a double-blind study, we evaluated the intramuscular administration of modified neurotoxin in 48 patients who were treated for 6 months. There was no evidence to support claims that patients receive any benefit from the neurotoxin. A significant number of patients had minor functional improvement, often of a transient nature, but these manifestations were more common in the placebo-treated patients than in those receiving neurotoxin. These variations in the course of motor neuron disease have not been stressed in the previous literature.
Is it a functional disorder or organic neurological disease?
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Respiratory muscle function in amyotrophic lateral sclerosis.
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Thalamic hemorrhage with speech disorder.
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Amyotrophic lateral sclerosis: a study of pulmonary function.
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Editorial: Neuropathy in uremic patients on dialysis.
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Atypical astrocytes and Rosenthal fibers in a case of amyotrophic lateral sclerosis associated with a cerebral glioblastoma multiforme.
A case of amyotrophic lateral sclerosis (ALS) and cerebral glioblastoma multiforme is presented in which bizarre astrocytes were found in the degenerating lateral corticospinal tracts, along with Rosenthal fibers, which were present in the corticospinal tracts of the lower medulla and spinal cord, and in anterior horns. These bizarre astrocytes did not result from direct infiltration of tumor from the cerebrum. "Malignant transformation" and/or an exceptionally intense glial response to the corticospinal tract degeneration are discussed as possibilities for the development of these bizarre astrocytes. Rosenthal fiber formation is described, to our knowledge, for the first time in ALS.