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Biomedical subjects

I Pollack

Publications and source records attributed to I Pollack.

At least 19 recordsLinked to original sources
PubMed1999

Increased intracranial pressure after coronal suturectomy in craniosynostotic rabbits.

It has been suggested that the complications associated with intracranial hypertension in craniosynostotic infants may be managed with surgical release of the synostosed sutures. However, both postoperative increases and decreases in intracranial pressure (ICP) have been reported in heterogeneous samples of infants with syndromic and nonsyndromic craniosynostoses. The present study was designed to describe longitudinal changes in ICP in a homogeneous sample of rabbits with uncorrected and corrected familial coronal suture synostosis and compare them with age-matched normal control rabbits. Fifty-three rabbits were divided into three groups: normal rabbits (n = 28), rabbits with uncorrected bilateral coronal suture synostosis (n = 9), and rabbits with bilateral coronal suture synostosis with coronal suturectomy at 25 days of age (n = 16). ICP was measured at 25 and 42 days of age using a Codman epidural microtransducer. Results revealed that rabbits with uncorrected craniosynostosis had significantly (P < 0.05) higher ICP at 25 days of age than normal control rabbits by approximately 86%. However, by 42 days of age, ICP in normal rabbits increased by 75%, whereas ICP in rabbits with uncorrected craniosynostosis decreased by 69% over the same time. Synostotic rabbits with coronal suturectomy showed a 50% decrease in ICP immediately after surgical release and then followed the normal, age-related ICP pattern, which significantly increased by 75% at 42 days of age. Results suggest that, in the rabbit model, the postsuturectomy rise in ICP may simply be normal, age-related changes, although a longer follow-up will be needed to determine the recurrence of pathological ICP. Possible multifactorial explanations for intracranial decompression and compensation in the craniosynostotic rabbit model are also discussed.

Analysis of Variance↗
PubMed1999

Phase II study of phenylacetate in patients with recurrent malignant glioma: a North American Brain Tumor Consortium report.

PURPOSE: To determine the response rate, time to treatment failure, and toxicity of phenylacetate in patients with recurrent malignant glioma and to identify plasma concentrations achieved during repeated continuous infusion of this agent. PATIENTS AND METHODS: Adult patients with recurrent malignant glioma were treated with phenylacetate. The schedule consisted of a 2-week continuous, intravenous infusion followed by a 2-week rest period (14 days on, 14 days off). A starting dose of 400 mg/kg total body weight per day of phenylacetate was initially used and subsequently changed to 400 mg/kg/d based on ideal body weight. Intrapatient dose escalations were allowed to a maximum of 450 mg/kg ideal body weight/d. Tumor response was assessed every 8 weeks. The National Cancer Institute common toxicity criteria were used to assess toxicity. Plasma concentrations achieved during the patients' first two 14-day infusions were assessed. RESULTS: Forty-three patients were enrolled between December 1994 and December 1996. Of these, 40 patients were assessable for toxicity and response to therapy. Reversible symptoms of fatigue and somnolence were the primary toxicities, with only mild hematologic toxicity. Thirty (75%) of the 40 patients failed treatment within 2 months, seven (17.5%) had stable disease, and three (7.5%) had a response defined as more than 50% reduction in the tumor. Median time to treatment failure was 2 months. Thirty-five patients have died, with a median survival of 8 months. Pharmacokinetic data for this dose schedule showed no difference in the mean plasma concentrations of phenylacetate between weeks 1 and 2 or between weeks 5 and 6. CONCLUSION: Phenylacetate has little activity at this dose schedule in patients with recurrent malignant glioma. Further studies with this drug would necessitate an evaluation of a different dose schedule.

Adult↗
PubMed1998

Phase I study of paclitaxel in patients with recurrent malignant glioma: a North American Brain Tumor Consortium report.

PURPOSE: To determine the maximum-tolerated dose (MTD) of paclitaxel administered as a 3-hour infusion in patients with recurrent malignant glioma. PATIENTS AND METHODS: Patients were stratified by starting dose of paclitaxel and concurrent anticonvulsant (AC) use and were treated in cohorts of three patients. The starting dose was 240 mg/m2 administered intravenously with escalations of 30 mg/m2 until the MTD was established. Pharmacokinetic data were obtained for each patient for the first infusion. Tumor response was assessed at 6-week intervals and treatment was continued until documented tumor progression, unacceptable toxicity, or a total of 12 paclitaxel infusions. RESULTS: From April 1995 to December 1996, 34 patients were treated; 27 patients in the AC group and seven patients in the non-AC group. The MTD for patients who received ACs was established at 360 mg/m2 and the dose-limiting toxicity (DLT) was central neurotoxicity, characterized as transient encephalopathy and seizures. In contrast, the MTD for patients who did not receive ACs was 240 mg/m2, and myelosuppression, gastrointestinal toxicity, and fatigue were the DLTs. Pharmacokinetic data confirmed that the plasma drug levels and clearance rates were similar for patients in both groups at the respective dose levels that produced DLTs. CONCLUSION: The pharmacokinetics of paclitaxel are altered by ACs, and significantly larger doses of the drug can be administered to patients with brain tumors on AC therapy. The toxicity profile is different for patients on AC therapy treated at these higher doses. A phase II study has been initiated that uses a dose of 330 mg/m2 for patients on AC therapy and 210 mg/m2 for patients not on AC therapy.

Adult↗
PubMed1994

Vein of Galen aneurysms: a review and current perspective.

Our approach to treating a patient with a vein of Galen aneurysm is, of course, influenced greatly by the age of the patient, the clinical symptoms, and the angiographic architecture of the malformation. Therapeutic options are primarily based on whether a true AVM is present or if the malformation represents an arteriovenous fistula involving the vein of Galen. Arterial endovascular approaches, microneurosurgery, and/or radiosurgery are preferred for management of the former; the transvenous endovascular approach has become the cornerstone of treatment in the latter. The most critical group, however, is the neonates in extreme cardiovascular distress. In this case our therapeutic intervention is initially endovascular from the venous side, either transfemoral or transtorcular. The immediate goal is to increase resistance to right ventricular output. Advantages of this approach over a transarterial approach include a shorter anesthesia time, minimal fluid and/or contrast administration, and creation of a wire "basket" or "bird's nest" on the venous side that helps prevent emboli that may be deposited on the arterial side in subsequent embolizations from passing through the malformation. The transvenous approach can be easily repeated multiple times and may be supplemented by transarterial embolizations. Endovascular coils have been the mainstay for such venous embolizations. The end point of treatment is not complete occlusion of the fistula but improvement in cardiac function. Often, more than one stage is required to reach our goal. The results in recent years have been encouraging and are to a large degree attributable to the advances in endovascular approaches. With future improved tools for diagnosis and treatment, perhaps the prognosis for this difficult malady also will continue to improve.

Arteriovenous Fistula↗
PubMed1993

Histamine is a major mechanosensory neurotransmitter candidate in Drosophila melanogaster.

Histamine is known to be the neurotransmitter of insect photoreceptors. Histamine-like immunoreactivity is also found in a number of interneurons in the central nervous system of various insects. Here, we demonstrate by immunohistochemical techniques that, in Drosophila melanogaster (Acalypterae), most or all mechanosensory neurons of imaginal hair sensilla selectively bind antibodies directed against histamine. The histamine-like staining includes the cell bodies of these neurons as well as their axons, which form prominent fibre bundles in peripheral nerves, and their terminal projections in the central neuropil of head and thoracic ganglia. The specificity of the immunostaining is demonstrated by investigating a Drosophila mutant unable to synthesize histamine. Other mechanosensory organs, such as campaniform sensilla or scolopidial organs, do not stain. In the calypteran flies, Musca and Calliphora, we find no comparable immunoreactivity associated with either hair sensilla or the nerves entering the central nervous system, observations in agreement with earlier studies on Calliphora. Thus, histamine seems to be a major mechanosensory transmitter candidate of the adult nervous system of Drosophila, but apparently not of Musca or Calliphora.

Animals↗
PubMed1991

Histamine-like immunoreactivity in the visual system and brain of Drosophila melanogaster.

In this study, immunohistochemistry on cryostat sections is used to demonstrate anti-histamine immunoreactivity in the Drosophila brain. The results support earlier findings that histamine is probably a transmitter of insect photoreceptors. It is further shown that, in Drosophila, all imaginal photoreceptors including receptor type R7 are anti-histamine immunoreactive, whereas the larval photoreceptors do not seem to contain histamine. In addition to the photoreceptors, fibres in the antennal nerve and approximately 12 neurons in each brain hemisphere show strong histamine-like immunoreactivity. These cells arborize extensively in large parts of the central brain.

Animals↗
PubMed1991

Herniated L4-L5 disc after placement of Harrington instrumentation for a fracture of the thoracolumbar spine.

The authors report a case in which L5 radiculopathy developed acutely after surgery for placement of Harrington rod instrumentation for an L1 body fracture. Computed tomographic myelography demonstrated a large L4-L5 herniated disc that had not been present in preoperative studies. An emergency laminectomy was performed, and a large, free, subligamentous disc fragment was removed. The patient subsequently regained L5 sensorimotor function. The postoperative development of lumbar radiculopathy is an uncommon complication of Harrington rod instrumentation that may result from several biomechanical features of the instrumentation. These injuries may not be detected by intraoperative monitoring of somatosensory evoked potentials, and therefore, the postoperative neurological examination assumes a crucial role in the early diagnosis of these lesions. As our case demonstrates, these radicular deficits may be reversible if their cause is promptly recognized and treated.

Aged↗
PubMed1990

Detection and discrimination thresholds for auditory periodicity.

Complex periodic auditory signals, produced by the Guttman-Julesz procedure of repeating segments of random noise, were employed to address the low region of auditory periodicity. Periodicity detection and discrimination tasks were examined with a common experimental procedure and a common measure of thresholds. Typically, detection and discrimination performance suffer at extremely low periodicities, presumably because of the extremely close spacing of harmonics throughout the auditory spectrum. Interaural phase effects are extremely weak for these signals, being largely confined to threshold-detection tasks. Despite qualitative phenomenological differences for different periodicity regions, detection and discrimination functions show no sharp discontinuities over a wide range of periodicities.

Adult↗
PubMed1989

Physiological response patterns to cognitive testing in adults with closed head injuries.

Physiological measures were taken from 7 closed-head-injured patients and 7 control subjects while they took a series of cognitive tests: the finger tapping test from the Halstead Reitan battery, the Digit Symbol test from the WAIS-R, a test of logical memory, and a paced arithmetic test. Physiological reactivity was assessed relative to rest periods, which occurred at the beginning and end of each session. The tests and physiological assessment were administered twice, approximately one month apart. The patient group performed more poorly on the cognitive tests, and showed less physiological reactivity during them than did the control group. This pattern was statistically significant for heart rate, frequency of electrodermal responses, and, during the initial session, respiration rate. The control group also showed greater finger pulse amplitude during the first posttest rest period in the first session, and greater constriction during a logical memory task in the second session. No significant between-groups differences emerged for state or trait anxiety. The patients showed higher frontalis EMG and respiration rate during rest. These results suggest a pattern of poor physiological modulation for task performance in the patients with closed head injuries. The therapeutic implications are discussed.

Adolescent↗
PubMed1988

Touch preparations in the rapid intraoperative diagnosis of central nervous system lesions. A comparison with frozen sections and paraffin-embedded sections.

Cytologic preparations provide a rapid, simple method for intraoperative diagnosis of central nervous system (CNS) lesions. Details of cellular morphology are defined sharply, avoiding artifacts often introduced by the frozen section technique. In 100 neurosurgical biopsies performed between 1984 and 1986, touch preparations and cryostat (frozen) sections were made at the time of surgery for preliminary intraoperative diagnosis. To assess the accuracy of each of the diagnostic methods used independently, slides obtained with each of the two techniques were later reviewed retrospectively with appropriate clinical and radiological data, but without knowledge of the final neuropathological diagnoses. When compared with the final diagnoses, intraoperative diagnoses were confirmed in 95 cases. The diagnoses based on cytologic and frozen section techniques were compared with the final diagnoses based on paraffin sections. Touch preparation diagnosis was confirmed by paraffin sections in 76 cases; in 18 additional cases a clinically useful, but nonspecific diagnosis (benign versus malignant, glial versus nonglial) was established by touch preparation. In five cases with firm or rubbery tumors, insufficient cells were imprinted for reliable evaluation, and no definitive diagnoses could be made. Specific cryostat diagnoses were confirmed by paraffin sections in 88 cases; nonspecific diagnoses were made in 11 cases. A single incorrect diagnosis was obtained with each technique. When the two techniques were used together, a specific and accurate diagnosis was achieved in 95 cases. Touch preparations were superior to frozen sections for evaluating soft or highly cellular tumors and for preliminary diagnosis from a minute surgical specimen (i.e., stereotactic biopsy).(ABSTRACT TRUNCATED AT 250 WORDS)

Central Nervous System Diseases↗
PubMed1979

Optic disc parameters and onset of glaucomatous field loss. I. Methods and progressive changes in disc morphology.

Serial stereoscopic fundus photographs taken in known relationship to the onset of glaucomatous visual field loss on 12 eyes were intermixed with those from 206 age- and race-matched controls and analyzed in randomized masked fashion. Progressive changes in the size, shape, or contour of the disc, and a newly described parameter, thickness of the nerve fiber layer as it crosses the disc rim, were readily apparent by the time of onset of glaucomatous field loss in all but two abnormal eyes (one case). In the latter instance, direct comparison of stereophotos indicated progressive pallor of the remaining disc tissue. Serial stereophotographs appear superior to fundus drawings for anticipating glaucomatous field loss.

Glaucoma↗
PubMed1979

Optic disc parameters and onset of glaucomatous field loss. II. Static screening criteria.

Stereoscopic fundus photographs of 17 abnormal eyes, taken in known temporal relationship to the onset of glaucomatous visual field loss, and 206 eyes of age- and race-matched controls were examined in randomized masked fashion. Width of the narrowest remaining disc rim, size of the vertical and horizontal physical cups, contour of the temporal and nasal slopes (vertical ovalness), and a newly described parameter, thickness of the nerve fiber layer as it crosses the disc rim, were all useful for distinguishing patients with impending or established visual field loss. None, however, was as effective as defects in the nerve fiber layer, the only parameter displaying sufficient promise as a clinical screening tool to warrant initiation of large-scale prospective evaluation.

Glaucoma↗
PubMed1979

Discrimination of uniform spectrum pulse sequences.

Random polarity-modulated sequences were produced with a uniform short-term spectrum over defined sampling intervals by a method described by Pierce, Lipes, and Cheetham [J. Acoust. Soc. Am. 61, 1609-1621 (1977)]. These are identified as PLC sequences. By contrast, unconstrained random polarity-modulated pulse trains with a constant interpulse interval may depart from a short-term uniform spectrum. It is shown that listeners can clearly discriminate between PLC sequences and unconstrained random sequences, and can discriminate among different PLC sequences. This discrimination is more nearly related to the statistical redundancy of the PLC sequences. This discrimination is more nearly related to the statistical redundancy of the PLC sequences than to their run-length distribution. Such discrimination is relatively resistant to moderate degrees of temporal jitter and is obtained with other forms of information coding. Discrimination of PLC sequences is presumably based upon phase information.

Acoustic Stimulation↗
PubMed1978

Decoupling of auditory pitch and stimulus frequency: the Shepard demonstration revisited.

With ten successive octave tones, Shepard demonstrated that upward shifts in frequency might be heard as downward shifts in pitch. This decoupling of auditory pitch and frequency has important consequences for any representational theory of pitch. Experiments are reported that attempt to identify the crucial features of Shepard's demonstration.

Acoustic Stimulation↗
PubMed1978

Temporal switching between binaural information sources.

An estimate of the rate of perceptual switching between two binaural information sources was sought by a procedure which employed an emergent perceptual property--the shape of the binaural sound image. Random polarity-modulated pulse trains were delivered to the two ears with controlled periods of interaural phase agreement and of phase disagreement. As the rate of alternation between the two interaural states is increased, discrimination suffers. With equal periods of phase agreement and disagreement, threshold periods of 2.2-3.4 ms, or about 300-450 alternations per second, are obtained. Such rates far exceed estimates of the rate of interaural switching obtained by other experimental paradigms. With unequal periods of agreements and disagreements, a minimum threshold period of 1.5 ms is the limiting factor. Large individual differences were noted. Other procedures for coding binary information yielded similar results. Rapid switching rate thresholds are obtained for narrow-band signals over a wide frequency range. A "central integration time" is identified with the threshold interaural switching period, and appears to be identical with the minimum integration time for monaural tasks.

Acoustic Stimulation↗
PubMed1978

Periodicity measures for repeated random auditory patterns.

Random auditory patterns were repliated according to defined rules, converted toauditory pulse trains, and presented to listeners. Three ined: the threshold fraction of repeated elements necessary for a fixed level of discrimination from a nonrepeated pattern; the accuracy of periodicity matching; and periodicity magnitude ratings. A short-term periodicity analysis over successive replications appears to be more representative of the behavioral measures than a long-term periodicity analysis. Of the signal measures of periodicity examined, the maximum autocorrelation, irrespective of delay, most closely reflects behavioral measures of periodicity strength.

Auditory Perception↗