Biomedical subjects
C D Hall
Publications and source records attributed to C D Hall.
Clinical and pathological features of an autosomal recessive neuropathy.
Two siblings are described, ages 49 and 45 years, having a distinct hereditary motor and sensory neuropathy (HMSN) with severe peroneal nerve involvement. The neuropathic symptoms began in childhood. Both patients have sensorineural deafness. The proband was found to have a cardiac conduction abnormality in the absence of known ischemic heart disease. Electrodiagnostic studies were consistent with a demyelinating peripheral neuropathy. The presence of parental consanguinity and absence of affected individuals in succeeding or preceding generations suggested that the sensorimotor neuropathy in this family is inherited in an autosomal recessive manner. The sural nerve of the proband had significant loss of myelinated fibers and demyelination but few regenerating myelinated fibers and no onion-bulbs. The pathological findings, while nonspecific, are not characteristic of the hypertrophic, neuronal or intermediate types of HMSN.
Primary brain stem reticulum cell sarcoma causing dementia.
Primary reticulum cell sarcoma-microgliomas of the brain stem are extremely rare. Described here is an unusual case with profound episodic dementia as the predominant clinical manifestation.
Pituitary adenoma presenting as recurring painful ophthalmoplegia.
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Sciatic entrapment neuropathy. Case report.
A case of sciatic entrapment neuropathy is discussed. When evaluating patients with unilateral leg pain and paresthesias, one should consider the possibility of entrapment of peripheral nerve. Electrodiagnostic studies are helpful in establishing the diagnosis.
Reactions of cytosine and cytidine with O-substituted hydroxylamines.
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Speed kills: fatality from the self-administration of methamphetamine intravenously.
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Rapid deterioration in patients with parkinsonism following tryptophan-pyridoxine administration.
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Liothyronine with levodopa in parkinsonism.
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"Stiff man syndrome" and trauma.
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Inefficacy of tryptophan-pyridoxine in essential tremor.
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Pathology of disulfiram neuropathy.
The pathological changes in a sural nerve biopsy from a 42-year-old woman with disulfiram-induced peripheral neuropathy were assessed by quantitative light microscopy, electron microscopy, and the study of teased nerve fibres. The nerve had a marked loss of myelinated fibres; of the remaining myelinated fibres some were undergoing Wallerian-type axonal degeneration. Large myelinated fibres were preferentially involved. Primary demyelination, remyelination, and evidence of regeneration were not present. Because of the marked differences between the pathological findings in disulfiram neuropathy and carbon disulfide neuropathy, it is concluded that carbon disulfide is not responsible for the neurotoxic effect of disulfiram.
Progressive multifocal leukoencephalopathy in AIDS: are there any MR findings useful to patient management and predictive of patient survival? AIDS Clinical Trials Group, 243 Team.
BACKGROUND AND PURPOSE: While MR findings in progressive multifocal leukoencephalopathy (PML) have been described previously, usually in retrospective studies with limited sample size, what has not been well addressed is whether any are predictive of longer survival. Our participation in a large prospective clinical trial of AIDS patients with biopsy-proved PML and MR correlation allowed us to test our hypothesis that certain MR features could be found favorable to patient survival. METHODS: The patient cohort derived from a randomized multicenter clinical trial of cytosine arabinoside for PML. Pretreatment T1- and T2-weighted noncontrast images (n = 48) and T1-weighted contrast-enhanced images (n = 45) of 48 HIV-positive patients with a PML tissue diagnosis as well as the follow-up images in 15 patients were reviewed to determine signal abnormalities, lesion location and size, and the presence or absence of mass effect, contrast enhancement, and atrophy, and to ascertain the frequency of these findings. A statistical analysis was performed to determine if any MR abnormalities, either at baseline or at follow-up, were predictive of patient survival. RESULTS: No MR abnormalities either on univariate or multivariate analysis significantly correlated with patient survival, with the exception of mass effect, which was significantly associated with shorter survival. The mass effect, however, always minimal, was infrequent (five of 48). More severe degrees of cortical atrophy and ventricular dilatation, lesion location and size, and other MR variables were not predictive of outcome. CONCLUSION: Except for mass effect, we found no MR findings predictive of the risk of death in patients with PML. The mass effect, however, was so infrequent and minimal that it was not a useful MR prognostic sign.
Cerebrospinal fluid analysis in human immunodeficiency virus infection.
Cerebrospinal fluid (CSF) analytes were evaluated in 59 human immunodeficiency virus (HIV+) individuals to assess neurological involvement. Glucose, total protein, cell counts, p24 antigen, CSF: serum albumin/IgG ratios, and oligoclonal bands were measured. Eighty percent of samples showed abnormalities in one or more analyte. In some patients samples, these abnormalities could mimic those of secondary opportunistic infection when none was present. The presence of oligoclonal banding in CSF (31 percent) and disturbances in CSF: serum albumin/IgG ratio (30 percent) were related to decreases in serum CD4+ lymphocytes. Disturbances in CSF: Serum albumin/IgG ratio were also related to severity of non-neurological HIV disease staging. Cerebrospinal fluid oligoclonal bands were distinct from that found in serum in the same subjects. Since immune complexes between immunoglobulins and enzymes are observed in these same patients, these oligoclonal bands may result in artifactually elevated enzyme results secondary to decreased clearance leading to erroneous clinical decisions. There was no significant relationship between any abnormalities and the presence of neurologic disease as established by a wide variety of other studies. It is important to recognize the limits of CSF interpretation in this patient group.
Median nerve F wave conduction in healthy subjects over age sixty-five.
Parameters of the median nerve F wave and peripheral motor nerve conduction in 51 healthy male and female human subjects 67 to 89 years of age are described. F wave responses were elicited by stimulation of the nerve at the wrist. Motor nerve conduction velocity (MNCV) was determined for the forearm segment. Major results of this study of an older group of subjects demonstrate that: 1) the shortest F wave latency (SFWL) and the MNCV were slower in our older subjects than values in younger subjects; 2) there was no significant correlation between SFWL and age within the age group examined; 3) distal motor conduction latency was significantly slower in subjects age 75-89 years than in those age 67-74 years; 4) SFWL and MNCV of females were significantly faster than that of males; 5) a positive correlation was found between SFWL and arm length and a predictive formula is derived. An upper limit of normal F wave wrist latency of 31 msec for females and 34.4 msec for males over 65 years of age is proposed as a guideline.