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Biomedical subjects

H Morris

Publications and source records attributed to H Morris.

At least 73 records · Page 4Linked to original sources

Registration of EEG electrodes with three-dimensional neuroimaging using a frameless, armless stereotactic wand.

A technique of image and electrode registration has been developed that allows electroencephalogram electrode location to be merged with 2-D or 3-D MRI or CT. An armless, frameless stereotactic localization system that may be used in or out of the operating room is used to generate spatial data for surface and accessible intracranial electrodes. Acquisition of electrode position data may be obtained before or after neuroimaging and the locations of additional electrodes added at any time. The methodology of this system and representative cases with MRI imaging are presented.

Adult↗

Narrative representation, narrative enactment, and the psychoanalytic construction of history.

This paper develops the idea that the fundamental tension between representation and enactment described by psychoanalytic historical theories also determines and limits our theorizing attempts themselves. Freud moves toward this recognition in his late work as he brings a challenge to the lifting-of-repression model of historical recovery. One basis of this challenge is that Freud now implicates the analyst, as well as the analysand, in the tension between the capacity of historical narratives to represent the past, and their tendency to enact it. From the perspective of Freud's explicitly dialogic model in 'Constructions in analysis', the task of establishing historical reference in psychoanalysis cannot be separated from the narrative actions of the analyst. These narrative actions would necessarily include manifestations of denial and disavowal that I designate as 'narrative enactments'. My discussion expands upon this linguistic dimension of questions Freud raises about the limits of the psychoanalytic construction of history. Narrative enactments work against an interpretive restoration of historical reference based upon the lifting of repression, but at the same time, seen as an aspect of narrative functioning, they are founding acts upon which our historical constructions rest.

Defense Mechanisms↗

Adaptive changes in the pyloric motor response to intraduodenal dextrose in normal subjects.

Gastric emptying of glucose is faster after dietary supplementation of glucose, suggesting specific adaptation to changes in nutrient intake. In the present study, the effects of a continuous long-term (0-120-minute) and two short-term (0-20- and 80-100-minute) intraduodenal infusions of dextrose (2.4 kcal/min) on antropyloroduodenal motility and blood glucose, plasma gastric inhibitory polypeptide, and insulin concentrations were evaluated in nine volunteers. In four volunteers, an intraduodenal infusion of triglyceride (2.4 kcal/min) was administered immediately after the long-term dextrose infusion. The long-term dextrose infusion initially increased isolated pyloric pressure waves (IPPWs) and basal pyloric pressure (P < 0.05 for both), but after about 30 minutes IPPWs and basal pyloric pressure decreased and returned to baseline within 80 minutes. Each short-term infusion increased IPPWs and basal pyloric pressure (P < 0.05 for both). Antral pressure waves remained suppressed during the long-term dextrose infusion. Intraduodenal triglyceride increased IPPWs and basal pyloric pressure (P < 0.05 for both). The long-term dextrose infusion was associated with a sustained increase, and both short-term dextrose infusions were associated with peaks in glucose, insulin, and gastric inhibitory polypeptide levels. There was no significant relationship between biochemical measurements and antropyloroduodenal motility. It is concluded that specific adaptive changes occur rapidly in the phasic and tonic pyloric motor response, but not the antral motor response, to intraduodenal dextrose.

Adaptation, Physiological↗

Results of surgery and radiotherapy for early breast cancer.

Primary radiotherapy for 127 early breast cancers produced five-year local control of 96.1 percent and NED results of 81.1 percent. Results from a large community cancer center in New Jersey are comparable to results of major university cancer centers.

Adult↗

Biochemical and behavioral characterization of a novel cholinergic agonist, SR 95639.

Selective M1 cholinergic agonists may be useful in treating dementias due to cholinergic hypofunction. SR 95639 has recently been described as such a compound. We found the compound to have affinity for M1 sites (Ki = 2.1 microM) which was approximately 3-fold higher than its affinity for M2 sites. Functional partial agonism was suggested by an inconsistent increase in phosphoinositide (PI) turnover in rat hippocampal slices, combined with blockade of carbachol-stimulated PI turnover. In vivo M2-mediated effects were absent. Scopolamine-induced hyperactivity was attenuated by SR 95639 and scopolamine-impaired inhibitory avoidance and radial maze performance were improved. The compound appears to be a weakly selective M1 partial agonist with potential advantages over existing compounds.

Animals↗

Outcome of psychogenic seizures in children and adolescents compared with adults.

We compared outcome of psychogenic seizures documented by video-EEG in 18 nonepileptic children and adolescents (ages 8 to 18; median, 14.5 years old) and 20 adults (ages 25 to 56; median, 34.0 years old). Outcome was significantly better for the younger patients at 1 year, 2 years, and 3 years after diagnosis. At these follow-up times, the percentages of children and adolescents free of psychogenic attacks were 73%, 75%, and 81%; at the same follow-up times, the percentages of adults free of psychogenic attacks were only 25%, 25%, and 40%. Factors leading to better outcome for younger patients may have been different psychological mechanisms at different ages of onset and greater effectiveness with earlier intervention.

Adolescent↗

Psychogenic seizures in children and adolescents: outcome after diagnosis by ictal video and electroencephalographic recording.

Psychogenic seizures in 21 nonepileptic children and adolescents, aged 8 to 18 (mean 14.5) years, were recorded by means of video recording and electroencephalography. The episodes included thrashing movements, limb jerking, or staring, with unresponsiveness. Ictal and interictal electroencephalograms showed no abnormalities after antiepileptic medication was discontinued. Fifteen patients had psychogenic seizures spontaneously during recording, and six had seizures in response to suggestion and intravenous saline injection. After the video-electroencephalographic evaluation, patients and families were told that the episodes were emotional in origin. All patients but 1 agreed to remain without antiepileptic medication, and 16 patients (76%) agreed to begin psychiatric treatment. At 6 to 66 (mean 30) months' follow-up, 14 of 18 (78%) were free of episodes. These data indicate that the majority of young patients with psychogenic seizures have a good outcome. A firm diagnosis is critical so that the episodes can be classified and emphasized as medically not worrisome, permitting a shift away from antiepileptic medication and toward psychiatric treatment.

Adolescent↗

Speech manifestations in lateralization of temporal lobe seizures.

To evaluate the role of speech manifestations in lateralization of temporal lobe seizures, we reviewed videotapes of 100 complex partial seizures in 35 patients who underwent temporal lobectomy for intractable epilepsy. All patients had prolonged electroencephalographic video monitoring with scalp and subdural electrodes, and their speech dominance was determined with an intracarotid amobarbital test. Speech manifestations were observed in 79 seizures and were classified as vocalization, normal speech, or abnormal speech. Vocalization of sounds without speech quality occurred ictally in 48.5% of patients. Normal speech (identifiable speech) occurred ictally in 34.2% of patients. Abnormal speech (speech arrest, dysphasia, dysarthria, and nonidentifiable speech) occurred in 51.4% of patients, either ictally or postictally. Of all the above speech manifestations, only postictal dysphasia and ictal identifiable speech had significant lateralizing value: 92% of patients with postictal dysphasia had their seizures originating from the dominant temporal lobe (p less than 0.001), and 83% of those with ictal identifiable speech had their seizures from the nondominant side (p = 0.013). This study shows that speech manifestations are common in complex partial seizures of temporal lobe origin and can provide an excellent clinical tool for lateralization of seizure onset.

Adolescent↗

The patient-analyst match and the outcome of psychoanalysis: a pilot study.

This paper presents a pilot study in which we explore the possibility that the match between analyst and analysand is a factor of central importance in the analytic situation. It is an attempt to look at the issue of match across a large number of patients. The data we used were not collected for studying this topic; thus, the study has serious limitations. Nevertheless, certain patterns emerged which support our thesis that patient-analyst match plays a significant role in the outcome of psychoanalysis. We present this work as a first step in developing concepts and methods which will be pursued in a more systematic and rigorous fashion in a later study.

Adaptation, Psychological↗

The dexamethasone suppression test in relation to symptomatology: preliminary findings controlling for serum dexamethasone concentrations.

A diagnostically heterogeneous sample of psychiatric inpatients (n = 52) was administered the 1 mg dexamethasone suppression test (DST) shortly after hospital admission. Each was also assessed using the Hamilton Rating Scale for Depression (HRSD) and selected items of the Present State Examination (PSE) representing psychomotor retardation and anxiety. A potent determinant of postdexamethasone serum cortisol concentrations was found to be the level of serum dexamethasone concentration achieved following the oral dose. No relationship was found between postdexamethasone cortisol concentration and the scores on either the HRSD or an anxiety scale derived from selected PSE items. However, symptoms of psychomotor retardation were significantly related to postdexamethasone serum cortisol concentration, particularly when the serum dexamethasone concentrations were taken into account. It may be that DST nonsuppression in psychiatric patients is in part a reflection of the presence of psychomotor retardation, a phenomenon that cuts across diagnostic categories.

Adolescent↗

Reflections on Lacan: his origins in Descartes and Freud.

Appreciation of Descartes' importance to Lacan's reading of Freud is a point of entry into Lacan's seemingly hermetic theoretical system. Lacan's analysis of Descartes' search for ontological certainty draws him, in Freud, to the ontological implications of castration anxiety, disavowal, and splitting of the ego. Lacan's theory both derives from and develops Freud's late work on the narcissistic origins of conflict within the ego.

Anxiety, Castration↗

The source of 'paradoxical lateralization' of cortical evoked potentials to posterior tibial nerve stimulation.

We report the potentials elicited by posterior tibial nerve stimulation and recorded simultaneously from the scalp and from electrodes within the interhemispheric fissure. The primary cortical potential was recorded from cortex contralateral but from scalp ipsilateral to the stimulated nerve. The scalp recordings thus demonstrated "paradoxical lateralization" as reported previously, and the similar morphology of the scalp and contralateral cortical recordings confirm that this "paradoxical lateralization" is most likely the result of a horizontal dipole located within the interhemispheric fissure.

Adolescent↗

Treatment of postmenopausal hyperparathyroidism with norethindrone. Effects on biochemistry and forearm mineral density.

The effects of norethindrone (5 mg daily) on biochemical variables and forearm mineral density were assessed in 20 postmenopausal women with mild primary hyperparathyroidism. Norethindrone produced a significant fall in plasma calcium levels and the fasting urinary calcium-creatinine and hydroxyproline-creatinine ratios after three months of treatment. There was no change in the plasma parathyroid hormone concentrations. The forearm mineral density before treatment was low in 16 of the 20 patients and there was a significant increase in forearm mineral density after norethindrone treatment. No side effects were reported. We conclude that norethindrone is an effective treatment for mild hyperparathyroidism in postmenopausal women.

Aged↗

Langerhans' cells, papillomaviruses and oesophageal carcinoma. A hypothesis.

A hypothesis linking the concept of mucosal immune surveillance (Langerhans' cells and intra-epithelial lymphocytes) with recent evidence of human papillomavirus (HPV) infection of the oesophagus in a sequence of events which leads to squamous dysplasia and invasive carcinoma is presented. It is believed that the essential pathway to squamous carcinoma involves an aberration of the Langerhans' cell/lymphocyte network and its symbiotic relationship with squamous cells as a result of persistent HPV infection in the epithelium. Neoplastic transformation may occur when this 'at-risk' mucosa is exposed to one or several co-carcinogenic factors present in the environment. This hypothesis is supported by morphological changes present in acanthotic lesions of the oesophagus and by immunocytochemical evidence of HPV infection of the mucosa. In addition, this viewpoint offers a possible explanation for the regional variation of oesophageal carcinoma, the rising incidence of the disease, and the association with multifocal squamous carcinomas of the upper aerodigestive tract.

Cell Transformation, Neoplastic↗

The effect of serum dexamethasone concentrations in the dexamethasone suppression test.

Serum dexamethasone and cortisol concentrations were measured in a sample of 98 psychiatric inpatients during the course of the 1-mg oral overnight Dexamethasone Suppression Test (DST). Suppressors were found to have significantly higher serum dexamethasone concentrations than nonsuppressors at each time of sampling (8:00 AM, 4:00 PM, and 11:00 PM). There was a significant inverse curvilinear relationship between serum dexamethasone and cortisol concentrations at each sample time. Although serum dexamethasone concentration was a potent determinant of postdexamethasone serum cortisol concentration, there were still significantly higher serum concentrations of cortisol in patients with major depression compared with patients with other disorders when dexamethasone concentrations were statistically controlled. By taking serum dexamethasone concentrations into account in defining DST suppression status, a modest increase in diagnostic specificity was achieved, but no substantial change in sensitivity.

Adult↗

Lymphoid tissue of the normal fallopian tube--a form of mucosal-associated lymphoid tissue (MALT)?

Mucosal-associated lymphoid tissue (MALT) is a specialized form of peripheral lymphoid tissue which is found in mucosal surfaces directly or indirectly exposed to the environment. Using immunohistological labeling techniques and electron microscopy, we have explored the possibility that MALT exists in the normal fallopian tube. Immunohistological analysis has demonstrated a striking degree of uniformity in the phenotype of intraepithelial lymphocytes with a predominance of T-lymphocytes of T-cytotoxic/suppressor subtype. Occasional intraepithelial macrophages are also present, but B-cells, T-helper cells, and natural killer cells are absent or are rarely found in the epithelium. Electron microscopy has provided morphological evidence of an interaction between epithelial cells and intraepithelial lymphocytes. The opposing plasma membranes of these two cell types are arranged in the form of complex interdigitations and laminations. These striking arrangements substantially increase the total area of contact between the two cell types. We conclude that MALT does exist in the fallopian tube and that epithelial cells form an integral part of the system. A hypothetical view of the relationship between these cell types is presented.

Adult↗