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Biomedical subjects
Publications and source records attributed to J Walsh.
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Spindles of 12-14 Hz were recorded in the hippocampus of 13 epileptics during sleep. This activity was more prominent in patients in whom the hippocampal region was not the site of the primary focus and in whom the electrical activity was normal during wakefulness. Spindles were more numerous during stage 2 non-rapid-eye-movement sleep, especially in patients who had seizures in this stage. It is postulated that this activity is either a normal activity of human brain or an evoked response of the hippocampus to an epileptic afferent discharge. In either case, hippocampal spindles may contribute to the triggering of nocturnal seizures.
The parents or care-givers of over 200 mentally handicapped adults, living at home in the city of Dublin, were interviewed as to how their son or daughter spent their leisure time. The picture that emerged was of a sheltered existence within the community. Mostly their activities were passive and solitary in nature - watching T. V.; listening to radio or records. Nearly half of the sample did not take part in any activity outside of the family; only one third took part in the community activity and only one fifth were reported to have non-handicapped friends. It would appear that parents are willing for this to continue, in that they had few suggestions for new activities; they felt their son or daughter was not interested and most thought that recreational activities should be supervised. It is argued that services should teach leisure skills in the same systematic and structured way as for other areas of the curriculum. This should reassure parents and help to ensure that mentally handicapped people not only live in the community but that they can participate in community activities.
We studied a patient with hippocampal epilepsy who had frequent nocturnal and diurnal seizures. Depth electrode recording showed that focal seizure discharges in the right hippocampus were of shorter duration in REM and non-REM sleep. However, awakening, especially from REM sleep or shortly after a REM period, facilitated the occurrence of a generalized seizure. There was no ultradian fluctuation in frequency or duration of seizure during diurnal recording. Night terrors (but not nightmares) disappeared after right temporal lobectomy, suggesting that pavor nocturnus was an ictal manifestation in this case.
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A substance with somatostatin-like immunoreactivity (SLI) was found in extracts of goldfish, frog, and cow retina. Dilutions of retinal SLI parallel the standard curve for radioimmunoassay obtained with synthetic somatostatin. Chromatography of goldfish retinal extract on Sephadex G-50 revealed two peaks of SLI, one that coeluted with synthetic somatostatin and one that eluted as a larger molecule. Incubation in 8 M urea did not alter the chromatographic pattern of the extract. SLI was present in extracts of frog optic nerve and tectum in concentrations higher than those found in the retina. In goldfish retina, SLI was localized by immunofluorescence to four types of processes in the inner plexiform layer; their origins could be traced to three classes of SLI-containing cell bodies in the proximal row of the inner nuclear layer and one class in the ganglion cell layer. Localization of SLI to cells of the retina and characterizations of the molecular forms of retinal SLI suggest that the retina is a promising model system for studies on the potential neurotransmitter function of somatostatin.
The diagnosis of primary subclavian axillary venous thrombosis (SAVT) was evaluated in eight patients to compare the accuracy of clinical diagnosis and noninvasive vascular evaluation with phlebography. Clinical evaluation led to three misdiagnoses: lymphedema (1), and inflammatory breast carcinoma (2). Doppler ultrasound detection of venous flow performed on three patients detected SAVT in only one. Plethysmography also performed on three patients led to unquestionable diagnosis in only one. Plethysmography also performed on three patients led to unquestionable diagnosis in only one. Phlebography positively identified SAVT in all patients and showed bilateral disease in one. Two patients had pulmonary embolism, and in one, permanent sequelae developed, thus emphasizing the necessity for energetic treatment of SAVT. Because of the risks of therapy and the inaccuracy of other diagnostic methods, SAVT should be positively identified by phlebography if anticoagulation is considered. Doppler and plethysmography are useful to rule out concomitant leg phlebothrombosis, to evaluate the arterial sector, and to document venous hemodynamic recovery after SAVT.
Bulletins issued by both the United States Public Health Service and the Pan American Health Organization have noted a sharp increase in the incidence of public lice infestation (pediculosis pubis) in this country. At the Haight-Ashbury Free Medical Clinic we conducted a controlled, open study comparing the efficacy and safety of Kwell Shampoo (gamma benzene hexachloride; lindane) with RID, an over-the-counter, pyrethrin-based pediculicide. The results showed the two treatments to be equally effective and safe. All adult lice, nymphs, and nits were eradicated at the one week follow-up in fifteen patients treated with single applications of either product. Two patients in each group experienced very slight and transient erythema.
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Computed body tomography has become useful in the diagnosis of pancreatic disease. Pancreatitis frequently results in lateral and posterior extension of inflammatory tissue into the pararenal fat planes, which can be visualized by CT. In our series it was associated with clinically diagnosed pancreatitis. Of 100 cases studied for abdominal pathology where pancreatic visualization was optimum, 10 had enlargement of the pancreas with destruction of soft tissue planes extending into the left pararenal space and clinical findings of pancreatitis. Carcinoma of the pancreas was identified in 12; no abnormality was identified in 49; the remaining cases were mixed intraabdominal and retroperitoneal pathology. The value of this sign lies in separating inflammatory processes from neoplastic disease; the sign was not found in normals.
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