Biomedical subjects
Publications and source records attributed to H Weinberg.
Mycobacterium fortuitum was isolated from the synovial tissues of the dorsum of the hand after a dog bite. Caseating granulomas with Langhans' type giant cells were demonstrated microscopically. Healing followed prolonged treatment with antituberculosis drugs. It is suggested that the organism was forced into the patient's tissues by the dog's bite.
The cerebral potentials associated with self-paced rapid dorsiflexion and plantarflexion of the left toes were compared in the same experiment using 10 subjects 5 of whom were female and 5 of whom were male. The EEG was recorded from C3, C1, Cz, C2 and C4 including computed bipolar recordings C4/C3 and C2/C1. For both kinds of movements, the Bereitschaftspotential (BP) or readiness potential was bilaterally symmetrical in the first half of the foreperiod. In the later foreperiod, an ipsilateral preponderance of negativity (IPN) developed. The direction of toe movement had no effect on the IPN. The etiology of the paradoxical BP side preponderance prior to toe movements is discussed which can probably be referred to the unique dipole orientation of a generator situated on the mesial cortical surface in the depth of the interhemispherical fissure.
A slow magnetic field shift has been detected in the human brain occurring in the foreperiod of a voluntary finger movement. This magnetic field accompanies a slow negative electrical cerebral potential which occurs in the same foreperiod, the Bereitschaftspotential (BP) of Kornhuber and Deecke. The present report is the first of a magnetic field associated with the BP, and has been named the Bereitschaftsmagnetfeld (BM) or readiness magnetic field. The BM is oriented with the field lines directed out of the head in the pre-rolandic region and with the field lines directed into the head in post-rolandic areas, suggesting a source in the sensorimotor area for the contralateral hand. Distribution of the magnetic fields has so far not revealed a source in the fronto-central midline where the BP is recorded maximally. The time course and morphology of the BP and BM are similar, but they have different topography over the skull.
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The behaviour of intermediate and long-latency evoked potential (EP) components were investigated in a semantic categorisation task. Visually presented 'narrow' and 'wide' priming category questions, intended to vary processing load, were followed, after 1.5 sec by a 100 msec presentation of a positive or negative instance for decision. Neither behavioural response latencies nor amplitudes of N1-P2 (130 and 212 msec mean latencies) differentiated between 'narrow' and 'wide' category decisions. However, response latencies were faster and N1-P2 amplitudes greater for positive than for negative instances of primed categories. This result is attributed to the priming effect, by 'spreading activation, of prior category questions on 'logogen-like' pre-conscious word detecting devices within the brain. Semantic discrimination by N1-P2 contradicts previous assertions that intermediate components only reflect selection based on crude stimulus characteristics. Comparison of N1-P2 amplitudes at lateral electrodes offered no evidence of hemispheric lateralisation of language function in the experimental task. There was no late wave unequivocally identifiable as P300 on morphological and scalp distribution criteria. A positive peak at mean latency 327 msec (called P3) was of low amplitude and stable latency and did not appear to index processing load as defined by the experimenters. However, the amplitude of N2-P3 was larger to positive instances of narrow categories than any of the other three conditions. This could be the sort of probability effect seen in P300 behaviour if it is assumed that the brain can discriminate between stimuli on the basis of the size of the subset from which they come.
Prior reports of neuroleptic malignant syndrome (NMS) concerned patients with psychiatric disorders, usually schizophrenia, who were taking dopamine receptor blocking agents. We report the syndrome in a patient with Huntington disease who was treated with dopamine-depleting agents. He had a negative evaluation for malignant hyperthermia (MH), and we suggest that NMS differs from MH. The occurrence of NMS caused by dopamine-depleting agents suggests that anticholinergic properties of phenotiazines are not the only cause. Central dopaminergic systems probably participate in thermoregulation, and dopamine depletion probably plays a pathogenetic role in this syndrome.
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The relationship of the pelvis, acetabulum, spine and femur was studied in the adult in the newborn. It was noted that when the flexed spine and pelvis derotated at or soon after birth, the femoral head dislocated anteriorly in a number of anatomic preparations, and, in the process of "unfolding," the femoral head assumed the classically recognized dislocated position. The "weak" areas in the fibrocartilaginous makeup are also described.
Fracture dislocation at the base of the fifth metacarpal is a rare injury. Fewer than 25 cases have been published in the English-language literature. A force acting along the longitudinal axis of the fifth metacarpal causes a fracture dislocation at the base of the bone in a dorsal-ulnar direction, because of the anatomy of the joint and the mechanical properties of the bone and the intermetacarpal ligament. The mechanism of other types of injury to this joint, namely dorsal-radial or palmar-radial dislocation of the base of the fifth metacarpal is different. A case is presented which demonstrates the mechanism of the fracture dislocation.
The techniques of fibular bypass grafting for massive tibial bone loss have been well described over the past 50 years. These techniques have generally been used as salvage procedures in post-traumatic civilian patients with chronic sepsis, or for congenital pseudoarthrosis. We present the experience of the Orthopaedic Department of the Hadassah University Hospital in successfully treating massive tibial bone loss by early fibular bypass grafting in four war injuries, where such definitive procedures would have been avoided in the past.
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