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Biomedical subjects

H Robinson

Publications and source records attributed to H Robinson.

At least 109 records · Page 6Linked to original sources

Modification of the projection from the sensory cortex to the motor cortex following the elimination of thalamic projections to the motor cortex in cats.

Examination of the projection from area 2 of the sensory cortex to the motor cortex revealed substantial changes following lesion of the ventrolateral nucleus of the thalamus. These observed changes were as follows. (1) The polarity of the evoked potentials elicited by area 2 stimulation reversed in the depth of the motor cortex whereas in normal animals, there was no reversal. (2) The amplitude of area 2-elicited EPSPs in the motor cortical neurons became greater following the lesion of VL. (3) The shape of the observed EPSPs was characterized by multiple peaks whereas in normal animals, the EPSPs were generally smooth and monophasic. (4) Neurons receiving a short-latency input from area 2 were distributed throughout the depths of the motor cortex whereas in normal animals, they were located only in the upper layers (layers II and III). (5) Intracellular injection of HRP revealed that the neurons receiving short-latency input were not restricted to typical stellate type cells, but also included bipolar or bitufted neurons with elongated cell bodies and polarized arborizations. These neurons were located in the superficial (II and III) as well as in the deep (V) layer. It is concluded that the elimination of thalamic input resulted in the reinforcement of the corticocortical input to the motor cortex. The subsequently observed corticocortical projection extended to neurons did not originally innervated by the association fibers. The results suggested that functional recovery following thalamic lesion is partly due to reorganization of projections from the sensory cortex to the motor cortex.

Animals↗

The use of methylprednisolone and metoclopramide in control of emesis in patients receiving cis-platinum.

cis-Platinum is a chemotherapeutic agent with benefits often limited by the severe gastrointestinal reactions it produces in nearly all patients. Persistent anorexia, nausea, and vomiting may continue for days after therapy and are poorly controlled by conventional antiemetics. Patients at times refuse continuation of cis-platinum chemotherapy because of these severe gastrointestinal side effects. Intravenous methylprednisolone (Solu-medrol) as well as intravenous metoclopramide (Reglan) have been shown effective in the treatment of chemotherapy-induced nausea and vomiting. This randomized, double-blind study is a comparison of the efficacy of Solu-medrol vs Reglan, as well as, the combination of Solu-medrol and Reglan in the prevention of cis-platinum-induced nausea and vomiting. In this study patients receiving Reglan had better protection from vomiting than patients receiving Solu-medrol (P = 0.0564). Patients receiving the combination of Reglan and Solu-medrol had better protection from vomiting than patients receiving Reglan alone (P = 0.0332), or patients receiving Solu-medrol alone (P = 0.0010). Finally, older patients experienced less vomiting than younger patients, regardless of the anti-emetic drugs used (P = 0.0730).

Adult↗

Insulin release pattern after blockade of catecholamine synthesis with alpha-methyl tyrosine in vivo.

Insulin release pattern in vivo was studied using 30 control rats and 30 rats treated with alpha-methyl tyrosine to block catecholamine synthesis in vivo four days before the time of investigation. The drug treated animals exhibited significantly higher fasting insulin levels, and also the first phase insulin release after the B cell was challenged with a glucose load was significantly higher in these animals than occurred in the controls. This observation implies that the B cell is modulated by the sympathetic nervous system in its function and the insulin release would vary according to the emotional state of the individual.

Animals↗

Occult hepatic sinusoid tumor of infancy simulating neuroblastoma.

Two infants with hepatosplenomegaly and an occult tumor of hepatic sinusoids are reported. Although secretion of biogenic amines of neuroblastoma was not elevated, infrequent neurosecretory granules were observed by electron microscopy in the cytoplasmic processes of the tumor cells. The infants responded to vincristine and prednisone therapy and are tumor free 8 and 2 years later, respectively. The clinical, radiographic, biochemical, and microscopic findings of these cases are presented. The distinction from other infantile hepatic sinusoid small round cell tumors is based on the light and electron microscopic findings. This neuroepithelial tumor is either an unusual form of neuroblastoma or a neoplasm of APUD cell origin. If chemotherapy is utilized, it should be selective and limited.

Drug Therapy, Combination↗

Usefulness of theophylline saliva levels in neonates.

In order to establish an alternative means for monitoring serum theophylline concentrations in neonates, the reliability of salivary theophylline concentrations was investigated. Eight premature neonates with apnea of prematurity were studied. Neonates received between 1.25 and 2.5 mg/kg of intravenous aminophylline every 12 h. Simultaneous samples of blood (0.25 ml) and unstimulated saliva (0.25-0.50 ml) were obtained 4 and 8 h after drug administration. Serum and salivary theophylline concentrations statistically correlated (r = 0.98, p less than 0.01). The mean serum/saliva ratio was 1.02 +/- 0.09, with an 8.9% interpatient variation. Serum theophylline concentrations can be predicted from the equation: serum concentration = 1.069 x saliva concentration - 0.193. The data suggest that theophylline serum and saliva concentrations in the apneic neonate are approximately equal. Salivary theophylline concentrations may be clinically useful when serum is not readily available.

Humans↗

Free-standing emergency clinics: community development guidelines.

When a free-standing emergency clinic (FEC) unexpectedly opened in Montgomery County, Maryland, the local emergency medical services council thought the FEC's operational plan was in conflict with the community concept of emergency medical services (EMS). Because there were no agreed upon factual guidelines with which to judge the FEC, the council established a task force to study the problem and to develop standards and guidelines. This article is based on that report. We recommend that if a facility physically separate from a hospital uses the words "emergency" in offering medical services, it means at least 24 hours of operation with standards at least equal to those offered by the local EMS system.

Allied Health Personnel↗

Detection of urinary incontinence.

Thirty patients complaining of stress incontinence were investigated by clinical examination, videocystourethrography and Urilos device. The latter was the most effective method of confirming the history. Standing and lying made no difference to detection of incontinence on clinical examination. A scheme for use of these investigations was proposed.

Adolescent↗

Evaluation of flurbiprofen in detrusor instability.

Thirty women with detrusor instability (27 cases idiopathic, and three secondary to multiple sclerosis) completed a double-blind, cross-over trial of the prostaglandin synthetase inhibitor flurbiprofen and a placebo, results being evaluated by questionnaire and cystometry. Frequency, urgency, and urge incontinence were all significantly reduced with flurbiprofen (P less than 0.001, P less than 0.025, and P less than 0.025 respectively), as was the detrusor-pressure rise during bladder filling (P less than 0.01). Side effects, however, occurred in 13 patients while taking flurbiprofen compared with five while taking placebo (P less than 0.025). After the trial 19 patients wished to continue with flurbiprofen. Flurbiprofen is a useful treatment for idiopathic detrusor instability and is well tolerated by most patients.

Adult↗

Preovulatory follicular size: a comparison of ultrasound and laparoscopic measurements.

Ovarian follicles in the immediate preovulatory period were measured with real-time or static ultrasound. Thirty-nine follicles were examined in thirty-six patients. In 29 spontaneous cycles the mean follicular diameter was 21.1 mm (range 17 to 25 mm) and the mean volume was 5.1 ml. In seven stimulated cycles the mean diameter was 18.4 mm and the mean volume was 3.5 ml. Laparoscopic needle aspiration of the follicular contents was performed within 12 hours of ultrasound examination in every case. Follicular dimensions based on the volume of aspirated fluid correlated well with the ultrasound measurements (r = 0.847; P < 0.001), which suggests that ultrasound is a useful technique for examining preovulatory follicular development.

Female↗

The use of meditation--relaxation techniques for the management of stress in a working population.

The efficacy of meditation-relaxation techniques has been widely researched in the laboratory, but their effectiveness for management of stress in organizational settings is still relatively unexplored. The present study compared relaxation and control conditions as part of a program of stress-reduction in industry. A total of 154 New York Telephone employees self-selected for stress learned one of three techniques--clinically standardized meditation (CSM), respiratory one method meditation (ROM) or progressive relaxation (PMR)--or served as waiting list controls. At 5.5 months, the treatment groups showed clinical improvement in self-reported symptoms of stress, but only the meditation groups (not the PMR group) showed significantly more symptom reduction than the controls. The meditation groups had a 78% compliance rate at 5.5 months with treatment effect seen whether subjects practiced their techniques frequently or occasionally. The safe and inexpensive semi-automated meditation training has considerable value for stress-management programs in organizational settings.

Adult↗

Theophylline-induced seizures in accidentally overdosed neonates.

Theophylline-induced seizures are reported in two neonates. The serum theophylline concentration during seizures were 51.0 mg/liter and 54.0 mg/liter. Toxic symptoms prior to seizures may be absent or undetected, suporting the necessity of blood level monitoring during theophylline therapy.

Female↗

Epidemiology of subacute sclerosing panencephalitis.

The Subacute Sclerosing Panencephalitis Registry has compiled data from 453 instances of SSPE occurring in the United States from 1960 through 1976. The mean annual incidence during this period was 3.5 per 10 million persons under 20 years of age, 2.3 times higher for males than females, and 4.0 times higher for whites than blacks. Although the long-term pattern of incidence is unknown, the incidence of reported SSPE declined dramatically from 1970 to 1976. There are marked geographic variations of SSPE activity within the United States and also a higher incidence for children from farms (9.4 per 10 million persons under 20) compared with children from other rural domiciles (3.7 per 10 million), suburban children (2.9 per 10 million), and inner-city children (1.6 per 10 million). Available epidemiologic evidence suggests that some extrinsic factor, unrelated to measles or measles vaccine, is important in the pathogenesis of the disease.

Adolescent↗