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Biomedical subjects

H S Levin

Publications and source records attributed to H S Levin.

At least 217 records · Page 12Linked to original sources
PubMed1979

Impaired recognition memory after head injury.

A continuous recognition memory task employing 120 line drawings of familiar stimuli was administered to patients recovering from closed head injury of varying severity and control patients. Mildly injured patients obtained significantly more correct responses, and higher memory sensitivity (d') values than moderately and severely injured patients who performed similarly. The measure of response criterion, c, was significantly lower in patients with injury of moderate severity when compared to mildly injured cases and control patients. Controls and mildly injured patients did not differ in their performance. In general, the total correct responses most impressively differentiated head injured patients with measurable coma duration as more than two-thirds had scores below the control group. Group differences in hits, false alarms and misses were examined also. Age and education, skull fracture, and hematoma were generally unrelated to any of the measures, whereas coma duration was significantly related to most measures of mnemonic efficiency.

Adolescent↗
PubMed1979

Testicular biopsy in the study of male infertility: its current usefulness, histologic techniques, and prospects for the future.

Testicular biopsy has been widely used for the diagnosis of male infertility for more than three decades. During that time, with advances in cytogenetics, radioimmunoassay, and endocrinology, the role of testicular biopsy has changed. Testicular biopsy is still useful in the diagnosis of azoospermic and oligospermic males without stigmata of gonadotropic insufficiency or Klinefelter's syndrome. A classification and description is presented of pathologic changes in the testis as seen on testicular biopsy by light microscopy. The present rationale for testicular biopsy in infertility, the processing and staining of histologic material, and the role of testicular biopsy in infertility and infertility related situations, including cryptorchidism, malignant disease, and chemotherapy related changes, are discussed. Further understanding of testicular function and disease will depend upon the correlation of histologic and ultramicroscopic changes, immunohistologic localization of hormones, and epidemiologic and endocrinologic data.

Adolescent↗
PubMed1979

The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury.

The Galveston Orientation and Amnesia Test (GOAT) was developed to evaluate cognition serially during the subacute stage of recovery from closed head injury. This practical scale measures orientation to person, place, and time, and memory for events preceding and following the injury. The distribution of test scores in 50 patients who had recovered from a mild closed head injury was used to define the range of variation in performance and to analyze the effects of demographic factors. In a validity study of 52 closed head-injured patients, the duration of impaired GOAT scores was strongly related to the acute neurosurgical ratings of eye opening, motor responding, and verbal responding on the Glasgow Coma Scale. Duration of post-traumatic amnesia, as defined by the persistence of defective GOAT scores, was longer in patients with computed tomographic evidence of diffuse or bilateral brain injury as compared to cases with focal unilateral lesions. Serial GOAT scores were also predictive of long term level of recovery. Review of the brief cognitive test literature disclosed that several techniques have adequate validity data substantiating their use in the detection of dementia in geriatric, psychiatric, and medical populations. Recommendations for the clinical application of the various brief cognitive tests are discussed.

Adolescent↗
PubMed1979

Neuropsychological outcome of closed head injury in children and adolescents.

45 children and adolescents recovering from closed head injury underwent neuropsychological testing. Multiple indices were used to classify the severity of injury but most important in this study were the persistence of coma indexed by grades I--III and the Glasgow Coma Scale. Although the presence of early neuropsychological sequelae and long-term intellectual deficit was generally related to the severity of injury, residual impairment was also found in patients with relatively mild injuries. Analysis of memory and learning demonstrated disruption of both storage and retrieval processes.

Adolescent↗
PubMed1979

Alexia without agraphia in a musician after transcallosal removal of a left intraventricular meningioma.

After a meningioma situated in the trigone of the left lateral ventricle was excised by the transcallosal approach of Kempe and Blaylock, a right-handed musician with a right hemianopsia developed alexia without agraphia. In contrast to previously reported cases of this syndrome arising from other etiologies, he was unable to read single letters or numbers. Neuropsychological studies at 42 and 126 days after operation also disclosed an inability to associate auditory or tactile stimuli with visually perceived material, whereas speech and verbal comprehension were intact. Although the alexia extended to musical notes, he could interpret other musical symbols (e.g., treble clef). Appreciation of rhythm and expressive musical ability were relatively preserved, although judgment of other musical features (including discrimination of pitch, duration, and loudness) was compromised. The findings suggest that alexia may occur as a consequence of the transcallosal procedure when a right hemianopsia is present. However, other linguistic abilities may be better preserved by the transcallosal approach to the ventricle than by a transcortical operation.

Agraphia↗
PubMed1979

Long-term neuropsychological outcome of closed head injury.

Long-term recovery from severe closed head injury was investigated in predominantly young adults whose Glasgow Coma score was 8 or less at the time of admission. Of the 27 patients studied (median follow-up interval of 1 year), 10 attained a good recovery, 12 were moderately disabled, and five were severely disabled. In contrast to previous studies suggesting that intellectual ability after severe closed head injury eventually recovers to a normal level, our findings showed that residual intellectual level, memory storage and retrieval, linguistic deficit, and personal social adjustment corresponded to overall outcome. All severely disabled patients and several moderately disabled patients exhibited unequivocal cognitive and emotional sequelae after long follow-up intervals. Analysis of persistent neuropsychological deficit in relation to neurological indices of acute injury severity demonstrated the prognostic significance of oculovestibular deficit.

Adolescent↗
PubMed1978

Behavioral sequelae of closed head injury. A quantitative study.

We determined the profile of behavioral disturbance in relation to closed head injury of graded severity. Patients with severe injuries, as defined by duration of coma and the presence of neurological deficit, were differentiated from a group of mildly injured patients by behavioral ratings that reflected cognitive disorganization, emotional withdrawal, and motor retardation. Neurologic measurements of injury related to the severity of behavioral disturbance included hemiparesis, aphasia, and abnormalities on computerized axial tomography. Agitation during the acute phase of injury was also predictive of residual behavioral disturbance. Hemispheric lateralization of the site of greatest injury had no discernible effect on behavioral sequelae.

Adult↗
PubMed1978

Correcting for cultural factors in evaluating intellectual deficit on the WAIS.

Obtained estimates of the effects of ethnic group, sex, education, and clinical diagnosis on WAIS IQ scores of 776 psychiatric patients by least squares regression methods. Estimates of expected IQ for various demographically defined segments of the general population were obtained by setting the expected IQ for white high school graduates at 101 and then adding or subtracting the specific effects associated with different ethnic group, sex, and education. A formula for norming WAIS Full Scale IQ scores to X = 100 and SD = 15 within various demographically defined segments of the population is proposed.

Adult↗
PubMed1978

Normal urinary excretion of catecholamine catabolites in children with retinoblastoma.

Urinary catecholamine catabolites, homovanillic acid, vanillylmandelic acid, total metanephrines, and total catecholamines were assayed in 12 patients with newly diagnosed retinoblastoma prior to surgery and treatment. These values were within normal limits for the ages of all 12 patients, including one with metastases to brain, liver, lymph nodes, and bone marrow. The predictive value and efficiency of these tests in the diagnosis of retinoblastoma are insufficient to warrant their continued use on a routine basis.

Catecholamines↗
PubMed1978

Histiocytic medullary reticulosis presenting as Mucha-Habermann disease.

Histiocytic medullary reticulosis (HMR) is a rare, progressive, fatal reticuleondothelial proliferative disorder. It was diagnosed in a 10-year-old boy who had pityriasis lichenoides et varioliformis acuta of Mucha-Haberman which was controlled by dapsone for 2 years. One month after cessation of dapsone therapy, cutaneous tumors associated with fever, lymphadenopathy, and hepatosplenomegaly developed. Tissue biopsy specimens of skin, liver, spleen, lymph nodes, and a bone marrow aspirate demonstrated histiocytic erythrophagocytosis and atypical histiocytosis compatible with HMR. A rapidly progressing, fatal course followed despite intensive chemotherapy.

Child↗
PubMed1977

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.

Adolescent↗
PubMed1977

Impairment of facial recognition after closed head injuries of varying severity.

Perceptual matching of photographs of unfamiliar faces was studied in 46 patients with closed head injury. The severity of head injury as indexed by duration of coma and neurological deficits was inversely related to accuracy of performance. Impairment of facial recognition was specifically associated with signs of concomitant hemispheric and brain stem injury. The presence of neurologic deficits suggesting less pervasive injury essentially confined to the cerebral hemispheres, skull fracture, and EEG abnormality was not related to this visuoperceptive deficit. The findings are discussed in relation to hypotheses concerning neurological dysfunction in head injury.

Adult↗
PubMed1977

Facial recognition in "pseudoneurological" patients.

A test of facial recognition was given to 44 patients whose symptoms raised a question of differential diagnosis between brain disease and functional psychiatric disorder. These "pseudoneurological" patients presented symptoms (e.g., memory impairment, headache, sensory disturbances) that were sufficiently suggestive of CNS disease to warrant thorough neurological evaluation. In each case, such evaluation disclosed no evidence of brain disease and the final diagnosis was some type of functional psychiatric disorder. Facial recognition performances of these patients were indistinguishable from those of medical patients without history or evidence of brain disease. The findings support the clinical application of this type of task in cases presenting problems of differential diagnosis.

Adult↗
PubMed1977

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.

Adult↗