Biomedical subjects
B H Peters
Publications and source records attributed to B H Peters.
Effects of physostigmine and lecithin on memory in Alzheimer disease.
Because there is evidence that central cholinergic mechanisms are depleted in dementia, we studied the effects of central cholinergic augmentation on the memory of 5 patients with Alzheimer disease. Patients received placebo, lecithin, physostigmine, or lecithin plus physostigmine in a double-blind study using titrated doses of the acetylcholinesterase inhibitor physostigmine. Memory was evaluated with alternate forms of the selective reminding procedure. Compared with lecithin alone, the combination of physostigmine and lecithin consistently enhanced memory storage and retrieval; physostigmine without lecithin produced no memory facilitation. The strategy of combining a cholinergic agonist and precursor holds promise, although a larger clinical trial is needed.
Regulation of plasma potassium in hyperkalemic periodic paralysis.
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Memory enhancement after physostigmine treatment in the amnesic syndrome.
Central anticholinergic agents (eg, scopolamine) are known to produce transient memory deficits in human and animal subjects. Damage to the limbic system frequently results from herpes simplex encephalitis (HSE) and produces a memory deficit. If this deficit is due to limbic cholinergic pathway destruction, it might improve with central cholinergic agonists (eg, physostigmine). In a doubleblind study over a three-week period, we compared memory performance on three days after 0.8-mg subcutaneous physostigmine therapy (three sessions) to baseline performance and that obtained in three randomly interspersed control sessions. Serial assessment of memory by the Selective Reminding Test showed reproducible enhancement of long-term storage and retrieval with physostigmine treatment. Performance after control injections did not exceed baseline levels. Our findings encourage the hypothesis that cholinergic mechanisms subserve memory and that their pharmacological potentiation might favorable influence some amnesic conditions.
Neuropathy presenting as prolonged dyspnea. Case report and review of literature.
Polyneuropathy presented as isolated respiratory muscular paralysis. Transdiaphragmatic pressure measurements, nerve conduction studies, electromyography, and biopsy of intercostal muscle confirmed the nature of the process. Patients with unexplained respiratory insufficiency must be carefully evaulated for underlying neuromuscular disease.
Neurologic and psychologic manifestations of decompression illness in divers.
It has been widely accepted that the neurologic sequelae of decompression illness are confined to the spinal cord. Of 10 divers who gave a history of an episode of decompression illness involving the central nervous system, we found that eight had unequivocal neurologic deficits implicating multiple supraspinal lesions. Seven of these neurologically impaired divers completed a battery of neuropsychologic tests that revealed severe deficits in all cases. The findings show that diffuse and multiple central nervous system lesions result from decompression illness and demonstrate the importance and close correlation of thorough neurologic and neuropsychologic tests in assessment following diving accidents.
Hyperbaric oxygenation in the treatment of postencephalitic amnesic syndrome.
The efficacy of hyperbaric oxygenation in the treatment of an amnesic disorder was studied in a young woman with a residual memory impairment 2 years after Herpes Simplex Encephalitis. Quantitative testing of memory was performed under controlled conditions before, during, and immediately following treatment. There was no systematic change in storage and retrieval of either verbal or essentially nonverbal information when testing was performed during hyperbaric oxygenation or after termination of four daily treatment sessions. The findings support recent studies which have indicated a lack of therapeutic effects of hyperbaric oxygenation on the mental efficiency of older demented patients.
Pronator syndrome: clinical and electrophysiological features in seven cases.
The clinical and electrophysiological picture of seven patients with the pronator syndrome is contrasted with other causes of median nerve neuropathy. In general, these patients have tenderness over the pronator teres and weakness of flexor pollicis longus as well as abductor pollicis brevis. Conduction velocity of the median nerve in the proximal forearm is usually slow but the distal latency and sensory nerve action potential at the wrist are normal. Injection of corticosteroids into the pronator teres has produced relief of symptoms in a majority of patients.
Neuropsychological testing following head injuries: prosopagnosia without visual field defect.
Assessment of residual cerebral dysfunction in the post-traumatic patient poses considerable problems particularly when the neurological examination yields minimal or equivocal findings. The clinical picture is frequently complicated by emotional disturbance not easily differentiated from "post-traumatic neurosis." This report describes such a patient whose disorder was elicidated by neuropsychological testing. Numerous studies have established the validity of neuropsychological tests particularly when they are interpreted by psychologists specifically trained in their use. These procedures are also useful in differentiating patients with neurologic complaints of a nonorganic etiology from patients with similar complaints secondary to confirmed brain lesions. Although the findings reported here pertain to a patient exhibiting a rare neurologic consequence of closed head injury, the methods employed are applicable to subtle behavioral manifestations of diverse etiologies. Neurophyshological findings in a patient unable to recognize faces of familiar persons (prosopagnosia) disclosed a severe impairment of visual perception despite intact visual acuity and fields. The prosopagnosia was also associated with a pervasive memory deficit without dementia. Our results challenge current concepts of prosopagnosia and support the need for neuropsychological evaluation of post-traumatic patients.
Recurrent sciatica associated with herpes simplex. Case report.
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Thoracic duct lymphocyte depletion in myasthenia gravis.
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Hyperglycemia with relative hypoinsulinemia in diphenylhydantoin toxicity.
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On the association of pheochromocytoma and cerebellar hemangioblastoma.
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