Biomedical subjects
Publications and source records attributed to S Grand.
We analyse clinical characteristics, presurgical investigations, surgical procedures and outcome of 137 patients operated-on for a drug-resistant partial epilepsy, in Grenoble from January 1990 to December 1993. Moreover we present data of 63 patients suffering from a "pure" temporal lobe epilepsy selected using the following criteria: 1. surgery limited to temporal lobe structures 2. totally cured after surgery (Engel's class la).
STUDY DESIGN: This study examined the effect of radio-frequency thermocoagulation on cadaveric disc material. Radio-frequency lesions are induced to decompress the nerve root by coagulating the nucleus pulposus. OBJECTIVES: The purpose of this study was to assess the potential of the radio-frequency lesion technique for treating lumbar disc herniation percutaneously. The effect of radio-frequency thermocoagulation on cadaveric disc material was studied. SUMMARY OF BACKGROUND DATA: An intradiscal bipolar electrode is used for the thermocoagulation of the nucleus pulposus. METHODS: Lumbar discs of 27 adult cadavers were used for the experiments within 72 hours of donors' deaths. The physical and thermal parameters of intradiscal radio-frequency thermocoagulation were determined experimentally. Acute macroscopic and histologic changes before and after thermocoagulation were investigated. The temperature distribution of the tissue surrounding the disc was measured during the operation using thermocouples to evaluate potential heat damage. Also, computed tomography and magnetic resonance imaging of the disc were performed before and after thermocoagulation. RESULTS: Macroscopic observation showed that the lesion induced by radio-frequency thermocoagulation is homogeneous and intense without necrosis, and is limited to the nucleus pulposus. Histologically, the endplates and vertebral bodies were unaffected and an architectural disorganization of the stroma of the nucleus pulposus was seen. The temperature increase of the tissue surrounding the discs did not exceed 3-4 C. CONCLUSION: A bipolar electrode and a radio-frequency alternating current permits percutaneous intradiscal thermocoagulation for destruction of a portion of disc material in a cadaveric spine.
Five patients, each with a brain abscess, were examined by means of 1H MR spectroscopic imaging in vivo. The aspirated pus was analyzed in vitro by means of 1D and 2D COSY 1H MRS. In addition to resonance lines from compounds (lactate, alanine and lipids) often found in the spectra from intracranial tumors, resonance lines were detected from a number of markers of infectious involvement (acetate, succinate, and various amino acids). These results suggest that 1H MRS in vivo might contribute in establishing noninvasively a differential diagnosis between brain abscess and tumor.
Leo Stone's "The Widening Scope of Indications for Psychoanalysis" has had a major influence on the way almost two generations of American psychoanalysts have been taught to think about and practice psychoanalysis. Contemporary elaborations and extensions of the ideas contained in Stone's paper have, however, been used to move us steadily toward a shift in the treatment paradigm that underlies the way psychoanalysis is currently being conducted. This contemporary tendency to enlarge the scope of the mode of action of psychoanalysis, in order to accommodate the wider range of patients being treated today, blurs those aspects of psychoanalytic technique that distinguish the unique psychoanalytic perspective from the more general psychotherapeutic perspective. Several ideas contained in Stone's paper are considered as a basis for clarifying this distinction and the technical implications deriving from it. Two clinical vignettes are presented to illustrate these issues.
Nine patients with haemangioblastoma of the posterior cerebral fossa were explored by computerized tomography (CT), then by magnetic resonance imaging (MRI) with enhancement by gadolinium in 4 cases. Following a review of clinical and laboratory data, the radiological images are detailed and distributed into three forms: cystic with mural nodule, solid, and annular. The usefulness of the different imaging techniques is specified, and the stress it put on the need to look for multiple sites in the entire central nervous system.
A case of Lhermitte-Duclos disease is reported. Characterized by architectural disruption of the cerebellar folia with disorganization of the normal three layers, the lesion is easily identified using magnetic resonance imaging.
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Feedback from one's own voice provides important vocal-motor cues for effective cognitive processing. Reduction of such feedback is known to disturb such functioning. Work in our laboratory has shown that kinesic self-stimulation also plays an important role in cognition, and appears to regulate the focusing of attention under conditions of distraction. The present study investigated the effects of both auditory feedback and kinesic self-stimulation in the regulation of cognitive interference during performance of the Stroop Color-Word Task. Twelve subjects were tested on the Stroop task under conditions of normal and occluded hearing. Kinesic self-stimulation and response errors during color-word performance were recorded on video tape. The findings indicated that not only did self-stimulation increase when voice feedback was reduced, but that this increase was associated with a reduction in specific types of color-word performance errors. Individual differences revealed that high kinesic responders made significantly fewer errors in task performance than did low kinesic responders. Results were interpreted as revealing a kinesic feedback mechanism which has adaptive significance in regard to self-editing when auditory feedback is reduced.
The present study tested the hypothesis that vocal feedback affects the interference obtained during performance on the Stroop Color-Word task. Two measures were studied as indicators of ability to name colors on the Stroop, speed (performance time) and accuracy (number of errors). Speed of performance on the interference task by 16 male college students was not aided by reduction of vocal feedback. Accuracy of performance in the interference condition was strongly facilitated by reduction of vocal feedback, while little change was noted with no interference. These results are consistent with a view that in vocal feedback on Stroop interference the experience of a mismatch between the auditory feedback produced by the weaker color-naming response in the presence of the prepotent tendency to make the reading response increases interference.
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The language behavior of field-independent (F-D) clinically normal, verbally resourceful femal college students was examined in three different communication conditions: Dialogue, Warm (vissually supportive) monologue, and Cold (visually nonsupportive and stressful) Monologue. F-I and F-D Ss produced similar amounts of the different types of language behavior evaluated in each of the three communicative conditions. However, they differed with respect to verbal output and length of sentence "packaging" unit in Monologue conditions. F-D Ss talked considerably less but at the same time produced different types of grammatically more elaborate language behavior in Warm and Cold Monologue compared to their Dialogue language behavior. F-I Ss talked considerably more but also showed a type of language autonomy. The pattern of language behavior which characterized F-I speech in Dialogue remained the same in both Monologue conditions.
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Recent studies of formal kinetic and linguistic aspects of communication suggest that these may be important signposts of internal processes responsible for the regulation and organization of verbal thought. If so, the formal analysis of communication patterns of patients known to have difficulty in cognitive organization (chronic schizophrenics) should reveal kinetic and linguistic characteristics consistent with their level of adaptive cognitive functioning. In the present study, 16 chronic nonparanoid schizophrenic patients were video recorded during a clinical interview, and their kinetic and linguistic behavior was analyzed according to systems developed in our laboratory. Eight of these patients were chronic, isolated patients, classified by means of a scale for measuring proneness to future hospitalization, as extremely "prone" to rehospitalization, and eight were chronic, overtly oppositional patients, classified as "nonprone" to hospitalization. Prone patients are known to exhibit a relatively impoverished form of cognitive functioning, while nonprone patients exhibit more highly differentiated cognitive functioning. The major findings of this study revealed that the isolated prone patients could be distinguished from the nonprone patients, in their communicative behavior, by an increased utilization of the most repetitive and unpatterned stimulation of body parts, as well as the most simple form of linguistic narration of experience. The oppositional nonprone patients more often utilized circumscribed, patterned, and brief kinetic stimulation of body parts, as well as a form of language construction characterized by a complex conditional (i.e., causal, deductive, or purposive) framework for the expression of thought. In addition, social and affective components of the scale measuring hospital proneness were related to our formal kinetic and linguistic scoring categories. An explanation of these findings was offered based upon the well documented relationship observed in the literature between isolation and hyperarousal in chronic schizophrenia. That is, an attempt was made to integrate these findings with the notion that the schizophrenic disorder reflects an integrative deficit which is regulated by increasing the magnitude of proprioceptive feedback (and hence, arousal) through stereotyped repetitive motor activity.
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