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At least 73 records · Page 4Linked to original sources
PubMed1996

Crossed aphasia. Functional brain imaging with PET or SPECT.

OBJECTIVES: To study patients with crossed aphasia (aphasia secondary to lesions in the right hemisphere in right-handed patients) with functional brain imaging using positron emission tomography (PET) or single photon emission computed tomography (SPECT); to see whether left hemisphere structures were metabolically depressed during the acute phase and, in 1 patient, during recovery; and to review the modern literature on crossed aphasia, with special reference to left hemisphere involvement. DESIGN: Case studies of 3 patients with crossed aphasia, including language testing, computed tomographic scanning, and functional imaging with PET or SPECT. SETTING: Hospital case studies. PATIENTS: Three right-handed patients with crossed aphasia secondary to acute infarctions in the right hemisphere and left hemiparesis. METHODS: All 3 patients were studied by means of bedside language testing, computed tomographic scanning, and functional brain imaging with PET or SPECT. Patient 1 also underwent serial testing with the Boston Diagnostic Aphasia Examination and follow-up PET scanning after 2 months of recovery. OUTCOME MEASURES: Clinical examination in all 3 patients and follow-up Boston Diagnostic Aphasia Examination and PET scanning in patient 1. RESULTS: Two patients had severe global aphasia and 1 had Broca aphasia. In all cases, computed tomographic scans failed to reveal any left hemispheric lesions. Functional imaging with PET or SPECT showed extensive hypometabolism or hypoperfusion in the right hemisphere, with initial reductions in the left hemisphere as well. In patient I, a follow-up PET image showed only persistent hypometabolism in the right hemisphere. CONCLUSIONS: These findings suggest that abnormal dominance for at least some language functions in the right hemisphere underlies the syndrome of crossed aphasia. Diaschisis, or functional depression of the anatomically normal left hemisphere, was seen in all 3 patients during the acute phase, but not in patient 1 after recovery had begun.

Aged↗
PubMed1978

The management of clinical stage I endometrial carcinoma.

A retrospective analyses of 307 cases with clinical Stage I endometrial carcinoma was done in an attempt to determine the role of radiation therapy in the optimal treatment of this disease. A review of the modern literature with over 9000 cases served as a useful tool to corroborate inferences and conclusions. The present series has 155 patients (51%) treated with preoperative megavoltage external pelvic radiation with a variation in doses of less than 6%. Five-year survival estimates (79%-83%) in clinical Stage I endometrial carcinoma are similar among the several main treatment combination that are employed; they become a useless parameter for any comparison. The pelvic failure rate constitutes a more useful guideline in assessing the most adequate therapy. The pathologic grade of the tumor is the main prognosticator in endometrial carcinoma. Intimately related to the tumor grade is the depth of myometrial invasion of the carcinoma. The size of the uterus and/or its cavity carry less prognostic significance than traditionally thought. For grade I lesions, there is little error in diagnosis, few pelvic failures and excellent survival (96%); they could be approached with initial surgery and postoperative radiation reserved for selected patients. For grade 2 tumors, the error in diagnosis and the failure rate increases with an overall survival of 87%. For grade 3 tumors, the error in diagnosis and failure rates are quite high with a 5 year survival of only 70%. Preoperative radiation, especially external beam therapy, is suggested for grades 2 and 3 Stage I tumors. The use of this treatment modality yields only 3% pelvic failure and an overall 5 year survival of almost 90%.

Carcinoma↗
PubMed2001

Astrocytic clasmatodendrosis in hippocampal organ culture.

Mechanisms by which astrocytes are irreversibly injured from ischemic brain injury remain incompletely defined. More than 90 years ago Alzheimer showed that astrocytes lose their distal processes (i.e., undergo "clasmatodendrosis") when irreversibly injured by a reduction in blood flow, a process shown by Friede and van Houten (1961) to be due to energy failure and acidosis. Such alterations in astrocytic morphology can relate directly to changes in cell function. However, astrocytic clasmatodendrosis has largely been lost to the modern literature, perhaps because of a inability to study it under controlled conditions. In the present study, novel four-dimensional (4D)and digital deblurring imaging of glial fibrillary acidic protein (GFAP) immunostaining changes in hippocampal organ cultures (HOTCs) were used to establish an in vitro model of astrocytic clasmatodendrosis. Also, astrocytes in primary culture were transfected with green fluorescent protein (GFP) to show the occurrence of clasmatodendrosis via a parallel and separate means. In HOTCs, a significant reduction in astrocytic process length occurred 15 min (and remained for 60 min) after exposure to acidic Ringer's and mitochondrial inhibition in the pyramidal cell body layer. Time-lapsed images of primary cultures showed thinning of cell processes within 15 min of exposure to acidic Ringer's and mitochondrial inhibition. Distal processes subsequently broke away but retained their fluorescence for minutes before disintegrating along with their parent cell bodies. This report shows the spatiotemporal occurrence of clasmatodendrosis in astrocytes of HOTCs closely parallels that seen in vivo. Thus, HOTCs, where microenvironmental conditions can be controlled and single, identified cells can be followed in space and time, can be applied to study the interrelations between energy metabolism and pH that result in clasmatodendrosis.

Acidosis↗
PubMed1995

Primary soft tissue sarcoma of the extremities in adults.

The modern literature on adult extremity sarcoma implies that adjuvant therapy (usually irradiation) is mandatory for adequate local control, at least in patients with high-grade tumours undergoing limb-sparing procedures. In 152 primary extremity soft tissue sarcomas, wide or radical resection was employed (116 patients) including amputation in nine patients (6 per cent), or local excision followed by adjuvant postoperative radiation therapy (36). Local recurrence alone occurred in 5 per cent of patients, and in combination with distant metastases in 9 per cent. The total rate of local recurrence was 10 per cent after wide resection (with or without chemotherapy) and 25 per cent after conservative resection and radiotherapy (with or without chemotherapy). Limb sparing was possible in 94 per cent of patients. The majority (76 per cent) had surgical resection alone as local treatment with satisfactory results. Wide resection, when feasible, provides acceptable local control and may be preferable to local excision plus radiation therapy.

Adolescent↗
PubMed2002

Flaubert's Madame Bovary: a study in envy and revenge.

Flaubert's Emma Bovary is one of the most convincingly realized characters in modern literature. Her husband, Charles, a rural doctor, loves her dearly, but he is dull, ineffectual, and boring. Emma seems to hate him with a fury that knows no bounds. She betrays him sexually, ruins him financially, and ultimately destroys his very life. What drives her to such unmitigated rage? The authors identify evidence in the novel suggestive of a dynamic thrust for revenge along the lines described by Freud (1918) in "The Taboo of Virginity." Elements of narcissistic rage and a sense of entitlement intensify Emma's anger and vengefulness.

Emotions↗
PubMed2006

Tau-predominant-associated pathology in a sporadic late-onset Hallervorden-Spatz syndrome.

Hallervorden-Spatz syndrome (HSS) is a heterogeneous clinicopathological disorder currently included within the broader title of neurodegeneration with brain iron accumulation (NBIA). The classic histological hallmarks of HSS are axonal spheroids and excessive iron-containing granules accompanied by neuronal loss and gliosis in the globus pallidus and substantia nigra reticulata. In the modern literature, attention has been drawn to the co-occurrence of two other histological markers: Lewy bodies mainly composed of abnormal alpha-synuclein, and neurofibrillary tangles due to hyperphosphorilated tau aggregation. Discrepancies exist regarding the importance of these molecular changes and its relevance for the nosology of HSS. Most authors have emphasized the importance of the Lewy body-like pathology, favoring the inclusion of HSS within the alpha-synucleinopathies. We report on a case of late-onset HSS, with the typical histological findings restricted to the basal ganglia and cerebellum in which tau pathology was exceedingly more abundant than alpha-synuclein pathology. This case contributes to the increasing evidence about the heterogeneity of HSS. We favor the view that the molecular changes and the protein misfolding underlying the Lewy body and tangle formation in HSS/NBIA are secondary to the main pathological process and should not be taken as the basis for its nosological classification.

Axons↗
PubMed1989

Spasms of amputation stumps: a report of 2 cases.

The occurrence of involuntary movements of stumps following amputation is described in two patients. Although recognised for over 100 years, this phenomenon has received little attention in the modern literature. The condition appears to represent a variant within the spectrum of movement disorders induced by injury to the peripheral nervous system.

Aged↗
PubMed2003

Prognostic factors in non-small cell lung cancer.

Identification of prognostic factors is critical in optimizing treatment for patients with cancer. The purpose of this work is to review the modern literature with regard to prognostic factors for patients with non-small-cell lung cancer (NSCLC) taking into account ongoing advances in clinical evaluation, staging, surgery, radiation therapy, chemotherapy, and molecular biology in this widely heterogeneous patient population.

Carcinoma, Non-Small-Cell Lung↗
PubMed1994

Left and right in the Bible from a neuropsychological perspective.

Although in several neuropsychological works dealing with hemispheric specializations a few passages of the Bible referring to the left and the right have been mentioned now and then, a systematical study with a neuropsychological approach to this topic was still a missing link. By using concordance texts from the Bible books of the Hebrew Canon (Old Testament, OT) and from the New Testament (NT), all the verses containing any reference to the left and the right (OT = 151, NT = 49 verses) have been identified and classified into 10 groups: (1) references to space, (2) symmetric sayings, (3) the right hand is the favorite hand, (4) right eye preference, (5) God's right hand, (6) the right side is more prestigious, (7) the right side in liturgy, (8) left hand preference, (9) fatal left-hand shots, and (10) on the left side. Some statistical considerations have been put forward and a neuropsychological, anthropological approach has been suggested for the purpose of interpreting the most interesting verses. According to the author of the present paper, it would be worthwhile commenting on some texts of ancient and modern literature not only from a linguistic, historical, religious and theological point of view, but also by means of a neuropsychological approach.

Bible↗
PubMed1996

Psychotropic drug prescription in rehabilitation. A survey in Hong Kong.

Rational pharmacotherapy helping chronic psychiatric patients in the difficult process of reintegration into the community is an important prerequisite of successful rehabilitation. Results of a survey conducted at the opening of a rehabilitation facility in Hong Kong revealed a number of illogicalities in prescription patterns. Frequently encountered faulty treatment decisions incompatible with the recommendations of modern literature included polypharmacy, higher than necessary doses of anticholinergic antiparkinsonian agents and giving psychotropic drugs in inconveniently divided doses. With the newly emerging subspecialty of rehabilitation-community psychiatry in Hong Kong, it is expected that large numbers of chronically hospitalized patients will enter rehabilitation programmes. The present survey indicated that it is imperative to pay continued attention to their medication status.

Adult↗
PubMed2004

The discovery of perforating veins.

Many authors of the 19th century are erroneously credited for their discovery of perforating veins. In this report, we show the first representations of perforating veins, dated 1793. These are from the German anatomist Justus Christian Von Loder, who correctly described most of the groups of perforating veins we currently know. These drawings have never appeared in the modern literature.

Anatomy↗
PubMedDate not supplied

Delusion of parasitosis or chronic tactile hallucinosis: hypothesis about their brain physiopathology.

The abnormal belief of having the skin infested by parasites is a syndrome with different etiologies. Approximately 12% of cases are induced by another patient with the same syndrome. In noninduced cases, two physiopathological brain mechanisms have been proposed: a delusion, or a primary abnormal tactile sensation with a secondary delusional elaboration. These two hypotheses have been characterized by Berrios as cognitive and sensorialist approaches, respectively. Although modern literature defines this syndrome as a delusion, early literature, particularly German, described both approaches, and even emphasized the sensorialist approach, classifying it as a chronic tactile hallucinosis. A thorough review of the literature suggests both mechanisms may be possible.

Brain↗
PubMed1992

The tradition of medicinal plants in Zagori, Epirus (northwestern Greece).

Traditional herbal medicine in the Zagori region of Greece was studied by obtaining information from users and collecting herbs. In addition, traditional remedies found in old manuscripts and books were compared with those currently used in modern literature. The 36 medicinal plants used today are listed, including their common and scientific names, indications (some new) and recipes for preparations.

Greece↗
PubMed2005

Neurolysis for meralgia paresthetica: an operative series of 45 cases.

BACKGROUND: Failure of symptom relief after neurolysis for meralgia paresthetica (MP) is reported frequently, yet systematic outcome analysis is limited in the modern literature. The present operative series of 45 cases aims to address this issue. METHODS: From 1996 to 2000, all patients who had neurolysis for MP by our senior author were enrolled in the study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic and steroid injection. Attention to the anatomical variability of the lateral femoral cutaneous nerve was made during nerve exploration. Decompression of the nerve was performed at the level of the iliac fascia, the inguinal ligament, and the fascia of the thigh distally. The outcome of surgery was assessed 6 weeks after the procedure followed by 3 monthly intervals if symptoms persisted. Telephone interviews were conducted to assess long-term results. RESULTS: Forty-five decompressive procedures were performed in 42 patients over the 5-year period. The average duration of symptoms was 31 (2.5-180) months. All patients were followed for an average of 4.1 years. Complete and partial symptom improvements were noted in 33 (73%) and 9 (20%) cases, respectively. No recurrence was reported. Analysis of clinical variables demonstrated that the duration of symptoms preoperatively did not affect the rate of complete symptom relief, but obese patients (body mass index > 30) was 6 times more likely to have (odds ratio 6.16, P = 0.04) incomplete relief after surgery at long-term follow-up. CONCLUSION: High success rate was recorded in our series of 45 cases. Prolonged duration of symptoms did not preclude favorable outcome but obesity had a negative association with good outcome.

Adult↗
PubMed2002

Anxiety and affective style: role of prefrontal cortex and amygdala.

This article reviews the modern literature on two key aspects of the central circuitry of emotion: the prefrontal cortex (PFC) and the amygdala. There are several different functional divisions of the PFC, including the dorsolateral, ventromedial, and orbital sectors. Each of these regions plays some role in affective processing that shares the feature of representing affect in the absence of immediate rewards and punishments as well as in different aspects of emotional regulation. The amygdala appears to be crucial for the learning of new stimulus-threat contingencies and also appears to be important in the expression of cue-specific fear. Individual differences in both tonic activation and phasic reactivity in this circuit play an important role in governing different aspects of anxiety. Emphasis is placed on affective chronometry, or the time course of emotional responding, as a key attribute of individual differences in propensity for anxiety that is regulated by this circuitry.

Amygdala↗
PubMed2000

Abdominoscrotal hydrocele in childhood: is it really a rare entity?

OBJECTIVES: Abdominoscrotal hydrocele (ASH) is an apparently highly uncommon clinical entity especially in childhood, with only about 80 pediatric cases reported in the modern literature. METHODS: The incidence, diagnosis, and treatment of ASH are discussed with reference to 9 cases observed at our institution and to cases in the literature. RESULTS: Surgical correction was successful in all our cases and no hydrocele or hernia recurrence was registered. CONCLUSIONS: ASH incidence appears to be higher than reported; undescended testis is a frequent association and surgical correction through an inguinal approach is always possible and curative. Ligation of the processus vaginalis may prevent recurrence.

Abdomen↗
PubMed1989

Syphilitic gastritis: demonstration of Treponema pallidum with the use of fluorescent treponemal antibody absorption complement and immunoperoxidase stains.

Because of the decrease in the overall incidence of syphilis, syphilitic involvement of stomach is seldom reported in the modern literature. Because of the nonspecific symptoms and signs of the disease, it is necessary to demonstrate Treponema pallidum in the gastric lesions to confirm the diagnosis. With the use of immunofluorescence and immunoperoxidase methods we have succeeded in identifying T. pallidum in the gastric wall of a patient who initially had cutaneous manifestations of secondary syphilis and gastric symptoms.

Adult↗