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Biomedical subjects

J DeLuca

Publications and source records attributed to J DeLuca.

At least 73 records · Page 4Linked to original sources
PubMed1992

Cognitive dysfunction after aneurysm of the anterior communicating artery.

The present study examined the nature of the amnestic syndrome following aneurysm of the anterior communicating artery (ACoA) in humans. Eleven ACoA and 13 subjects with intracranial hemorrhages (ICH) elsewhere in the brain were administered a battery of standard neuropsychological tests. The ACoA group performed significantly worse than the ICH controls on tests of delayed verbal memory and on the Wisconsin Card Sorting Test, despite significantly higher Full Scale IQ. No significant differences were observed between groups on tests of immediate recall, attention and concentration, and visuo-spatial functions, although the ACoA group tended to perform better on many of these tests. The results do not support the hypothesis that the cognitive impairments observed following ACoA aneurysm are the result of diffuse cortical damage. The role of specific anterior cerebral structures in defining the "ACOA syndrome" are discussed.

Adult↗
PubMed1992

Clinicopathologic study of lacrimal sac and nasal mucosa in 44 patients with complete acquired nasolacrimal duct obstruction.

We studied 44 patients who had dacryocystorhinostomy for primary acquired complete nasolacrimal duct obstruction. The lacrimal sac and nasal mucosa adjacent to the osteotomy were examined histologically. The lacrimal sac had chronic inflammatory changes in 33 of 37 patients with varying degrees of fibrosis in 34 of 37. Focal ulceration of the lacrimal sac epithelium was present in 15 cases. Goblet cells, present in 11 specimens, were not identified in 26 specimens. Moderate or severe chronic inflammation was found in 14 of 44 nasal mucosal specimens and marked fibrosis in 22. The pathology of the lacrimal sac and nasal mucosa is similar to that of the nasolacrimal duct in complete nasolacrimal duct obstruction. The nasal inflammation may have resulted from dacryocystitis or alternatively contributed to the dacryocystitis.

Adolescent↗
PubMed1992

Management of traumatic optic neuropathy--a study of 23 patients.

Twenty three patients with traumatic optic neuropathy were managed by medical and surgical treatment as follows. High dose intravenous steroids were initiated in all patients. If visions did not improve significantly after 24 to 48 hours decompression of an optic nerve sheath haematoma by medial orbitotomy and neurosurgical decompression of the optic canal were considered based on computed tomographic scan findings. Nine of 16 patients who received steroids only showed significant improvement. One of three showed improvement on optic nerve decompression after steroid failure; three or four showed improvement on optic nerve decompression after steroid failure; three or four showed improvement with combined optic nerve sheath decompression by the medial orbitotomy and decompression of the optic canal by frontal craniotomy. A lucid interval of vision after injury and an enlarged optic nerve sheath were associated with an improved prognosis. Five of the 23 patients had a lucid interval and all five had a final improved vision, while only five of 18 patients without a lucid interval improved. Similarly seven of the nine with an enlarged optic nerve sheath showed improvement while only three of 10 patients (three bilateral cases) who presented with no light perception improved with medical and surgical treatment. While a prospective controlled study of the management of traumatic optic neuropathy is necessary this preliminary study suggests that treatment of traumatic optic nerve sheath haematoma by optic nerve sheath decompression should be considered in selected patients.

Adolescent↗
PubMed1992

Sequelae of minor traumatic brain injury.

Minor traumatic brain injury is the most common type of traumatic encephalopathy, with approximately 290,000 to 325,000 new cases occurring each year. Recent research has suggested that both anatomic factors (acceleration-deceleration injury, contusions) and neurotransmitter factors (cholinergic systems) may contribute to the pathologic sequelae. Symptoms may be broadly categorized as physical, behavioral/affective, cognitive and integrative. Patients with mild brain injury may demonstrate significant attention and information-processing impairments in the absence of apparent neurologic problems. Most symptoms abate within the first few months, but a sizable subgroup of patients remain symptomatic up to one year or more. Evidence suggests that patients whose symptoms persist are not simply "neurotic." Rehabilitation efforts should focus on proper evaluation, reassurance, education, support and monitoring of progress.

Animals↗
PubMed1991

Monitoring rate of recovery to predict outcome in minimally responsive patients.

Existing methods of assessing neurobehavioral responsiveness in severely brain-injured patients are limited by their inability to recognize subtle clinical changes over time. This study evaluates the Coma Recovery Scale (CRS), developed for use during acute rehabilitation. The CRS was designed to detect subtle changes in neurobehavioral status and to predict outcome in patients with sever alterations of consciousness. Acceptable levels of concurrent validity were established with the Disability Rating Scale ([DRS], r = -.93) and the Glasgow Coma Scale ([GCS], r = .90). The CRS was also found to have adequate interrater reliability (kappa = .83). Twenty-eight minimally responsive patients, unable to communicate or follow commands reliably, were evaluated on the CRS, the DRS, and the GCS. Although initial scores on all three scales were significantly correlated with outcome at discharge, change scores were more predictive of outcome. In addition, CRS change scores correlated higher with outcome (r = -.78, p less than .01) than DRS and GCS change scores. These findings indicate that the CRS is a sensitive measure of neurobehavioral responsiveness and suggest that rate of change during acute rehabilitation may be an important outcome predictor.

Adolescent↗
PubMed1991

Confabulation following aneurysm of the anterior communicating artery.

Nine subjects with aneurysms of the anterior communicating artery (ACoA) and 17 subjects with other intracranial hemorrhages (ICH) were evaluated for confabulatory responses under two naturally occurring conditions: (1) when subjects were not oriented to person, place, month and year, (2) when subjects were fully oriented. Confabulation was observed in all 9 of ACoA patients both during disoriented and oriented periods. In contrast, 7/17 of the other ICH patients showed signs of confabulation while disoriented, whereas only one continued to display confabulatory tendencies while fully oriented. Confabulation was more severe in the ACoA group. These data suggest that the confabulation observed in the other ICH group may be secondary to an acute confusional state while the prolonged confabulation in ACoA patients may be a manifestation of a more primary cerebral disorder.

Adult↗
PubMed1991

Research in physical medicine and rehabilitation. XII. Measurement tools with application to brain injury.

There are basic principles and techniques of measurement that are relevant across biomedical disciplines. The purpose of this article is to explain some of the most important of these for medical rehabilitation, to illustrate how to use them to choose assessment instruments and to describe the nature of measurement in medical rehabilitation by examples in brain injury rehabilitation. Reliability is basic to any scientific measure. Validity, the ultimate criterion, is closely associated with the purpose of the measure. Content validity, criterion validity and construct validity are explained. Sensitivity to rehabilitative interventions and significance in patients' real lives (ecological validity) are emphasized. Measures of functional outcomes (disability) may show improvement after rehabilitation even when impairment measures do not. An extensive but selected list of measures of coma, global status, disabilities, communicative and cognitive impairments, and handicaps is presented, and their main uses are illustrated. Examples illustrate how to choose measures to study comprehensive program-level outcomes, to study learning-based interventions and to develop a general purpose database. Although there are many measures of activities of daily living and mobility, little published evidence of reliability and validity could be found even for some well-known scales. Ecologically valid and sensitive outcome measures are especially needed. Studies of the clinical utility of measures were also scarce. Many of these gaps can be spanned by clinical researchers with limited resources. Physical medicine and rehabilitation will benefit from formal studies of the reliabilities and validities of both its old and its new measurement instruments and by increased sophistication in choice of measures.

Brain Injuries↗
PubMed1990

Asymmetries in hand movement during block design construction.

Changes in patterns of hand use were examined as a function of task demand characteristics. Using blocks, right- and left-handed male and female subjects were asked to simultaneously construct two replicas of presented patterns, one with each hand. With the presentation of visual-spatial patterns, a shift toward use of the left hand from baseline was observed. This change was least evident among right-handed females. The observed shift in hand use toward the left on a visuo-constructive block design task might suggest differential involvement of the right hemisphere with changes in task demand characteristics.

Adult↗
PubMed1990

Manual asymmetries during verbal and spatial block design construction.

To examine the effects of cognitive task demands on manual asymmetry, 40 male and 40 female college students were asked to simultaneously construct two replicas of a verbal or spatial block design task, one with each hand. In addition, a verbal and spatial competition task also was performed concurrently with each of the two primary tasks in a dual task paradigm. The spatial primary task elicited increased left-hand use relative to baseline performance, but only in males. An increase in right-hand use was observed during performance of the verbal primary task, again primarily among males. The effects of concurrent cognitive tasks on hand utilization were observed only in subjects performing the verbal primary task, and only when the concurrent task was verbal in nature. Implications for theories of functional cerebral lateralization are discussed.

Adult↗
PubMed1989

Genotypic influences on lead-induced hyperactivity in mice.

Male mice, genetically selected for differences in brain weight or from a heterogeneous (HET) stock, were used to explore potential interactions between genotype and exposure to lead as manifested in activity. At the time of birth dams and their pups were given either water or a 0.5% lead acetate solution as the sole source of fluid. Fluid conditions remained constant throughout the experiment. The effects of chronic lead on activity in young adult mice depended on the genotype of the individual. Specifically, in an open field, HET mice exposed to lead tended to be more active than their control counterparts. Low- and high-brain weight lead-exposed mice at times were hypoactive but this effect depended on the specific nature of the measure.

Animals↗
PubMed1983

Brain growth in young mice: evidence on the theory of phrenoblysis.

Brain growth was studied from day of birth through 23 days of age in three outbred and one inbred groups of mice. The results showed that the brain grows rapidly from Birth through 11 days and quite slowly thereafter. We found no evidence of the several spurts and plateaus in growth that are central to the theory of phrenoblysis (correlated brain and mind growth). Our results show the main features of mouse brain growth to parallel those of human brain growth except for timing of rapid and slow growth.

Aging↗
PubMed1982

Effect of brain growth stages on T-maze acquisition in mice.

Recently, it has been shown that brain growth is characterized by periods of especially large increases in growth, with "plateaus" in growth between these "spurt" periods. In humans, these spurts in brain growth are correlated with spurts in mind growth, collectively termed phrenoblysis. Brain growth spurts in rodents occur at 0-6, 8-12, and 17-23 days of age with plateaus in-between. We examined two questions. First, are there differences in learning ability associated with spurts and plateaus in brain growth? Second, can learning during these stages be altered through genetic and environmental manipulations? We employed the high and low lines of the Fuller brain weight selection mice, which are known to have different developmental patterns, and early handling procedures, known to alter growth rates. The results showed that animals tested during a proposed brain growth spurt were superior to animals tested during a brain growth plateau in learning a shock-escape T-maze.

Age Factors↗
PubMed1982

The effects of dietary fat and lead ingestion on blood lead levels in mice.

To examine the effects of dietary fat on the levels of lead in the blood, 34-40-d-old male mice were fed normal or high-fat diets along with distilled water for an initial 48-h exposure period. Following this session, subjects from each diet condition were administered either 0, 0.075, or 0.5% lead acetate through the drinking water during the next 48 h along with their respective diets. Atomic absorption was used to analyze blood-lead levels. At each concentration of lead, the high-fat diet increased the blood lead content over subjects fed the control diet. The highest blood lead levels were found in the 0.5% lead acetate, high-fat diet condition. The importance of nutritional considerations in understanding lead toxicity is discussed.

Animals↗
PubMed1976

Immune markers in adult acute leukemia.

Three cases of adult acute leukemia were examined for immunologic markers. Incubation of leukemic cells with anti-D (IgG)-coated erythrocytes was used for the identification of monocytes; sheep erythrocytes were employed for T-cells and fluorescein-conjugated anti-mixed immunoglobulins for B-cells. It was shown that IgG receptors (monocytes) were present on immature cells with predominant monocytic components; T- and B-cell markers were absent in the mono- and myelocytic leukemias.

Adult↗