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Biomedical subjects

J S Haller

Publications and source records attributed to J S Haller.

At least 19 recordsLinked to original sources

Assessing short-term recognition memory with forced-choice psychophysical methods.

The rationale and methodology for using computer-controlled forced-choice psychophysical methods to assess short-term recognition memory in human subjects are presented. Here, we use non-verbal computer-synthesized auditory and visual stimuli with an adaptive psychophysical procedure. Sequence-length thresholds (SLTs, span lengths) for randomly generated binary auditory and visual-sequential patterns and simultaneous visual-spatial patterns are determined to assess short-term memory capacity. The SLTs can also be used to equate for initial retention level for delayed matching-to-sample (DMS) or delayed matching-to-non-sample (DMNS) tasks which assess memory decay. The DMS/DMNS tasks have also been modified for use with the forced-choice paradigm. In contrast to many verbal paradigms requiring immediate ordered recall, non-verbal stimuli in a forced-choice paradigm provide a more direct measure of sensory memory because long-term memory, complex encoding/decoding processes, and motor-sequencing factors are minimized or avoided. Furthermore, the forced-choice recognition memory tasks are applicable over a broad age range, are less sensitive to socio-economic factors and educational level, and avoid complex instructions. Taken together, these factors enhance the applicability of these tasks in children and adults with CNS lesions, particularly where cognitive status may be compromised.

Acoustic Stimulation

Intraspinal hematomas in hemophilia.

We report herein a case of a intraspinal hematoma in a 9-year-old boy with factor IX deficiency. Replacement of factor IX resulted in resolution of symptoms. The most frequent presentations of intraspinal hematomas are neck or back pain, paresis, sensory impairment, and urinary retention. Intraspinal hematomas may have devastating sequelae, including hemiplegia and quadriplegia. The occurrence or development of sequelae are related to the length of time between onset of symptoms and factor replacement. Whenever the physician suspects intraspinal hematoma, immediate replacement should be given to obtain levels of 80-100% prior to any imaging studies. Factor levels should be maintained at 30-50% for 10-14 days while the patient is monitored closely with serial neurological examinations. Most patients respond to factor replacement, but laminectomy should be considered for intractable or progressive cases.

Child

Cerebral blood flow mapping using stable xenon-enhanced CT in sickle cell cerebrovascular disease.

The cerebral blood flow (CBF) of 25 patients with sickle cell cerebrovascular disease (SCCVD) was examined using a Xenon-CT flow mapping method. Brain CT and MR findings were correlated with those of the Xenon-CT flow studies. CBF defects on Xenon-CT correlated reasonably well with the areas of cortical infarctions on the MR images, but in 27% of the cases, flow defects were slightly larger than the areas of infarctions on the MR images. In deep watershed or basal ganglia infarctions, abnormal CBF was noted about the cerebral cortex near infarctions in 72% of the patients, regardless of infarction sizes on the MR images. However, decreased CBF was recognized in 4 of the 9 children whose MR images were virtually normal. Thus, the extent of flow depletion cannot be predicted accurately by MR imaging alone. Xenon-CT flow mapping proved a safe and reliable procedure for evaluation of the CBF of patients with SCCVD. Although this study is preliminary, it may have a potential in selecting patients for hypertransfusion therapy, as a noninvasive test and for following children with SCCVD during their therapy. Careful correlation of results of CBF with those of MR imaging or of CT is important for objective interpretations of flow mapping images.

Adolescent

Trench foot--a study in military-medical responsiveness in the Great War, 1914-1918.

Along the nearly 15,000 miles of trenches on the western front in the Great War of 1914-1918, a condition known as "trench foot" caused serious attrition among the fighting troops and resulted in swollen limbs, impaired sensory nerves, inflammation, and even loss of tissue through gangrene. Physicians, sanitarians, and military officers explored numerous theories regarding etiology and treatment before focusing on a combined regimen of common-sense hygiene and strict military discipline.

Germany

Eclampsia: a pediatric neurologic problem.

Eclampsia is a syndrome of hypertension, proteinuria, edema, and neurologic manifestations such as seizures, focal deficits, or blindness occurring during pregnancy, mainly in primigravidas. Although it is not seen often in the pediatric population, it occurs with greater frequency among pregnant patients under the age of 15 than in the general population. Serious sequelae can be prevented with prompt and adequate treatment, including termination of pregnancy.

Adolescent