Instability of localization of cerebral blood flow activation foci with parametric maps.
Explore the source record for details and available documents.
Analysis of Variance↗
Biomedical subjects
S F Taylor
Publications and source records attributed to S F Taylor.
Association of cytomegalovirus with Ménétrier's disease in childhood: report of two new cases with a review of literature.
Explore the source record for details and available documents.
Albumins↗
Automated detection of the intercommissural line for stereotactic localization of functional brain images.
A technique has been developed for automated detection of the intercommissural (AC-PC) line for positron emission tomography (PET). The AC-PC line is estimated from the location of four internal landmarks; the frontal and occipital poles, the inferior aspect of the anterior corpus callosum, and the subthalamic point. The landmarks are detected automatically in PET mid-sagittal slices by combining edge detection, interpolation and profile curve analysis techniques. The anatomical relationships between the true and estimated AC-PC lines from the landmarks was confirmed by analysis of magnetic resonance (MR) images. Accuracy of the automated estimation technique was assessed in co-registered PET and MR images, which showed minimal angular differences and displacements of the estimated from the true AC-PC lines. The automated detection of the AC-PC line in a PET study enables accurate stereotactic localization of functional signals without the need for additional anatomical imaging and provides a basis for objective and reproducible intersubject comparison.
Brain↗
Neuropsychological function and REM sleep in schizophrenic patients.
To test the hypothesis that rapid eye movement (REM) sleep in schizophrenic patients is associated with cognitive function, we studied 18 schizophrenic inpatients by means of electroencephalograms taken during sleep in their own hospital beds after a minimum 2-wk medication withdrawal period. Patients underwent neuropsychological tests to measure memory function and other aspects of cognitive performance. REM sleep measures demonstrated positive and negative correlations with cognition and memory measures, depending on when REM occurred after sleep onset. Minutes of REM sleep and REM density in the first period correlated negatively with performance, while REM minutes occurring after the first REM period correlated positively with neuropsychological performance. Further work should test whether phasic REM sleep regulation at the beginning of the night plays a compensatory role for neuropsychological dysfunction in schizophrenics.
Adult↗
Technetium-99m-N1-(2-mercapto-2-methylpropyl)-N2-(2-propargylthio-2- methylpropyl)-1,2-benzenediamine (T691): preclinical studies of a potential new tracer of regional cerebral perfusion.
We report in vitro and in vivo preclinical studies of a new cerebral blood flow tracer, [99mTc]N1-(2-mercapto-2-methyl-propyl)-N2-(2- propargylthio-2-methylpropyl)-1,2-benzenediamine (T691). The tracer demonstrates excellent in vitro chemical stability and accumulates regionally in the brain in a pattern consistent with that of cerebral blood flow. First-pass cerebral extraction determined with the use of the brain uptake index method in the rat was 0.76. Bolus intracarotid injection in monkeys indicated a cerebral extraction of 68% and prolonged retention of 67% of the initially extracted activity. Autoradiographic studies in rats revealed a pattern characteristic of cerebral blood flow at both 1 and 60 min after systemic injection. Dynamic tomographic imaging following systemic injection in the monkey revealed peak brain activity 1 to 2 min postinjection, without significant decline over 60 min. Chromatographic studies of brain as long as 60 min following systemic injection of [99mTc]T691 showed no evidence of tracer metabolism to account for its retention. Overall, [99mTc]T691 demonstrates promise as a potential new clinical tracer of cerebral perfusion.
Animals↗
Effect of neuroleptic treatment on polysomnographic measures in schizophrenia.
To study the effects of neuroleptic therapy on sleep EEG variables in schizophrenia, as well as the clinical correlates of these variables, we performed polysomnographic (PSG) studies on 14 schizophrenic inpatients before and during neuroleptic therapy. Sleep continuity measures improved after 3 weeks of neuroleptic therapy, showing decreased sleep latency and improved sleep efficiency. REM latency increased with treatment, although half the patients continued to exhibit REM latencies less than 60 min. Other sleep stages and measures of REM sleep (density, activity, number of periods) did not appear to change with neuroleptic treatment. At baseline, REM latency had strong negative correlations with BPRS and SANS scores, but with 3 weeks of such treatment, this association disappeared. Further work is needed to distinguish direct medication effects from the effects of the changing clinical state on PSG measures.
Adult↗
Sleep onset REM periods in schizophrenic patients.
Explore the source record for details and available documents.
Adult↗
Cervical, cervicomediastinal and intrathoracic lymphangioma.
Lymphangiomas result from abnormal development of the lymphatic system, with obstruction to lymph drainage from the affected area. The neck is the most common site (25%). In this study, we review the literature of lymphangioma in the neck and thorax and have undertaken detailed analysis of 52 children with cervical lymphangioma treated during the 20 years 1969-1988. Cervicomediastinal lymphangioma is uncommon (4%) and lesions confined to the thorax are rare, with none in our series. Neck lymphangiomas occur in early childhood with half being diagnosed at birth and almost 90% before school age. All have a mass. Two-thirds are asymptomatic; sudden enlargement, inflammation, infection, feeding difficulties and respiratory symptoms occur in the remainder. Pharyngeal and laryngeal involvement, usually associated with large infiltrating lesions, results in acute airways obstruction. The respiratory symptoms caused by mediastinal extensions are usually less dramatic. Lymphangiomas have a characteristic appearance on ultrasound examination and CT scan. These investigations are mandatory for an undiagnosed intrathoracic mass and when there is clinical suspicion of mediastinal extension of cervical lymphangioma but should be obtained for neck swellings only when the clinical diagnosis is in doubt. The recommended treatment is surgical excision which can be achieved with no mortality and little morbidity. An initial period of observation is justified for asymptomatic cervical lesions because there is a small incidence (6%) of spontaneous regression. Cervicomediastinal lymphangiomas can be removed at one operation using a neck incision combined with median sternotomy. The surgeon must preserve vital structures (especially vagus, recurrent laryngeal and phrenic nerves) and should not necessarily attempt total removal of all lymphangiomatous tissue. Massive infiltrating cervical lesions pose a particular challenge and may require multiple operations over many years before a satisfactory result with good-quality survival is attained.
Child↗
Noninfectious colitis associated with short gut syndrome in infants.
We describe noninfectious bloody diarrhea in 13 of 16 infants referred for management of short bowel syndrome and parenteral nutrition during a 33-month period. The condition was characterized by bloody, watery stools associated with carbohydrate malabsorption. Colitis occurred at a mean age of 4.2 months during periods of advancing enteral feedings of a hydrolyzed protein- or amino acid-containing formula. Sigmoidoscopy performed in nine patients revealed edema, patchy erythema, loss of normal vascular pattern, and mucosal friability without ulcerations or pseudomembranes. Colonic biopsy specimens demonstrated edema and mixed hypercellularity of the lamina propria, with prominent eosinophilia. Rectal bleeding ceased if formula feedings were decreased or withheld. Of multiple medications administered, sulfasalazine seemed to improve rectal bleeding most effectively in our patients and allowed for more rapid reintroduction of enteral feedings.
Carbohydrate Metabolism↗
Safety, efficacy, and tolerance of intestinal lavage in pediatric patients undergoing diagnostic colonoscopy.
In an open-label prospective study the safety, efficacy, and patient tolerance of an enterally administered isotonic intestinal lavage solution containing polyethylene glycol-3350 was evaluated in 20 pediatric patients (ages 1 1/2 to 19 years) undergoing diagnostic colonoscopy. After an oral dose of metoclopramide, lavage solution was administered by mouth or nasogastric tube at a rate of 40 ml/kg per hour until stools were clear. Emesis occurred in 4 patients, nausea in 11, and abdominal distension in 5. Clear stools were produced in a mean (+/- SE) time of 2.6 +/- 0.3 hours. The volume of lavage solution delivered, which ranged from 15.6 to 183.3 ml/kg, varied inversely with the weight (and age) of the patient. Preparation of the colon was considered optimal in 11 patients, satisfactory in 7, and suboptimal in 2. Small but significant decreases in urine osmolality, blood urea nitrogen, serum glucose, and potassium values were noted at the termination of perfusion. Postperfusion serum glucose concentration in the smallest patient (11.4 kg) was 61 mg/dL (3.4 mmol/L). Mean (+/- SEM) change in weight after perfusion was 0.14 +/- 0.05 kg (range -0.2 to +0.6 kg). Of 20 patients, 11 required or requested nasogastric administration of the lavage solution because of its unpleasant taste. We conclude that whole intestinal perfusion with a balanced electrolyte solution containing polyethylene glycol is safe, acceptable, and efficacious in children.
Adolescent↗
South Carolina medical record department directors as health information managers.
Is the job of medical record department director substantially the same in any acute care hospital? If not, what are some of the differences in roles and responsibilities? This study addresses that question as it relates to medical record department directors in South Carolina acute care general hospitals.
Hospital Departments↗
Alteration of corticothalamic perfusion ratios during a PTSD flashback.
We performed a single photon emission computed tomography (SPECT) study of patients with posttraumatic stress disorder (PTSD) by measuring changes in regional cerebral blood flow (rCBF) during provocation by combat stimuli. A single patient experienced an actual flashback following exposure to combat sounds, exhibiting tearfulness, diaphoresis, tachypnea, and severe agitation. Results from his SPECT study demonstrated a dramatically altered ratio of cortical to subcortical perfusion during the flashback but not during the control scan. This altered pattern, which showed a peak of activity in the thalamus, was not consistent with global rCBF changes induced by hyperventilation. The perfusion pattern during the patient's control scan was qualitatively indistinguishable from any of the SPECT scans obtained for the other patients. This single case suggests a possible role for corticothalamic dysfunction in flashbacks.
Acoustic Stimulation↗
Facilitation and interference of selective attention in schizophrenia.
Theories of attentional impairment in schizophrenia predict excessive interference in selective attention tasks, such as the Stroop task, where subjects must name the color of words which spell colors different than the to-be-named-color. However, a recent study actually found greater facilitation, i.e. improved color-naming time when the color-word agrees with the to-be-named color, and near-normal interference in schizophrenic patients when compared to normal controls. To evaluate these findings, we studied 12 schizophrenic patients (10 on neuroleptics), and 12 age- and gender-matched, healthy subjects in a trial-by-trial Stroop task. The patients exhibited significantly greater facilitation on the Stroop task compared to the normal controls (81 and 12 ms, respectively). Interference effects were not significantly greater for the schizophrenic patients. These findings suggest a need for more work to investigate why schizophrenic patients appear to benefit from the facilitation condition more than normal controls do.
Adult↗
Symptom correlates of global measures of severity in schizophrenia.
There is an increasing need for practical instruments that can rapidly and accurately assess the effectiveness of treatments for mental illness in clinical settings. Symptom rating scales used in clinical research are too complex and time-consuming to be useful in these settings. In contrast, single-item global measures of severity such as the Clinical Global Impression-severity scale (CGI) and the Global Assessment of Function scale (GAF) are brief and easy to complete, but little is known about their relationship with the specific symptoms of severe mental illnesses. In this study, we examine the extent to which CGI and GAF scores reflect the severity and the change in severity of positive, negative, depressive, and agitation symptoms in a sample of 102 schizophrenia inpatients at the University of Michigan Medical Center. At admission, positive symptoms were the strongest correlates of both CGI and GAF scores, followed by negative symptoms, and agitation. Depressive symptoms did not correlate significantly with either global measure. The three symptom scores together explained 58% of the variation in CGI and 39% of the variation in GAF. A similar pattern of association was found for the scores measured at discharge and for the relationships between the change in global measures and change in specific symptom clusters. Thus, by demonstrating that single-item global measures, particularly the CGI, can be reasonably good indicators of psychopathology, this study suggests that these measures may be practical tools for routine monitoring of the effectiveness of treatments for severe mental illness in community settings.
Adult↗