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Biomedical subjects

M M Katz

Publications and source records attributed to M M Katz.

At least 55 records · Page 3Linked to original sources

Lower-extremity sensibility testing in patients with herniated lumbar intervertebral discs.

The significance of sensory changes determined by pinprick and light touch in individuals with a herniated lumbar disc has been questioned. Discrepancies may be related to the subjectiveness of the test, failure to use dermatome-specific testing sites, overlap of areas that are innervated by different nerve roots, anatomical variations, or lack of sensitivity of the testing technique. For this study, we assessed the results of sensory examinations of twenty-five patients with documented herniation of a lumbar disc. The examinations were done using Semmes-Weinstein monofilaments, vibrometry, pinprick, and light touch in the autonomous skin areas supplied by the fourth and fifth lumbar and first sacral-nerve roots. Right-left differences in Semmes-Weinstein pressure thresholds of more than fifteen milligrams per square millimeter enabled us to localize disc lesions to a specific root in 100 per cent of patients and differences in vibratory thresholds of more than 3.5 micrometers, to localize the correct level in 88 per cent. Lesser differences in thresholds did not help to identify the involved root. The mean sensory threshold on the side of the disc lesion was found to be significantly greater than that on the opposite side by both vibrometry and pressure aesthesiometry (p less than 0.005). These findings were not duplicated using light touch or pinprick testing. Even with the most sophisticated sensibility-testing techniques, correct identification of the nerve root that was compressed by a herniated lumbar disc was accurate in only 50 per cent of patients.

Adult↗

Hereditary tendo Achillis contractures.

A study was performed on eight patients with tendo Achillis contractures. Family histories were obtained and a short regimen of casting was performed. Hereditary tendo Achillis contracture is an autosomal dominant condition with variable expression. It is a relatively benign condition that is both a cosmetic and functional problem for the patient. The disorder responds well to a short course of casting. Follow-up exercises are necessary to maintain normal ankle motion and heel strike during gait. Operative treatment was not necessary in these patients.

Achilles Tendon↗

Pretreatment neurotransmitter metabolite levels and response to tricyclic antidepressant drugs.

Relationships between pretreatment neurotransmitter metabolite levels and response to imipramine and amitriptyline were studied in 104 depressed patients. Normal values for urinary norepinephrine and low values for urinary MHPG were associated with greater incidence of drug response in bipolar, but not unipolar, patients. For unipolar, but not bipolar, patients low CSF 5-HIAA and high urinary metanephrine values were associated with a greater incidence of drug response. These data indicate that the pretreatment functional state of catecholamine and serotonin systems is associated with type of response to drug treatment. The authors present hypotheses about the association of alterations in serotonin and norepinephrine systems and definable subtypes of depression.

Amitriptyline↗

Behavioural measurement and drug response characteristics of unipolar and bipolar depression.

This research is part of the NIMH--CRB Collaborative Study on the psychobiology of depression. The main objective of the research programme is to test hypotheses concerning the interaction of neurobiological mechanisms and behaviour in the depressive disorders. Part I of the report describes the rationale and the overall approach to measuring behavioural state and outcome in the research programme. Part II reports on the results of applying the behavioural methods to a comparison of the clinical phenomenology of unipolar and bipolar depression. The behavioural patterns expressed during the episode by the two groups are different. Further, the two types are shown to react differently to treatment with tricyclic drugs, reinforcing the thesis that they are qualitatively distinct forms of the depressive disorders.

Antidepressive Agents, Tricyclic↗

Biological component of the NIMH clinical research branch collaborative program on the psychobiology of depression: I. Background and theoretical considerations.

There are many reports which suggest that patients with effective illness (mania and/or depression) have abnormalities in the functioning of one or more neurobiological systems. At a conference convened by the Clinical Research Branch, Division of Extramural Research Programs, National Institute of Mental Health, these findings were reviewed and some of the factors impeding movement towards a more complete and integrated view of the functioning of neurobiological systems in patients with mania or depression were identified. As a result, a multi-research centre, collaborative approach to the study of the psychobiology of affective disorders was developed. In this collaborative programme, which has now been underway for several years, the focus has been upon: (a) the assessment of the functioning of several different types of biological systems in the same patient, both before and during treatment; (b) obtaining a reasonably large number of patients and comparison subjects; and (c) the use within and across centres of standardized diagnostic categories and behavioural rating methodologies. In this paper the history, background, and rationale for this collaborative effort are reviewed. Those biological systems chosen for study are noted, and issues such as reliability and validity of diagnoses, measurement of state variables, assessment of change with treatment, and logistical and coordinating problems are discussed.

Affective Disorders, Psychotic↗

NIMH clinical research branch collaborative program on the psychobiology of depression.

This is a report on the history and implications of the collaborative effort that evolved from the 1969 National Institute of Mental Health conference on the psychobiology of depression. The major issues identified at that time were the need to (1) assess relative validities of current systems of nosology and (2) retest critical biological hypotheses concerning the etiology and nature of the depressive disorders. Research was required that would be multidisciplinary and involve clinical settings treating diverse types of depression. The objectives and the nature of the biological and clinical collaborative programs that were designed to address these problems are described. These unique programs, initiated in the early 1970s, currently span research on nosology, genetics, neurochemistry, neuroendocrinology, and psychosocial factors. Although these studies are still in the early stages, they have resulted in significant methodologic developments in diagnosis, descriptive psychopathology, and biological measurements.

Adrenocorticotropic Hormone↗

Behavioral change in the chronicity pattern of dementia in the institutional geriatric resident.

To determine whether behavioral change as a result of environmental stimulation can be reported in individualized terms for the aged with organic brain syndrome or senile dementia, a program of multimodal group interactive therapy was started in an extended care facility. During a 1.5-year period, the study included 108 residents, whose average age was 84 years. The technique used was a combination of modified Reality Orientation, Remotivation, Activity and Milieu therapies. Thirteen groups residing in different wings of the facility were treated for 55 sessions by 11 activity specialists and 2 elderly volunteers under the supervision of the consulting clinical psychologist. Data were collected on emerging behavioral changes with respect to awareness, attention, verbalized ideation, voice quality, speech quantity, sociability, self-care, quality of affect, energy level, expressed somatic concern and physical movement. Of the initial 108 residents, 80 had chronic brain syndrome of varying severity or senile dementia. During treatment, 35 of these 80 residents (44 percent) were improved, 17 (20 percent) were unchanged, 14 (18 percent) became worse, and 14 (18 percent) remained unrated. The results warrant a redifinition of the psychotherapeutic approach. It should include factors other than the severity and chronicity of disease in determining the prognosis for behavioral change in geriatric institutional residents.

Behavior↗