Biomedical subjects
J S Grisolia
Publications and source records attributed to J S Grisolia.
Physicians and their patients' suicides.
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Postoperative thromboemboli in cystathionine beta-synthase deficiency.
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Cysticercosis update.
Already the most common brain parasite disease, cysticercosis has been increasingly seen throughout the American Southwest. Symptoms arise from infection with larvae of Taenia solium, the pork tapeworm. Seizures, hydrocephalus, focal deficits and chronic meningitis most commonly result. Cerebrospinal fluid eosinophilia, serology by indirect hemagglutination and computed tomography are helpful adjuncts to diagnosis. New evidence suggests that selective immunosuppression is important for the parasites' survival and that cyst death permits renewed host immunity, which may actually precipitate an acute neurologic presentation. New larvicides, including praziquantel, are being tested in humans; caution is indicated in assessing these drugs because of the acute worsening associated with cyst death. Conventional therapy includes anticonvulsants, steroids or ventricular drainage as needed. Prevention remains the best management. Person-to-person transmission within the United States has recently been documented and merits public health scrutiny.
Cysticercosis. An old scourge revisited.
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CNS cysticercosis.
Worldwide, cysticercosis is the most common CNS parasite. Because of immigration from endemic areas, cysticercosis has become more common in the United States. Seventeen cases have been seen at the University of California Medical Center, San Diego (La Jolla) over the last ten years. Eight patients had intracranial hypertension; three, seizures; three, intracranial hypertension; and seizures; two, strokes; and one, retinal involvement. Diagnosis was by surgical biopsy in five cases and by clinical setting plus positive serologic findings in 12. Twelve patients underwent surgical procedures during their illness, one patient died, and five improved with steroid therapy. Clinical, serologic, and pathologic criteria permit definitive diagnosis. Therapy is currently directed toward complications of the primary infection, which usually is inactive at the time of presentation.
Sherlock in the emergency room.
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Short latency somatosensory evoked potentials from radial, median and ulnar nerve stimulation in man.
Short latency somatosensory evoked potentials (SEPs) were elicited by stimulation at the wrist of median, radial, and ulnar nerves, singly or in combination, using normal subjects. Amplitude of P10 was strikingly lower with radial stimulation than with median stimulation, while ulnar-derived P10 was intermediate in amplitude. This difference probably reflects the antidromic firing of motor fibers contained in median nerves as compared with the superficial branch of radial nerve, which is entirely sensory. Beyond P10, there appear to be no significant differences between median, radial and ulnar-derived SEPs. With simultaneous stimulation of several nerves within one arm, larger potentials were sometimes achieved but with poorer definition of P12 and P14. The clinical utility of radial, ulnar, and median stimulation for localizing peripheral lesions derives from the distinct anatomical pathways of the stimulated fibers through the brachial plexus and from the separable motor and sensory components of P10. SEP is less invasive than EMG; this fact, plus its freedom from sampling error, make it potentially more suitable than conventional EMG for sequentially following a patient's clinical course.