"You guys are on the fringe--aren't you?".
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Biomedical subjects
Publications and source records attributed to J J Manning.
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This uncontrolled study evaluates the efficacy of a combined treatment of medications (for the majority of patients) and a closed group, intensive (two-week) cognitive-behaviour therapy programme for heterogeneous groups of psychiatric patients. Five hundred and thirty-one patients at a private psychiatric clinic were included in the study. Self-report measures of depression, anxiety, self-esteem and "locus of control" were administered before and after treatment and at intervals up to one year later. Statistically and clinically significant improvements were found in all measures and these improvements were maintained up to one year. The results provide support for the efficacy of the treatment.
Gastric concretions secondary to a drug overdose are uncommon but potentially fatal if not recognized and treated. They may continue to release drug into the stomach for hours or days after the ingestion, complicating diagnosis and treatment. We describe the case of a man with the previously unreported association of bowel infarction with a verapamil ingestion and concretion. This case illustrates the need for a heightened awareness of this potential complication.
Monosynaptic Hoffman reflexes (H reflexes) were recorded from the soleus muscle during the response latency of a warned reaction time (RT) task that required plantarflexion of the foot. The task was done under four conditions of predictability of the response signal (RS), created by the factorial combination of foreperiod duration (1 and 4 s) and variability (fixed and variable). RT varied systematically with RS predictability and was facilitated in conditions that favored prediction of the RS. The response latency was divided into two successive phases by the onset of reflex augmentation: a premotor phase of constant reflex amplitude and a succeeding motor phase marked by progressively increasing reflex amplitude. Reflex augmentation during the motor phase was coupled more closely to the imminent movement than to the preceding signal to respond. The duration of the premotor phase was unaffected by RS predictability, but the duration of the motor phase (like RT) was shorter when the RS was more predictable. The maximum H reflex amplitude reached during the motor phase was greater when the RS was more predictable. The tonic level of H reflex amplitude during the premotor phase was greater in conditions that made prediction of the RS difficult. A second experiment showed that this difference was present throughout the foreperiod. These results suggest that conditions that favor prediction of the RS enhance motor preparation. changes in motor preparation (which affect RT) affect the processes underlying reflex amplitudes in the premotor phase and throughout the preceding foreperiod, in conditions that make prediction of the RS difficult, appear to reflect heightened general arousal.
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The relative effectiveness of plain computed tomography (CT), metrizamide CT, conventional myelography, and magnetic resonance (MR) imaging was compared for the examination of cystic spinal cord lesions. Intramedullary cavities in 18 patients were demonstrated by MR imaging: cavities were uncomplicated in 13 patients, associated with spinal tumors in two, and studied after occipital craniectomy for treatment of Chiari malformation and syringomyelia in two. Cavities were shown by MR imaging in all enlarged spinal cords, but a cavity was shown in only one of four small cords. The rostral limits of the cavities were demonstrated better than were the caudal extensions. Ventricular communication was not demonstrated. Chiari malformation was shown only in cavities that did not involve the medulla. Syringes associated with tumor were indistinguishable from uncomplicated cavities, but the tumor had abnormal signal on long spin-echo sequences in two cases. Cystic cord tumor (one case) had an inhomogeneous appearance. Caudal displacement of the cerebellar hemisphere through the surgical defect associated with compression of the fourth ventricle was shown in two cases after posterior fossa craniectomy. Thirteen patients were studied with metrizamide CT also. MR imaging proved to be as accurate as metrizamide CT in the diagnosis of intramedullary cavities that result in spinal cord enlargement, but it was less sensitive in detecting cavities within normal-sized or diminished spinal cords. It had the advantage that tumor tissue could be distinguished from associated syrinx cavities by differences in signal characteristics; and cerebellar ectopia was evaluated easily on sagittal MR views.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Twenty-eight patients with 32 meningiomas were studied on a 0.5-T superconductive magnetic resonance (MR) imager. This common, benign treatable tumor was more clearly seen on computed tomography (CT) than MRI in 53% of cases. This is a result of poor contrast between the tumor and the adjacent brain on all spin-echo and inversion-recovery pulse sequences. Those sequences that provide the greatest anatomic detail were best for identifying this low-contrast lesion. Inversion-recovery scans in particular demonstrated the tumor as a discrete hypointense mass (relative to nearby white matter) with excellent visualization of the dural base and white matter buckling indicative of extracerebral mass effect. Other characteristic features include: a hypointense rim because of the venous capsule (66%); mottling due to hypervascularity; a well defined edema collar that demarcates the tumor from adjacent brain; and hyperostosis with thickening of the calvaria and obliteration of its normal landmarks. MRI did not demonstrate tumor calcification but did demonstrate vascular encasement, displacement, and occlusion better than CT and as well as digital venous angiography.