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Biomedical subjects

H S Levin

Publications and source records attributed to H S Levin.

At least 127 records · Page 7Linked to original sources
PubMed1990

A prospective comparison of DNA quantitation by image and flow cytometry.

Advances in computer and video technology suggest that image analysis may be practical method of measuring DNA that also allows visual confirmation of cell type. The purpose of this study was to prospectively compare DNA quantitation from 92 solid tumors in which DNA indices had been measured by image analysis of touch preparations (CAS 100) and flow cytometry of cell suspensions (FACScan). For 81 cases, there was excellent correlation between the two methods. For nine cases, however, an aneuploid population, usually near tetraploid, was identified by image but not by flow cytometry. Three cases had aneuploid peaks by flow cytometry that were not identified by image. Although these methods show good correlation, rare populations may be missed by CAS, presumably because of sampling errors in the touch preparation. Aneuploid populations may also be missed by flow cytometry, either because of cell loss during processing or because visual identification by image can increase sensitivity.

Adenocarcinoma↗
PubMed1990

Frontal lobe dysfunction following closed head injury. A review of the literature.

This review of the relationship between frontal lobe pathology and sequelae of closed head injury (CHI) emphasizes the variety of neuropsychological disturbances that may be present and factors that influence symptom presentation. First, the mechanisms of injury in CHI are briefly summarized with an emphasis on frontal involvement. This summary is followed by an overview of frontal lobe structure and function including behavioral and cognitive sequelae associated with frontal damage in other patient populations. Next, findings specifically related to frontal dysfunction in CHI patients are presented. These studies, although few in number, indicate that CHI patients frequently exhibit deficits indicative of frontal damage. The clinical implications of frontal dysfunction following CHI and potential avenues for future research are discussed.

Behavior↗
PubMed1990

Mild head injury classification.

Inconsistencies across studies concerning outcome after mild head injury may reflect differences in the diagnostic criteria used for selection of patients. Consequently, we compared the neurobehavioral outcome in three groups of consecutively hospitalized patients (aged 16 to 50 years) who sustained a closed head injury (CHI) and had a Glasgow Coma Scale (GCS) score in the 9 to 15 range. These groups included patients with uncomplicated CHI with mild impairment of consciousness as reflected by a GCS score in the 13 to 15 range (n = 78), patients with initially mild impairment of consciousness complicated by brain lesion or depressed skull fracture (n = 77), and patients with moderate CHI (n = 60). Tests of memory, information processing, and verbal fluency were administered within 1 to 3 months after injury, and the Glasgow Outcome Scale was completed at 6 months. Neurobehavioral functioning was impaired in the groups with complicated mild CHI and moderate CHI as compared to the group with uncomplicated mild CHI. Although moderate CHI produced longer durations of impaired consciousness and posttraumatic amnesia than complicated mild head injury, patients in these groups did not differ in neurobehavioral performance. Global outcome at 6 months was better in the patients with mild CHI than in patients with complicated mild and moderate injuries. Analysis of the various complications of mild CHI revealed that the presence of an intracranial lesion was related to more severe neurobehavioral sequelae than injuries complicated by a depressed fracture.

Adolescent↗
PubMed1990

Corpus callosal atrophy following closed head injury: detection with magnetic resonance imaging.

To investigate evidence for diffuse white matter injury and hemispheric disconnection sequelae after severe closed head injury (CHI), this study evaluates the degree of posttraumatic atrophy of the corpus callosum. Corpus callosal atrophy was quantitatively determined using a digitizer to measure sagittal magnetic resonance images of 32 patients with moderate-to-severe CHI and those of 31 control subjects of similar age. In the CHI patients, measurements were significantly reduced for the areas of the anterior four-fifths, the posterior one-fifth, and the total corpus callosum. Moreover, the minimum width of the callosal body was reduced in the CHI patients as compared to that of control individuals. Indices of corpus callosal atrophy were significantly correlated with the chronicity of injury and the degree of lateral ventricular enlargement. There was no difference in callosal measurements between men and women. Magnetic resonance imaging provides an in vivo determination of corpus callosal atrophy which may reflect the severity of diffuse axonal injury and predict the type and severity of hemispheric disconnection effects.

Adolescent↗
PubMed1990

Neurobehavioral outcome 1 year after severe head injury. Experience of the Traumatic Coma Data Bank.

The outcome 1 year after they had sustained a severe head injury was investigated in patients who were admitted to the neurosurgery service at one of four centers participating in the Traumatic Coma Data Bank (TCDB). Of 300 eligible survivors, the quality of recovery 1 year after injury was assessed by at least the Glasgow Outcome Scale (GOS) in 263 patients (87%), whereas complete neuropsychological assessment was performed in 127 (42%) of the eligible survivors. The capacity of the patients to undergo neuropsychological testing 1 year after injury was a criterion of recovery as reflected by a significant relationship to neurological indices of acute injury and the GOS score at the time of hospital discharge. The neurobehavioral data at 1 year after injury were generally comparable across the four samples of patients and characterized by impairment of memory and slowed information processing. In contrast, language and visuospatial ability recovered to within the normal range. The lowest postresuscitation Glasgow Coma Scale (GCS) score and pupillary reactivity were predictive of the 1-year GOS score and neuropsychological performance. The lowest GCS score was especially predictive of neuropsychological performance 1 year postinjury in patients who had at least one nonreactive pupil following resuscitation. Notwithstanding limitations related to the scope of the TCDB and attrition in follow-up material, the results indicate a characteristic pattern of neurobehavioral recovery from severe head injury and encourage the use of neurobehavioral outcome measurements in clinical trials to evaluate interventions for head-injured patients.

Adolescent↗
PubMed1990

Mixed gonadal dysgenesis. A review of 15 patients reporting single cases of malignant intratubular germ cell neoplasia of the testis, endometrial adenocarcinoma, and a complex vascular anomaly.

The clinicopathologic features of 15 patients with mixed gonadal dysgenesis are presented with special regard to cardiovascular and neoplastic disease. Seven (47%) cases, all phenotypic females, had gonadal tumors: gonadoblastoma (5), germinoma (4), malignant intratubular germ cell neoplasia (1), and a unique gonadal stromal tumor (1). Gonadoblastoma was found in 4 of 10 testes and 4 of 17 streak gonads, and associated with germinoma in 4 cases. One patient developed grade 1 endometrial adenocarcinoma after estrogen therapy. Cardiovascular diseases (ie, bicuspid aortic valve, and a unique right aortic arch with a retroesophageal arch segment, aberrant left subclavian artery, coarctation, and dissection) are documented in our series. At the time of diagnosis of mixed gonadal dysgenesis, removal of streak gonads or testes will prevent further gonadal tumor development Cardiovascular examination may identify treatable and potentially lethal disease.

Adenocarcinoma↗
PubMed1990

The Children's Orientation and Amnesia Test: relationship to severity of acute head injury and to recovery of memory.

The Children's Orientation and Amnesia Test (COAT) was developed to assess cognition serially during the early stage of recovery from traumatic brain injury in children and adolescents. The norms for the COAT, which is composed of 16 items evaluating general orientation, temporal orientation, and memory, were defined from data obtained from 146 children aged 3 to 15 years. In 37 patients with head injuries, the duration of posttraumatic amnesia, as indicated by the number of days COAT scores were in the impaired range, was significantly related to both verbal and nonverbal memory at the baseline and 6 and 12 months after injury. COAT scores were a better predictor of verbal and nonverbal memory performance than the Glasgow Coma Scale score at 6 and 12 months after the injury. This study shows that the COAT has adequate reliability and validity as a measure of the duration of posttraumatic amnesia in children and adolescents.

Acute Disease↗
PubMed1990

Magnetic resonance imaging and neuropsychological findings in human immunodeficiency virus infection.

Neurobehavioral functioning and magnetic resonance imaging (MRI) were investigated in 25 patients with various Centers for Disease Control (CDC) stages of human immunodeficiency virus (HIV) infection and in a control group of seven normal subjects. Unequivocal slowing of information processing speed and cerebral atrophy were related to the stage of HIV infection, with patients in CDC group IV exhibiting the most abnormal findings. Slowing of response speed was directly related to the severity of cerebral atrophy.

Adult↗
PubMed1989

Duration of impaired consciousness in relation to side of lesion after severe head injury. NIH Traumatic Coma Data Bank Research Group.

The relation between hemispheric lateralisation of intracerebral lesion and duration of impaired consciousness was investigated in 43 survivors of severe closed head injury. Duration of impaired consciousness, defined as the time from injury until the obeying of commands, was significantly longer in patients with left hemisphere than right hemisphere lesions. However, the side of intracerebral lesion had no effect on duration of impaired consciousness defined as time from injury until localisation to pain. Use of verbal methods to assess level of consciousness may be responsible for the observation that lesions of the language dominant hemisphere produce greater disturbance of consciousness than similar insults to the right hemisphere.

Age Factors↗
PubMed1989

Adenocarcinoma of the prostate in cystoprostatectomy specimens removed for bladder cancer.

The prostate glands of 84 men undergoing cystoprostatectomy for bladder cancer were examined by whole-mount sections at 4-mm to 5-mm intervals to identify unsuspected prostate adenocarcinoma (PCa). Of 72 white patients with entirely normal digital rectal examinations (DRE), 33 (46%) were found to have PCa, including 12 (17%) who had a Gleason score of 6 or greater and seven (10%) who had penetration through the prostatic capsule. These observations are consistent with previous studies in autopsy populations but allow a more appropriate comparison with morphologic data generated from radical prostatectomy specimens. If these data can be extended to the age-matched general population, treatment at a 1% mortality rate for all white men 60 to 74 years of age with a PCa with a Gleason score of 6 or greater could cause between 6190 and 30,951 deaths, in contrast to 7335 deaths expected from the cancer. These data stress the need for a control group in a study designed to evaluate the benefit of early diagnosis and treatment of PCa.

Adenocarcinoma↗
PubMed1989

Procedural memory during posttraumatic amnesia in survivors of severe closed head injury. Implications for rehabilitation.

To investigate the possibility that learning of skills (ie, procedural memory) is preserved during posttraumatic amnesia, 16 amnesic survivors of severe closed head injury and 16 control subjects were studied. Procedural learning tasks included mirror reading, mazes, and a pursuit rotor task that involved tracking a rotating target. Declarative memory was assessed by testing recognition of the words used in mirror reading and a questionnaire concerning details of the previous testing session. Learning was evaluated on 3 consecutive days and a fourth session was scheduled after resolution of posttraumatic amnesia. Despite stable impairment of declarative memory during posttraumatic amnesia, the performance of head-injured patients improved across sessions on all procedural tasks and showed transfer to testing after resolution of posttraumatic amnesia.

Adolescent↗
PubMed1989

Conceptual encoding following severe closed head injury.

This investigation examined whether survivors of severe closed head injury encode semantic properties of to-be-remembered words and the relationship of such processing to frontal lobe functioning. Fourteen patients enrolled in rehabilitation and 12 controls were administered the Release from Proactive Inhibition paradigm involving trials of recalling words from the same category followed by a shift to a new category or continued presentation of identical material. Similar to the controls, patients demonstrated a facilitation in recall when the category shifted. An association between the amount of release and frontal lobe functioning (as evaluated by neuropsychological tests and magnetic resonance imaging) was not compelling and depended upon the particular measure of release that was utilized. Pending replication in a larger, more representative sample, we suggest that conceptual encoding is relatively preserved in long-term survivors. The failure to find a robust relationship between frontal lobe pathology and semantic encoding is discussed in light of other investigations suggesting an association.

Craniocerebral Trauma↗
PubMed1989

Identification of transitional cell carcinoma of the prostate in bladder cancer patients: a prospective study.

Transitional cell carcinoma involving the prostate in patients with bladder carcinoma impacts on the judicious use of intravesical chemotherapy, partial cystectomy and internal urinary reservoirs anastomosed to the urethra. We compared the accuracy of prostate needle biopsy, fine needle prostatic aspiration and transurethral resection biopsies of the prostate to detect the presence or absence of transitional cell carcinoma involving the prostate in 25 men undergoing radical cystectomy, of whom 40 per cent had transitional cell carcinoma of the prostate. The accuracy of the 3 detection methods was 20, 40 and 90 per cent, respectively. If any 1 of the 3 tests was positive all patients with transitional cell prostatic cancer were correctly identified. These tests should be performed in high risk patients, including those with transitional cell carcinoma in situ of the bladder, or with a positive urine cytology study and a cystoscopically as well as biopsy proved normal bladder urothelium.

Biopsy↗
PubMed1989

Transitional cell carcinoma of the prostate in cystoprostatectomy specimens removed for bladder cancer.

Specimens from 84 radical cystectomies for bladder carcinoma performed between January 1984 and July 1986 were reviewed to characterize the involvement of the prostate with transitional cell carcinoma. Whole-mount sectioning of the prostate was performed at 4 mm. intervals and processed in the same manner as radical prostatectomy specimens. A total of 36 patients (43 per cent) had transitional cell carcinoma of the prostate: 94 per cent of these had prostatic urethra involvement and 6 per cent had a normal prostatic urethra but transitional cell carcinoma was present in the periurethral structures. In situ prostatic duct or acini, ejaculatory duct and seminal vesicle involvement occurred, respectively, in 67, 8 and 17 per cent of the patients with prostatic involvement. Of the patients with prostatic involvement 39 per cent had stromal invasion (22 per cent focal and 17 per cent diffuse invasion). The incidence of carcinoma in situ of the bladder neck or trigone (59 per cent), previous intravesical chemotherapy (59 per cent) and ureteral carcinoma (79 per cent) was significantly increased in patients with prostatic involvement. In patients with carcinoma in situ of the trigone or bladder neck, or in whom previous intravesical chemotherapy treatments have failed prostatic involvement should be suspected so that this disease can be detected before stromal invasion occurs.

Carcinoma in Situ↗
PubMed1989

Visual Continuous Recognition Memory in normal and closed-head-injured adolescents.

The Continuous Recognition Memory Test was administered to 46 normal adolescents and 91 closed-head-injured adolescents. Performance on the test varied significantly with severity of injury as measured by the Glasgow Coma Scale score and duration of impaired consciousness. The performance of adolescents with diffuse injury, right, left, or bilateral mass lesions did not differ significantly. The efficacy of the test for use with head-injured adolescents is demonstrated.

Adolescent↗
PubMed1989

Distinguishing normal and demented elderly with the selective reminding test.

The selective reminding (SR) procedure, a popular technique for the study of verbal memory, was used to investigate aspects of memory functioning in a large group of normal elderly and in a smaller group of elderly subjects with Alzheimer Type Dementia (ATD). One hundred thirty-four normal elderly (mean age = 79.53 years) subjects and 21 ATD subjects (mean age = 68.3 years) were administered four versions of the SR test as part of a longitudinal study of risk factors in the development of dementia. Normative data were obtained for multiple components of memory functioning within the elderly sample. Test-retest reliability was .84 for long-term retrieval (LTR), .89 for sum of recall, and .92 for consistent retrieval. Clinical validity studies revealed that the components of sum of recall, storage estimate, LTR, and consistent long-term storage (CLTS) were most valuable in distinguishing mild ATD from normal aging. Positive predictive values ranged from 86% for CLTS, 89% for LTR, 91% for sum of recall, and 100% for storage estimate. These findings suggest that the SR test has considerable clinical utility in differentiating normal aging from dementia, and has promise as a useful tool in the preclinical detection of ATA.

Aged↗
PubMed1989

Intellectual, motor, and language sequelae following closed head injury in infants and preschoolers.

Examined cognitive and motor performance during the subacute stage of recovery and 8 months postinjury in 21 infants and preschoolers who sustained a closed head injury (CHI). Children sustaining severe CHI, who exhibited impaired consciousness for at least 1 day, were impaired on measures of intelligence, motor, expressive language, and receptive language functions on the baseline and follow-up evaluations relative to children with mild-moderate injuries. Irrespective of injury severity, motor and expressive language functions were the most vulnerable to the effects of CHI. Results are discussed in terms of the rate of development of cognitive functions.

Age Factors↗