Clinical etiquette: a critical primer.
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Biomedical subjects
Publications and source records attributed to T W Furlow.
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Monitoring evoked potentials from the brain for prolonged periods during neurosurgical procedures ideally requires attached scalp electrodes that may be placed in a sterile field. The limitations of conventional surface and percutaneous electrodes in the operating room environment have led to the development of a disposable curved-needle electrode which is inherently self-retaining. Clinical results have demonstrated the advantages of this new electrode over other electrodes currently used for intraoperative neurophysiological monitoring.
Twenty-four members of a family with benign familial chorea underwent testing for evidence of intellectual impairment. Lower verbal intelligence was found in affected individuals compared to unaffected family members, as were deficits in verbal abstract concept formation. These results challenge the notion that benign familial chorea uniformly spares the intellect in all kindreds.
A simplified technique that uses two radionuclide tracers has been devised to measure local cerebral glucose utilization (ICGU) and local cerebral blood flow (ICBF) in the same rat. The method employs [14C]-2-deoxyglucose and [14C]iodoantipyrine to produce an autoradiogram before and another after extraction into chloroform of the [14C]iodoantipyrine from the brain sections. The chloroform-extracted autoradiogram yields ICGU, and the difference in tissue carbon-14 concentration between the two autoradiograms permits calculation of ICBF. The double-isotope technique provides values of ICGU and ICBF that are statistically indistinguishable from those derived from conventional single-isotope methods.
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The short-latency auditory-evoked response was recorded from adult (over 8 wk) and young (16-22 day) mice of the audiogenic seizure-prone DBA/2J (D2) and seizure-resistant C57BL/6J (C6) strains. An auditory complex made up of eleven peaks and troughs was found within the first 20 ms after click stimuli. The latencies of the potentials tended to be shorter in the C6 mice and in the adults of both strains. The ratio of amplitude differences of late to early peaks ('amplitude index') was much larger (P less than 0.01) in D2 mice. The data are consistent with greater neuronal recruitment to acoustic stimuli in the higher-order auditory centers of D2 mice.
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The course of frontal lobe cerebritis in a teenage boy was followed with serial radionuclide and CT scans. During treatment with high doses of dexamethasone and antibiotics, the radionuclide scans became normal, whereas the CT scans remained abnormal and ultimately demonstrated an encapsulated abscess that was successfully drained. In patients receiving steroid therapy, the radionuclide brain scan may not be a reliable technique in demonstrating an intracranial abscess.
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Unilateral cerebrovascular occlusion was produced in heparinized rats within seconds after injection of microgram quantities of sodium arachidonate into the internal carotid artery. Electroencephalographic activity over the affected cerebral hemisphere became attenuated, and cerebral blood flow decreased by half. A neurologic syndrome, including ipsilateral blindness and contralateral sensorimotor deficits, resulted from occlusion of the microvasculature by platelet thrombi. Although aspirin strongly inhibited arachidonate-induced platelet aggregation in vitro, the drug offered little protection against arachidonate-induced stroke.
Unilateral cerebrovascular occlusion was produced in heparinized rats within 60 seconds after an injection of sodium arachidonate (in doses exceeding 0.45 milligram per kilogram) into the carotid artery. Electroencephalographic activity over the affected cerebral hemisphere was suppressed, and cerebral blood flow decreased by half. Microscopic examination revealed complete obstruction of the hemispheric microcirculation by platelet aggregates.
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