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Biomedical subjects

D Rosenthal

Publications and source records attributed to D Rosenthal.

At least 253 records · Page 14Linked to original sources

Results of carotid endarterectomy for vertebrobasilar insufficiency: an evaluation over ten years.

A review was performed of 114 patients with symptoms of vertebrobasilar insufficiency (VBI) alone, or in combination with carotid territory transient ischemic attacks or carotid territory completed stroke (cCS) with follow-up extending to ten years. The most frequent symptoms of VBI were visual changes (50%), dizziness (31%), and syncope (30%). Patients with symptoms of VBI and arteriographic evidence of intracranial disease, regardless of stump pressure, are at high risk for cerebral ischemia during endarterectomy. At late follow-up, ranging from one to ten years, 63% of the patients were alive; 88% were asymptomatic. Causes of death were mainly cardiac (44%) and stroke (36%), but patients with symptoms of VBI and cCS died earlier and from a second cerebrovascular accident. When a correct preoperative diagnosis was established, carotid endarterectomy produced relief of symptoms in 90% of the patients.

Adult↗

Comparison of gas chromatography mass spectrometry methods for the determination of delta9-tetrahydrocannabinol in plasma.

A method for the identification of delta9-tetrahydrocannabinol by gas chromatography mass spectrometry has been developed, and this method has been compared with other techniques, such as detection via thin-layer chromatography using tritium labeled delta9-tetrahydrocannibinol and a dual gas chromatographic method. The gas chromatographic mass spectrometric method was found to be equal or superior to other techniques and has the added advantage of being highly specific for the compound analyzed. An alternate approach using chemical ionization is also described; however, this procedure does not show significant advantages over the electron impact method. These methods show a practical lower detection limit of 500 pg ml-1 of plasma in clinical practice.

Chromatography, Gas↗

Xanthoma disseminatum. Clinical, metabolic, pathologic, and radiologic aspects.

A 55-year-old man with the classical mucocutaneous lesions of xanthoma disseminatum has been followed up for a period of 13 years. The special features of this case, which make it unique, are as follows: (1) the availability of histologic data on multiple lesions for more than a ten-year period; (2) the progressive nature of the multiple osseous lesions; (3) the metabolic studies that show no evidence for accumulation of abnormal sterols in a xanthoma, the blood, or intestinal aspirate; (4) the development of hypothyroidism and symptoms or signs, or both, of an intracerebral and an intraspinal lesion; (5) the partial regression of the cutanous symptoms and lesions while receiving clofibrate, in spite of progression of the mucous membrane and osseous lesions, and (6) the failure to develop diabetes insipidus to date.

Anus Diseases↗

Schizophrenics' adopting parents. Psychiatric status.

With the exception of one finding in one experiment, adoption studies have demonstrated that genetic and not rearing factors play an etiological role in the schizophrenias. In that one study, clinical evaluations showed the biological parents of schizophrenics as more disturbed than the adopting parents of schizophrenics, who were, in turn, slightly more disturbed than the adopting parents of normal persons. Both the biological and the adopting parents of schizophrenics showed an equivalent degree of Rorschach pathology, suggesting the possible role of a learned communication disorder in the schizophrenic disorders. A replicative study were performed, employing the same design but utilizing a systematic sample. Structured interviews and tests were administered to the biological parents of nongenetic retardates. Structured clinical evaluation showed the biological parents of schizophrenics to be more disturbed than the other two groups, between whom there was no difference in psychopathology. With analysis of the Rorschach tests, the biological parents of schizophrenics showed significantly more Rorschach pathology than found in the other two groups, whose degree of disorder was the same. This study again confirms the role of genetic factors and fails to show an environmental component in the etiology of the schizophrenias.

Adoption↗

The offspring of schizophrenics. II. Perinatal factors and IQ.

Within a sample of 60 children of schizophrenic parents, IQ and the correlates of IQ were examined. The Wechsler Intelligence Scale for Children was administered at age 7. The offspring of parents with schizophrenia were found to have a slightly lower IQ than their matched controls. This deficit could be attributed entirely to the male offspring. Using a second comparison group numbering several thousand, we computed correlations for various perinatal and socioeconomic factors with seven-year IQ. These correlations were also computed for the children of schizophrenics, and the difference in correlations was examined. IQs for the offspring of "continuous schizophrenics" (chronic, borderline, and chronic schizo-affective schizophrenics) were found to have lower correlations with socioeconomic indices and higher correlations, in a negative direction, with certain perinatal events. The findings were found to a lesser, nonsignificant degree among the small sample of offspring of acute schizophrenics. If these perinatal events are more negatively correlated with IQ because the children of continuous schizophrenics are specifically susceptible to them, it is possible that these factors are also influential in the later development of schizophrenia.

Acute Disease↗

Quadruplet hallucinations. Phenotypic variations of a schizophrenic genotype.

This article provides an in-depth analysis of hallucinations in monozygous quadruplets concordant for schizophrenia. Since all four are genetically identical, deviations among them with regard to various aspects of hallucinations probably represent the effects that nongenetic factors can produce in hallucinating schizophrenics. Concordance probably represent the effects of genetic factors. We present here findings based on this research strategy, and a brief review of the literature on hallucinations.

Adult↗

Carotid embolization presenting as total monocular blindness.

Blindness suddenly developed in the right eye of a 55-year-old man. There had been no antecedent illness suggestive of cardiovascular disease. Funduscopic examination eight hours later showed findings consistent with central retinal artery thrombosis. After an arteriogram showed an ulcerated plaque at the bifurcation of the right common carotid artery, the patient underwent thromboendarterectomy. The specimen contained an ulcer, presumably the nidus of an embolus to the central retinal artery. The patient's vision did not recover. This case demonstrates that, although it is rare, total monocular blindness may be caused by a large embolus from a carotid artery plaque.

Arteriosclerosis↗

Stages IIB and IIIB Hodgkin's disease. Results of combined modality treatment.

Between April 1969, and December 1974, 23 IIB and 26 IIIB surgically staged patients with Hodgkin's disease were treated at the Joint Center for Radiation Therapy. Stage IIB patients received either mantle and para-aortic-splenic pedicle, or total modal irradiation (TNI) alone or with the addition of combination chemotherapy. Relapse-free survival is 83% and overall survival 88%. Eleven patients received combination chemotherapy in addition to mantle and para-aortic irradiation, and both the relapse-free and overall survival are 100%. Of the stage IIIB patients, seven received TNI alone with four relapses, and 19 were treated with TNI and MOPP with two relapses. These relapse rates are significantly different (p less than 0.05). The relapse-free and overall survival for all stage IIIB patients is 66% and 84% respectively. These data imply that irradiation alone is not adequate treatment for stage IIIB Hodgkin's disease, and that with the addition of combination chemotherapy both the disease-free and overall survival is similar to that of early stage Hodgkin's disease without systemic symptoms. The ideal management of stage IIB Hodgkin's disease is less certain; it is our plan to study the efficacy of combined modality treatment.

Adolescent↗

Perinatal complications in offspring of psychotic parents.

The birth records of 78 subjects born to psychotic parents and 72 subjects born to normal parents were studied. No significant differences in the rates of pregnancy and birth complications (PBCs) were found between the offspring of psychotic parents and normal control parents. There were no differences between offspring born to psychotic mothers compared to psychotic fathers. Neither the onset of the parent's illness, nor the mother's age at delivery, nor the sex of the offspring seemed to influence the rate of PBCs. The offspring of chronic schizophrenic mothers and manic-depressive fathers had lower PBC rates than the offspring of parents of other diagnostic categories. The parents of these two groups, which were of a limited size, did not differ on any variable of significance, excepting the time of their first psychiatric hospital admission.

Adult↗

Lack of association between defective delinquents and antibody of herpesvirus hominis.

Several groups have reported a relation between herpesvirus hominis infection and certain psychiatric disorders. We have investigated herpes antibody levels in chronic criminal offenders who were diagnosed as defective delinquents and in criminals who were not defective delinquents. We found no difference in the frequency of titers of herpesvirus type I or type 2 antibody in these groups.

Adolescent↗

Bus use by disabled arthritics: functional requirements.

Twenty-five rheumatoid arthritic patients were studied to determine the extent of independence and functional requirements necessary to use public bus transportation in Philadelphia. To measure the extent of independence, a functional assessment scale was developed that evaluates 19 bus activities, each according to a four-point scale. Of the 11 subjects who stated that they used the public bus prior to admission, only 4 were found to be able to use the public bus independently at the time of evaluation. Ascending, descending and motion activities provided considerable difficulty for the sample population. Functional requirements of boarding and disembarking the bus are described in detail.

Activities of Daily Living↗

Mental illness in the biological and adoptive families of adopted individuals who have become schizophrenic.

In a sample of 5483 adults who had been legally adopted early in life by persons not biologically related to them, 33 were identified, from mental hospital records for whom a diagnosis of definite schizophrenia (chronic, latent, or acute) could be agreed upon by four raters. An equal number of matched controls were selected from the sample of adopted individuals who had never been admitted to a mental hospital. Ninety percent of the living parents, siblings, and half-siblings, biological and adoptive, cooperated in an extensive psychiatric interview permitting a consensus diagnosis by three blind raters. Schizophrenia and uncertain schizophrenia were found to be significantly concentrated in the population genetically related to the schizophrenic adoptees. Their adoptive relatives did not differ from the control populations in the prevalence of schizophrenic illness.

Adoption↗