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Biomedical subjects

M Schapiro

Publications and source records attributed to M Schapiro.

At least 37 records · Page 2Linked to original sources
PubMed1988

Longitudinal study of the early neuropsychological and cerebral metabolic changes in dementia of the Alzheimer type.

To examine the progression of neuropsychologic and metabolic changes in the early stages of dementia of the Alzheimer type (DAT), we studied 11 midly demented patients longitudinally. Three aspects of neuropsychological function were measured: memory, attention to complex sets and abstract reasoning, and lateralized functions, i.e., language and visuoconstruction. Regional cerebral metabolic rates for glucose were measured in frontal, parietal, and temporal association cortices. Our results show that, in general, memory deficits are the first neuropsychological impairments to occur in DAT, followed by problems with attention to complex cognitive sets and abstract reasoning, which are followed in turn by deficits in language and visuospatial abilities. In addition, neocortical metabolic abnormalities usually precede impairment of neocortically mediated attention and abstract reasoning by 8 to 16 months, and precede impairment of neocortically mediated language and visuospatial function by 12 to 37 months. These findings suggest that the first nonmnestic neuropsychological consequence of neocortical physiological dysfunction in DAT is a loss of attentional capacity. Since neocortical metabolic changes generally precede the appearance of neocortically mediated neuropsychological dysfunction, physiologic dysfunction may exist for some time before cognition is affected.

Aged↗
PubMed1988

Heterogeneous anterior-posterior metabolic patterns in dementia of the Alzheimer type.

The parietal-frontal distribution of reductions of regional cerebral metabolic rates for glucose (rCMRglc) was studied in 32 patients with mild to severe dementia of the Alzheimer type (DAT), using positron emission tomography and fluorodeoxyglucose, and was related to patterns of neuropsychological impairment. In moderate and severe DAT patients, one frontal association region, the premotor cortex, demonstrated significant metabolic reductions equivalent to reductions in the parietal association cortex, and the ratio of parietal to premotor rCMRglc had significantly greater variance than in controls. In moderately demented patients, parietal-premotor and parietal-prefrontal metabolic ratios correlated significantly with neuropsychological impairments. Disproportionate parietal hypometabolism was associated with more impairment of verbal comprehension, calculations, visuospatial construction, and immediate visuospatial memory span. Disproportionate frontal hypometabolism was associated with more impaired verbal fluency and attention. Longitudinal follow-up of 20 of the patients showed that parietal/frontal metabolic ratios and their correlated neuropsychological patterns were stable over time, as dementia severity worsened. These results indicate that in moderate to severe DAT patients, metabolic reductions in the premotor cortex are as severe as the reductions in the parietal association cortex. Moreover, the parietal-premotor distribution of metabolic reductions is variable and related to variable patterns of cognitive impairment.

Alzheimer Disease↗
PubMed1987

The electronic video endoscope: clinical experience with 1200 diagnostic and therapeutic cases in the community hospital.

Gastrointestinal endoscopic examinations with the Welch-Allyn and Fujinon electronic video endoscopes were evaluated in four phases in our community hospital endoscopy unit. Resolution and clinical comparisons to fiberoptic instruments offered advantages for the electronic systems. A review of 1200 consecutive procedures for efficacy, safety, and maintenance considerations was conducted. The use of the video endoscopes as first choice for nearly all diagnostic and therapeutic procedures was more favorable than for the ongoing experience with fiberoptic instruments.

Electronics, Medical↗
PubMed1987

Clinical experience with electronic video duodenoscopy in a community hospital.

Thirty consecutive endoscopic retrograde cholangiopancreatography examinations, including 14 cases of endoscopic sphincterotomy, were performed with either the Fujinon or Olympus electronic video duodenoscope. The clinical experience with these electronic instruments was similar to that occurring with fiberoptic duodenoscopes. These instruments complement the electronic upper gastrointestinal and colonoscopic endoscopes presently available.

Attitude of Health Personnel↗