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Biomedical subjects

L Stark

Publications and source records attributed to L Stark.

At least 19 recordsLinked to original sources
PubMed1992

Treatment of non-small cell lung cancer with external beam radiotherapy and high dose rate brachytherapy.

Between August 1985 and September 1989, 62 patients with medically inoperable or surgically unresectable, non-small cell lung cancer were treated with both external beam radiotherapy and high dose rate bronchial brachytherapy. Treatment consisted of external beam radiotherapy (5000-6000 cGy in 5-6 1/2 weeks) and weekly high dose rate bronchial brachytherapy (three to five fractions, 500 cGy at 1 cm from the source) delivered either concurrently or sequentially. Median survival for all patients was 13 months (m). Stage I and Stage IIIA-B patients had median survivals of 20 m and 10 m, respectively. Patients without nodal disease (No) had a significantly longer median survival compared to patients with regional node metastases (N1-3), 17 m versus 9 m. A total of 54 patients were evaluable for local tumor control analysis. Local tumor control was achieved in six of eight patients who had a normal pre-treatment radiograph. Patients with measurable tumor on the pre-treatment radiograph and negative regional nodes had local tumor control in eight of twenty-two (36%) cases. In patients with regional lymphadenopathy, loco-regional tumor control was achieved in four of eight cases. Additionally, there were sixteen patients with non-measurable tumor due to associated effusion, atelectasis and/or infiltrate. Four of these (25%) were considered to have local tumor control. Of 60 evaluable patients, there were nine occurrences of fatal hemorrhage, one of whom was disease-free (NED) at autopsy. The remaining eight patients had either clinical or pathological evidence of recurrent or persistent tumor. Patients who had follow up bronchoscopies were found to have varying degrees of concentric narrowing in the treated areas. One such patient had total lung collapse with no evidence of tumor. While this form of treatment may yield high local control rates in earlier stages, this study suggests the potential risk of fatal complication. Additional studies are warranted to further investigate the use of this modality in the treatment of lung cancer.

Adenocarcinoma↗
PubMed1992

Accommodation on downward gaze.

A study was conducted with the purpose of examining the possible effects of vertical and horizontal eye movements upon accommodation. A special Badal stimulator was made which was vertically rotatable around the center of an eye. The stimulator was attached to the Three-Dimensional Optometer III (TDOIII), which could measure accommodation, eye movement, and pupil diameter simultaneously. The reliability of the TDOIII measurements of accommodation was checked by comparing with a stigmatoscope measurement. Three young males served as subjects. A small but definite near accommodation was measured dynamically in association with vertical eye movement. We believe this to be the first report of this finding. The amount of near accommodation with downgaze showed a tendency to decrease when the target was brought near.

Accommodation, Ocular↗
PubMed1992

[The synchronous appearance of multiple testicular epidermoid cysts and of a malignant mixed germinal tumor in the contralateral testis].

We describe the simultaneous appearance of multiple epidermoid cysts in the right and an adult teratoma containing embryonal carcinoma and choriocarcinoma in the left testis. No similar case has previously been described. Epidermoid cysts of the testis are rare, accounting for about 1% of all testicular tumors. Epidermoid cysts are now regarded as monoepidermally developed teratomas of germ cell origin. Testicular teratomas in adults, however, are always malignant. Because epidermoid cysts are rare tumors, primary therapy often consists in ablation of the testis. In the case described, excision of the epidermoid cyst protected the patient from complete castration. This case demonstrates the simultaneous appearance of a malignant and a benign testicular germ cell tumor.

Adult↗
PubMed1991

Practical identification of functional expansions of nonlinear systems submitted to non-Gaussian inputs.

Time-domain identification of nonlinear systems represented by functional expansions is considered. A general framework is defined for the analysis of three identification methods: the widely used cross-correlation method, Korenberg's method, and a suboptimal least-squares method based on a stochastic approximation algorithm. First, the major characteristics of the underlying estimation problem are pointed out. Then, the identification methods are interpreted as approximations to an optimal estimator, which helps gain insight into their internal functioning and to the investigation of their connections and differences. Examination of results previously published and of the simulations reported in this article indicate that stochastic approximation is an interesting alternative to other existing methods. Identification of a biological system stimulated by a non-Gaussian input confirms the practicality of this approach.

Binomial Distribution↗
PubMed1991

Interpretation of functional series expansions.

While much research has been devoted to the implementation and application of Volterra and Wiener functional series expansions in the identification and characterization of biological systems, little effort has been focused on the fundamental problem of interpreting the resulting kernels. This paper describes the application of the series to the components of a known model of the human pupil control system. As more complicated elements are put together, insight into kernel interpretation is built up incrementally until the total system is identified. Practical limitations and methods are also discussed.

Humans↗
PubMed1991

Ocular proprioception and efference copy in registering visual direction.

We measured the roles of eye muscle proprioception ("inflow") and efference copy ("outflow") in registering eye position. During monocular fixation, pressing on the side of an occluded eye results in a passive rotation, changing the proprioception without affecting oculomotor efference. As we have shown previously, a constant press on the side of the viewing eye induces active resistance to rotation, changing efference because oculomotor innervation compensates for the eyepress; the viewing eye's fixation remains constant. Using these two types of eyepress, both perceived target deviations and pointing biases in an unstructured visual field were measured in 8 subjects under efference copy, proprioception and control (no eyepress) conditions. Eye deviation was measured photoelectrically. Physiological gains of efference copy and proprioception was about 5/8 and 1/4 respectively. There was no statistically significant difference between perceptual judgement and open-loop pointing. The sum of gains of efference copy and proprioception, about 7/8, indicates incomplete registration of eye eccentricity in an unstructured field, and quantitatively accounts for several previously unexplained results in the literature.

Adult↗
PubMed1979

Cyclovergence: the motor response to cyclodisparity.

Static photographic evidence of the occurrence of cyclovergence is presented that supports and extends the result of Crone and Everhard-Halm (1975). Wide-angle complex targets were a necessary condition; simple horizontal line targets were insufficient. Our asymmetrical disparity targets supported in part the conformance of cyclovergence to Hering's Law but raised questions relating to the computational process that also acts to remove cyclodisparity and permits cyclofusion. Saturation and hysteresis nonlinearities were observed.

Eye Movements↗
PubMed1979

Visual-motor adaptation. Quantitative demonstration in patients with posterior fossa involvement.

Short-term visual-motor adaptation to magnifying spectacle lenses was studied in normal subjects and in patients with nonacute posterior fossa lesions. When normal subjects, looking through magnifying lenses, pointed open loop to targets without viewing their hands, they initially underestimated the distance (magnification effect). After a 20-minute close-loop training or adaptation exposure period during which they viewed the performance of their hands, a modified visual-motor scheme evolved, compensating for about half of the lens-induced pointing error (adaptation effect). Removal of the lenses after adaptation caused open-loop, overshooting pointing errors (adaptation after-effect). Four patients with remission of cerebellar signs showed normal visual-motor adaptive performance, evidence of ability to recalibrate gain. One patient with persisting cerebellar ataxia was unable to recalibrate gain during close-loop visual-motor training. His history of transient palatal myoclonus implicates a role for the cerebellar-olivary system in calibration of visual-motor gain.

Adaptation, Ocular↗
PubMed1979

Saccadic intrusions in strabismus.

Fixational eye movements were studied to determine the presence of and to quantify saccadic intrusions under monocular and binocular viewing conditions in subjects with intermittent strabismus, amblyopia without stabismus, or constant strabismus amblyopia. Saccadic intrusions were present under most test conditions in intermittent strabismus, were rarely observed in amblyopia without strabismus, and were prominent during monocular fixation with the amblyopic eye in constant strabismus anblyopia. This suggests that the presence of saccadic intrusions was related to strabismus and not amblyopia. There was no relationship between saccadic intrusion amplitude and visual acuity. Two possible mechanisms for producing intrusions are abnormally rapid regional visual adaptation and strabismus-induced fixation degradation.

Adolescent↗
PubMed1979

Reply to Piggins.

Explore the source record for details and available documents.

Eye Movements↗
PubMed1979

Opposed adducting saccades in convergence-retraction nystagmus: a patient with sylvian aqueduct syndrome.

We report high resolution oculographic recordings on a patient with convergent-retraction nystagmus (Parinaud's Sign). Recordings show opposed adducting saccades which are slightly asynchronous (8 ms), in contrast to the conjugate horizontal saccades which are exactly synchronous (0.3 ms). Normal saccadic velocity of these opposed adductions necessarily implies reciprocal innervation of horizontal and vertical agonist-antagonist pairs. Lateral view cine films show absence of retraction, apparently as a consequence of normal orbital mechanics. We suggest that normal mechanisms for dynamic overshoot saccades are involved in the production of these abnormal opposed adducting saccades.

Adult↗
PubMed1979

Objective assessment of accommodation orthoptics. I. Dynamic insufficiency.

Three young adult females with symptoms related to focusing difficulties at near were treated by standard orthoptic procedures, including jump focus, plus-and-minus lens flippers, and pencil pushups. Home training was done 20 minutes each day for 4 1/2--7 weeks. Objective measures of dynamic accommodation were made each week in our Neuro-optometry Clinic. Initially, these objective measures showed prolongations of time constants and latencies of accommodation. During treatment, the patients showed significant reductions in time constants and latencies that correlated well with elimination of subjective symptoms. Also, in all three patients, flipper rates increased and symptoms were either markedly diminished or no longer present at termination of therapy. These results clearly demonstrate that orthoptic treatment in our three adult patients resulted in objective improvement of accommodation function.

Accommodation, Ocular↗
PubMed1979

Study of eccentric fixation with secondary visual feedback.

Secondary visual feedback (2VFB) is a visual signal derived from continuous measurement of eye position and provides an extra artificial indication of the point of gaze. 2VFB may be eccentrically displaced and subjects are able to visually superimpose 2VFB onto a visual target signal and thus achieve and maintain eccentric fixation. Initial transient patterns of movement depend upon training but even naive subjects can achieve eccentric fixation within the first 40 s of such a task. Individual strategies and idiosyncratic patterns are exaggerations of normal control and fixational eye movements. The variance of maintained fixation increases with eccentricity and appears to be related to visual acuity as well as to precision of ocular motor control.

Biofeedback, Psychology↗
PubMed1979

Abnormal saccadic substitution during small-amplitude pursuit tracking in amblyopic eyes.

Small-amplitude, low-velocity, predictable triangular tracking was tested in patients having amblyopia without strabismus, intermittent strabismus, or constant strabismus amblyopia by means of a photoelectric eye-movement recording technique. In the majority of amblyopic patients, abnormal saccadic substitution was found; that is, abnormally large saccades rather than small-amplitude smooth movements were used by the amblyopic eye to follow a spot stimulus that moved horizontally with low to high frequencies. Pursuit for the same range of stimuli was normal for binocular tracking and for monocular tracking with the dominant eye, pointing to a sensory rather than motor basis for the defect. This abnormal saccadic substitution response appeared to be related to the presence of amblyopia rather than strabismus. Several possible mechanisms responsible for causing this unusual response are discussed, including impairment of direction sense over small central regions of the amblyopic eye.

Adolescent↗
PubMed1979

Fixational eye movements in amblyopia and strabismus.

Horizontal eye position was monitored using a photoelectric method during monocular and binocular fixation in four patients having amblyopia without strabismus, thirteen patients having constant strabismus with amblyopia, and five patients having intermittent strabismus. Four abnormalities of fixation were found: increased drift, saccadic intrusions, manifest nystagmus, and latent nystagmus. Increased drift was related to the presence of amblyopia, while saccadic intrusions and nystagmus were related to the presence of strabismus. Understanding dynamic aspects of oculomotor control can provide insight into clinical assessment of fixation in amblyopia and strabismus.

Adolescent↗