Showing papers by "Rush University Medical Center published in 1979"

The problem of premorbid intelligence in neuropsychological assessment

Abstract: The aim of this study was to compare the utility of two methods of estimating premorbid IQ in the assessment of intellectual deterioration secondary to brain dysfunction. One estimate is based on demographic information, and the other is based on measures of present ability thought to be insensitive to brain dysfunction. Demographic and Wechsler Adult Intelligence Scale data were gathered for two groups: (1) 140 neurologic patients and (2) 140 nonneurologic subjects. This diagnostic dichotomy was regressed separately on two deterioration indices which differed only in the method used to estimate premorbid IQ. The index which relied on the demographic estimate was 11% more accurate than the present ability estimate in case classification. The results suggest that demographic information, when applied systematically, can provide a reasonably accurate and useful estimate of premorbid IQ.

Cerebral atrophy, EEG slowing, age, education, and cognitive functioning in suspected dementia

Abstract: Seventy-eight hospital patients, 50 years of age or older, were selected for suspected changes in mentation and for the absence of focal or other organic brain disease. They were studied in relation to education, age, cerebral atrophy (by computerized tomography), electroencephalographic (EEG) slowing, and performance in several neuropsychologic tests. Adequate test-retest reliability of the cognitive measures and interjudge reliability of the cerebral atrophy and EEG measures were demonstrated. Stepwise multiple regression analyses suggested the following: (1) EEG slowing is the strongest and most general pathologic influence on cognition in elderly persons without overt brain disease. (2) Cerebral atrophy independently affects primarily the verbal recall of recent and remote information. (3) Age independently affects primarily recent memory for both verbal and nonverbal material. (4) Formal education is a powerful influence that must be accounted for in all studies of the effects of age on cognition.

Protein-bound homocyst(e)ine in normal subjects and in patients with homocystinuria.

Abstract: Summary: A method was developed to quantitate protein-bound homocyst(e)ine using 2-mercaptoethanol. Protein-bound homocyst(e)ine was discovered in the plasma from normal individuals, ranging from 0.5–2.2 nmole/ml. In two obligatory heterozygotes for classical homocystinuria, plasma protein-bound homocyt(e)ine was 3.5 and 4.8 nmole/ml, respectively. Untreated homozygotes showed approximately a 40-fold increase of plasma protein-bound homocyst(e)ine. Furthermore, using conventional methods, no free homocystine was detectable in the supernatant of plasma precipitate from two classical homocystinuric patients treated with pyridoxine, but plasma protein-bound homocyst(e)ine showed a 10-fold increase. Protein-bound homocyst(e)ine was also demonstrated in the liver, kidney, and brain tissues from a patient with methylenetetrahydrofolate reductase deficiency. Speculation: The results in this study suggest that determination of proteinbound homocyst(e)ine using 2-mercaptoethanol may provide a more reliable assessment of treatment in patients with homocystinuria and a potentially useful tool for the definition of the carrier state. Demonstration of protein-bound homocyst(e)ine in various tissues of homocystinuric patients suggests the possibility that this compound may be directly associated with the development of some of the pathologic changes in the tissues

Seventeen-year experience with routine shunting in carotid artery surgery.

Abstract: Safety of carotid artery surgery depends on proper case selection, meticulous surgical technique, and appropriate protection of the brain during carotid artery cross-clamping. Various methods have been devised to determine the adequacy of collateral circulation, none of which has been proven practical and totally reliable. Attempts at increasing cerebral perfusion to the ischemic portion of the brain by induced hypertension, hypercarbia, and hypocarbia have been ineffective. The purpose of this presentation is to report our experience with routine intraluminal shunting in carotid artery surgery during the past 17 years. Advantages of routine shunting include maintenance of regional cerebral blood flow at the preclamping level and the elimination of any need for monitoring and haste during surgery. Insertion of the tube, properly done, does not injure the arterial wall and should not cause embolization. The presence of the tube within the arterial lumen does not interfere with exposure of the atheroma, yet it facilitates repair of the incision and prevents stricture by faulty suturing technique. Results of carotid artery surgery measured by the incidence of stroke are compared between shunted and nonshunted series. A review of the literature confirms our impression that shunting reverses ischemic changes detected by EEG and regional cerebral blood flow determinations. The usefulness of shunting in the surgical management of internal carotid aneurysm, kinked carotid artery, carotid body tumor, and carotid-subclavian bypass graft is also described.

Psychological disturbance and pain report differences in both organic and non-organic low back pain patients

Abstract: Patients with undiagnosable low back pain have been observed to differ from patients with proven low back pain in their clinical description of pain and in their psychological status. More variable and diffuse pain qualities are emphasized in their clinical reports and more psychological disturbance characterizes them as a group, suggesting an association between pain expression and psychological disturbance. One hundred and two patients with low back pain were administered a standardized pain questionnaire to determine more systematically the association between pain expression and psychological disturbance in patients with and without demonstrable organic disease. Patients with psychological disturbance differed significantly from patients without psychological disturbance in the following ways. They used more words in their description of pain, distributed these words over more pain factors, and endorsed significantly more pain of the affective and skin pressure variety. The results underscore previous clinical impressions and suggest that patients without either organic or psychological findings may be cases of undiagnosed organic disease.

Blood group isoantigen deletion in carcinoma in situ of the urinary bladder.

Abstract: Blood group isoantigens A and H (O) were measured by the Specific Red Cell Adherence (SRCA) Test in nine radical cystectomy specimens removed from patients with extensive carcinoma in situ of the urinary bladder. All bladders had areas of histologically normal epithelium and areas of epithelial atypia in addition to the carcinoma in situ. In eight cases, tissue-associated blood group isoantigens were deleted in areas showing either atypia or carcinoma in situ. Isoantigens were present in these areas in the ninth case. Blood group isoantigens were absent in approximately half of the sections of histologically normal epithelium. We propose that areas of epithelium which appear benign according to conventional histological criteria but in which the blood group isoantigens are absent may represent areas of low grade carcinoma in situ.Cancer 43:661-668, 1979.

The nature and function of repetitive dreams: a survey and speculation.

Abstract: (1979). The Nature and Function of Repetitive Dreams: A Survey and Speculation. Psychiatry: Vol. 42, No. 2, pp. 131-137.

Cytotoxicity and influence on radiation dose response curve of cis-diamminedichloroplatinum II (cis-DDP).

Abstract: Exponentially growing Chinese hamster ovary (CHO) cells were exposed to varying doses of Cis-diamminedichloroplatinum II ( cis DDP) for I hour. Cytotoxicity was found to be dose dependent and the dose response curve has shoulder and exponential portions. D o on the exponential portion of the curve was found to be 2.8 μ/ml. The values of D q and the extrapolation number (n) corrected for single cells were found to be 3.1 μ/ml and 12.0 respectively. The influence of exposure to cis DDP on the radiation dose response curve was also studied. The radiation dose response curve of the CHO cells not exposed to cis DDP is characterized by a D o of 139 rad. The values of D q and n corrected for single cells are 105 rad and 4.5 respectively. Exposure to 8 /ml of cis DDP for 1 hour decreased D o to 102 rad when exposure was immediately prior to irradiation and to 106 rad when the exposure was immediately after irradiation. D q and n were found to be 140 rad and 18 for pre-radiation exposure and 137 rad and 15 for post-radiation exposure. This influence on the radiation dose response curve was not found to be cis DDP dose dependent since at higher concentration of cis DDP (10 μ/ml, 12 μ/ml, 16 μ/ml) D o , D p and n were found to be the same as at 8 μ/ml.

Low back pain in patients with and without demonstrable organic disease.

Abstract: Pain descriptors of patients with low back pain were analyzed to determine their usefulness in identifying patients without demonstrable organic disease. Using a standardized back pain questionnaire which scales qualities of pain along 7 independent factors, it was possible to make clear distinctions between the subjective reports of patients with and without demonstrable organic disease of the lower back. Pain described by patients with demonstrable organic disease tends to be consistent and specific; whereas pain described by patients without demonstrable organic disease tends to be more variable and diffuse. Pain reported by the latter group was also more intense. Factors which may underlie these findings were discussed.

The health belief model and utilization of ambulatory care services.

Abstract: The applicability of a Health Belief Model for understanding variance in ambulatory care visits in a HMO setting was examined. Health beliefs concerning perceived vulnerability to illness, perceived seriousness of symptoms and perceived efficacy of health care were measured and evaluated against both retrospective and prospective utilization data. The results indicated that an individual's view of his own vulnerability is the single best predictor of utilization, followed by belief of benefits associated with preventive health behavior. The least salient attitude was seriousness. The results using retrospective and prospective utilization data were strikingly similar.

Coexistence of leukemic reticuloendotheliosis and histiocytic lymphoma: A case report

Abstract: A 65-year-old woman had pancytopenia, splenomegaly, and an inaspirable bone marrow. Diagnostic evaluation demonstrated that she had both leukemic reticuloendotheliosis (LRE), or hairy cell leukemia, and an additional lympho-reticular neoplasm, most likely a "histiocytic" lymphoma. The diagnosis of LRE was based on the histopathology of spleen tissue and of a bone marrow biopsy specimen. The diagnosis of diffuse "histiocytic" lymphoma was based on the histopathology of a splenic hilar and a mesenteric lymph node, tumor nodules in the kidney and spleen, and tissue from a mass obstructing a ureter. This is the first well-documented association of a second lympho-reticular neoplasm with LRE. Even relatively gently treatment of the "histiocytic" lymphoma resulted in fatal pancytopenia, illustrating the restricitons on therapy imposed by the marrow impairment due to the LRE.

Recruitment in the Coronary Drug Project and the Aspirin Myocardial Infarction Study

Abstract: Both the Coronary Drug Project (CDP) and the Aspirin Myocardial Infarction Study (AMIS) were successfully able to recruit adequate members of postmyocardial infarction patients to long-term multicenter clinical trials in the secondary prevention of coronary heart disease Aggressive efforts to achieve the recruitment within an acceptable time limit were found to be neccessary A direct approach to the general public via the mass media and painstaking search of hospital records proved to be the most effective methods Referral from physicians was not an effective way to recruit participants for the most part Both the general public and the medical profession are generally supportive of this type of research

Error measures for objective assessment of scene segmentation algorithms.

Abstract: Scene segmentation is an important element in pattern recognition problems. Previous efforts to evaluate and compare scene segmentation procedures have been largely subjective. Quantitative error measures would facilitate objective comparison of scene segmentation algorithms. A theoretical discussion leading to a new generalized quantitative error measure, G2, based on comparison of both pixel class proportions and spatial distributions of "true" and test segmentations, is presented. This error measure was tested on 14 manual segmentations and 40 gynecologic cytology specimens segmented with five different scene segmentation techniques. Results indicate that G2 seems to have the desirable properties of correlation with human observation, categorization of error allowing for weighting, invariance with picture size and ease of computation necessary for a useful scene segmentation error measure.