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Biomedical subjects

A Lieberman

Publications and source records attributed to A Lieberman.

At least 109 records · Page 6Linked to original sources
PubMed1978

An extraordinary form of confabulation.

We describe five patients with spontaneous, persistent confabulation. While the basis of confabulation in general is not known, the evidence in this specific group of patients with spectacular, impulsive, and spontaneous confabulation suggests a marked deficit in frontal function, superimposed upon a basic defect in memory, as a possible mechanism.

Adult↗
PubMed1978

Comparative effectiveness of two extracerebral DOPA decarboxylase inhibitors in Parkinson disease.

In four patients with Parkinson disease, we compared carbidopa combined with levodopa (Sinemet) and benserazide combined with levodopa (Madopar). All of these patients had responded to treatment, first with levodopa and then with Sinemet; after 6 years two continued to show a good response, while two developed marked "on-off" phenomena. Clinically, Sinemet and Madopar were similar; however, DOPA levels were higher, but with a shorter half-life, on Madopar. The higher DOPA levels may have been offset by the shorter half-life, resulting in no clinical change. DOPA levels were lower and half-life was shorter in patients with on-off phenomena. These differences may be responsible in part for the on-off phenomena.

Aromatic Amino Acid Decarboxylase Inhibitors↗
PubMed1978

Oral complications in patients receiving treatment for malignancies other than of the head and neck.

Oral complications in patients being treated for malignancies that were not in the head and neck were studied. Age, type of therapy, and type of malignancy were factors related to the prevalence of oral complications. Mucosal ulcerations, xerostomia, and bacterial and fungal infections were the most frequently encountered oral problems. The frequency of oral complications in these patients indicates the need for an awareness and involvement of dental practitioners in their management.

Adolescent↗
PubMed1977

Treatment of Parkinson's disease with lergotrile mesylate.

Lergotrile mesylate, an ergot alkaloid derivative and putative dopamine agonist, was effective in the majority of patients with Parkinson's disease who were showing signs of disease progression despite treatment with levodopa combined with a peripheral decarboxylase inhibitor (carbidopa). Among 20 patients completing a six-month trial, there was a significant (P less than .01) reduction in rigidity, tremor, bradykinesia, gait disturbance, and total score when lergotrile was added to levodopa plus carbidopa. Mean daily dose of lergotrile mesylate was 52 mg, and the mean daily dose of levodopa was reduced by 15%. Abnormal involuntary movements were decreased on addition of lergotrile and reduction in levodopa while mental changes and orthostatic hypotension were increased. Elevations in serum transaminase levels were noted in three patients. The ergot alkaloids promise to be an important new class of antiparkinsonian drugs.

Acetonitriles↗
PubMed1977

Control of emotional expression in pseudobulbar palsy. A personal experience.

This report is based on the recorded experience of a patient with lability of emotional expression and other features of the syndrome of pseudobulbar palsy. We describe severe emotional overflow despite an underlying affective tone that is normal. In this context, emotional lability is a misnomer. "Hyperactive emotional reflexes" would be a more appropriate descriptive term, as the underlying mood appears normal, and only the degree of emotional expression is pathological.

Bulbar Palsy, Progressive↗
PubMed1977

Brain death: I. Angiographic correlation with the radioisotopic bolus technique for evaluation of critical deficit of cerebral blood flow.

An innocuous intravenous portable radioisotopic test using technetium 99m pertechnetate was employed to demonstrate the deficit of cerebral blood flow associated with brain death. The results are compared to those of bilateral carotid and vertebral angiography in 20 patients. Absence of a bolus tracing from the head in the presence of a control tracing of a bolus from the femoral artery in two successive studies one hour apart reliably correlated with the clinical and electroencephalographic findings signifying cerebral death in comatose, apneic patients. Angiography indicated absence of intracranial circulation in 10 patients. Stasis filling or retrograde emptying of arterial vessels (or both) occurred in 7 patients. There was no evidence of venous filling in any of these 17 patients; all of them had either an absent head bolus or an "intermediate tracing." Results indicate that either form of tracing represents a critical decrease of cerebral blood flow. Two other patients had evidence of severely impaired abnormal posterior fossa circulation without angiographic evidence of cerebral circulation; both of these patients had an absent head bolus. An additional patient had an unusually small head bolus, and angiography revealed extravasation of radiopaque material but no evidence of intracranial circulation. We conclude that the bolus technique is a helpful adjunct in diagnosing brain death.

Adolescent↗
PubMed1977

Use of high dose corticosteroids in patients with inoperable brain tumours.

Eleven patients with inoperable brain tumours were treated with high doses of corticosteroids (methylprednisolone 200-2000 mg/day) for up to 151 days (mean 55 days). Neurological improvement occurred in eight patients on high doses after deterioration on concentional doses (methylprednisolone 80-120 mg/day). In two patients steroids could be completely discontinued for several months. Serious adverse effects included sepsis in three patients and myopathy in tow. All three patients with sepsis also received chemotherapy. There were no deaths that could be attributed to steroids. The most likely effect of high dosage steroids is reduction of cerebral oedema. It is conceivable that in some instances high dose steroids may also result in tumour inhibition or oncolysis or both.

Adult↗
PubMed1977

Visual scanning training effect on reading-related tasks in acquired right brain damage.

This study presents a method for analyzing and remediating the visual perceptual deficits often found in persons with acquired right brain injury due to stroke. A total of 57 patients were randomly assigned to experimental (N=25) or control (N=32) groups. All patients were administered the same test battery prior to assignment. Experimentals received the specific training program and the controls received standard rehabilitation. Both groups were retested after a period of one month. Analysis revealed the superior performance of the experimental group. The results suggest that the academic disorders found in right brain damage can be treated as secondary to a primary disturbance in visual scanning behavior.

Adult↗
PubMed1976

Treatment of parkinson's disease with bromocriptine.

Bromocriptine in high doses (up to 100 mg per day) was administered to 14 patients with advanced Parkinson's disease whose disorder was progressing despite optimum treatment with levodopa combined with a peripheral dopa decarboxylase inhibitor (carbidopa). In 10, bromocriptine (mean dose, 57 mg) induced a statistically significant (P less than 0.01) improvement in rigidity, tremor, bradykinesia, gait disturbance and total score. In seven patients levodopa with carbidopa was completely replaced by bromocriptine (mean dose, 70 mg), with improvement in four. Adverse effects were similar to those observed with levodopa and carbidopa, except that in individual patients abnormal involuntary movements and diurnal oscillations in performance (on-off effect) were decreased whereas orthostatic hypotension and mental changes were increased. Bromocriptine appears to be a major new agent in Parkinson's disease that is especially promising in patients no longer responding to levodopa.

Aged↗
PubMed1976

The antiparkinsonian efficacy of bromocriptine.

The antiparkinsonian activity of bromocriptine, a presumed dopaminergic receptor agonist, was investigated in monkeys with surgically induced tremor and in a group of parkinsonian patients. A single administration of bromocriptine resulted in a dose-dependent relief of tremor in monkeys. Repeated administration enhanced this effect. Only mild abnormal involuntary movements were observed and only after repeated administration. Eleven patients with Parkinson's disease were treated with bromocriptine (mean dose, 26.4 mg a day). Clinically obvious improvement was noted in one or more of the cardinal signs of the disease in six patients (responders). No obvious improvement in any of the cardinal signs was noted in the remaining five patients (nonresponders). Clinically, the responders were older and more severely affected and had been on a higher dose of levodopa. However, they had had the disease for a shorter period. It is suggested that failure to respond to bromocriptine may be related to a decrease in the sensitivity of postsynaptic dopaminergic receptors.

Age Factors↗
PubMed1975

Huntington's chorea associated with normal pressure hydrocephalus.

Two patients with Huntington's chorea (HC) developed a gait disturbance more suggestive of normal pressure hydrocephalus (NPH) than HC. The diagnosis of NPH was confirmed by pneumoencephalography and isotope cisternography. Both patients were shunted and both showed an improvement not only in their gait but, unexpectedly, a decrease in their abnormal involuntary movements (AIMs). The association of HC with NPH is discussed.

Adult↗
PubMed1975

Radioisotopic bolus technique as a test to detect circulatory deficit associated with cerebral death. 142 studies on 80 patients demonstrating the bedside use of an innocuous IV procedure as an adjunct in the diagnosis of cerebral death.

A portable radioisotopic technique was developed to demonstrate cerebral circulatory deficit, as part of a collaborative study to define and diagnose cerebral death simply and rapidly, in comatose, apneic patients with electrocerebral silence. The method involves an intravenous injection of 2mCi of 99mTcO4, and recording time/activity curves over the cranial cavity and a femoral artery simultaneously, using twin probe radioisotope detector equipment. Eight comatose, apneic patients had 142 studies in conjunction with clinical electroencephalographic and other laboratory evaluations. The results indicate that the absence of a bolus tracing from the head, as contrasted to the usual bolus seen is indicative of significant circulatory deficit to the cerebrum. This test may be used as an adjunct in confirming the diagnosis of cerebral death. A normal bolus tracing should be simultaneously observed over a femoral artery and this is used as a control. The method is safe and simple and offers significant information about the irreversibility of cerebral blood flow. Although further studies are indicated, the method appears to be most promising as a fundamental bedside laboratory test in the diagnosis of cerebral death in conjunction with other clinical and laboratory criteria.

Adult↗
PubMed1975

Comparison of dopa decarboxylase inhibitor (carbidopa) combined with levodopa and levodopa alone in Parkinson's disease.

A double-blind study comparing the effects of carbidopa and levodopa combined in a single tablet with levodopa alone was undertaken in 50 patients with Parkinson's disease. After 6 months, there was a statistically significant improvement over baseline in total score, rigidity, and tremor only in the patients randomized to carbidopa/levodopa. In addition, 40 percent of the patients treated with carbidopa/levodopa showed obvious clinical improvement (a greater than 50 percent reduction in their total score) over treatment with levodopa alone. However, after 2 years, only 20 percent continued to show this improvement. Nausea, vomiting, and anorexia developed in 56 percent of patients on levodopa but in only 27 percent of patients on carbidopa/levodopa. However, abnormal involuntary movements, observed in 48 percent of patients on levodopa, were present in 77 percent of patients on carbidopa/levodopa. Despite the increase in abnormal involuntary movements, carbidopa/levodopa is more effective than levodopa.

Adult↗