Biomedical subjects
S Solomon
Publications and source records attributed to S Solomon.
Nuchal features of cluster headache.
Nuchal symptoms were found in the majority of 100 consecutive patients with cluster headache. In 10%, pain was experienced in the neck with the initial typical orbitotemporal pain; in 37%, pain radiated from the orbit or temple to the ipsilateral side of the neck. Sometimes, neck pain heralded the onset of the attack by a few minutes. During an attack, neck stiffness was reported in 40% and tenderness in 29%. Movement of the neck, especially flexion, precipitated cluster headache in 9% of patients. This was particularly true of patients with chronic cluster headache. Neck movement aggravated the headache in 16 of 100 patients and an equal number reported amelioration of pain by neck movement, especially extension. The nuchal features did not necessarily accompany every attack and were usually overshadowed by the severity of the typical headache. Nevertheless, symptoms referable to the neck occur more commonly than is generally appreciated.
Spreading depression marches on.
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Activation of cholera toxin-specific T cells in vitro.
Cholera toxin (CT) and its B subunit (CT-B) are potent oral immunogens in vivo, although both strongly inhibit polyclonal lymphocyte activation in vitro. In order to help understand this paradox, we have studied the activation and proliferation of CT-specific T cells in vitro, by using CT-B-primed lymph node T cells as responders, concanavalin A-stimulated peritoneal macrophages as antigen-presenting cells (APCs), and various forms of CT-B as antigen. The results indicate that in many ways CT-specific T cells respond in a manner similar to that of T cells specific for other protein antigens: the degree of proliferation was proportional to the dose of antigen and APCs in the cultures, was antigen specific, and was H-2 restricted. APCs from genetic high-responder strains to CT stimulated significantly more proliferation in F1 (high x low) responder T cells than did APCs from low responder strains. However, there was a marked difference in the activation of CT-specific T cells when different forms of CT-B were used. Native CT-B stimulated little or no T-cell proliferation, whereas denatured CT-B or CT-B blocked by its ligand, GM1 ganglioside, stimulated T cells well. Addition of native CT-B to cocultures of primed T cells, APCs, and these latter stimulatory forms of CT-B inhibited the specific proliferative response to CT-B to varying degrees, depending on the ratio of the two forms in culture. We conclude that the ability of CT-B to inhibit T cells extends even to T cells specific for CT itself. Because of these inhibitory properties, processing of CT to nonbinding molecular forms or fragments must be an important prerequisite for the immune response to CT to occur in vivo, and such processing is likely to be important in the immune response to a variety of other enterotoxins as well.
The hypnic headache syndrome: a benign headache disorder of the elderly.
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Apoplectic headache and oculomotor nerve palsy: an unusual presentation of multiple sclerosis.
A patient with a history of facial myokymia presented with apoplectic headache and a 3rd nerve palsy. Initial CT, lumbar puncture, and cerebral angiogram were unremarkable, but subsequent CSF examination revealed oligoclonal bands. MRI displayed over 30 white matter lesions. This case demonstrates that multiple sclerosis may present with severe headache and a 3rd nerve palsy, simulating the clinical picture of a posterior communicating artery aneurysm.
Facial pain.
This article presents differential diagnosis and treatment of facial pain. Facial pain is classified in accordance with the recent work of the Headache Classification Committee of the International Headache Society. The two major divisions are facial pain associated with disorders of the head and neck, including their parts, and disorders of cranial nerves, including their central connections. Special attention is paid to the controversial topics of temporomandibular joint dysfunction and atypical facial pain.
Atrial natriuretic peptide inhibits renal glutamine extraction.
The effect of administered atrial natriuretic peptide, ANP, on renal glutamine extraction, oxygen consumption and ammoniagenesis was determined in the intact functioning kidney of nonacidotic and chronically acidotic rats. Chronic acidosis shifted the metabolic fuel dependency towards glutamine, reflected by a 3.7 fold increase in extraction. Bolus injection of ANP, 1 microgram/100g BW, results in increased GFR, massive diuresis and an acid urine. Glutamine uptake fell in both groups, reversing from uptake to release in nonacidotic animals and dropping nearly 50 percent in acidotic rats. In contrast, oxygen consumption fell only 20 percent. Inhibition of glutamine extraction appears to be an indirect effect of ANP dependent upon the elevated GFR and elimination of glutamine uptake from the blood, but not from the filtrate. Efficacy of ANP, unlike classical diuretics, was not affected by the prevailing acid base condition nor a large shift in the fuel utilized.
Evidence for terror management theory: I. The effects of mortality salience on reactions to those who violate or uphold cultural values.
On the basis of terror management theory, it was hypothesized that when mortality is made salient, Ss would respond especially positively toward those who uphold cultural values and especially negatively toward those who violate cultural values. In Experiment 1, judges recommended especially harsh bonds for a prostitute when mortality was made salient. Experiment 2 replicated this finding with student Ss and demonstrated that it occurs only among Ss with relatively negative attitudes toward prostitution. Experiment 3 demonstrated that mortality salience also leads to larger reward recommendations for a hero who upheld cultural values. Experiments 4 and 5 showed that the mortality salience effect does not result from heightened self-awareness or physiological arousal. Experiment 6 replicated the punishment effect with a different mortality salience manipulation. Implications for the role of fear of death in social behavior are discussed.
Variants of chronic paroxysmal hemicrania.
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Isolation and biological activity of corticostatic peptides (anti-ACTH).
Corticostatins (CS's) are a family of low molecular weight peptides, rich in arginine and cysteine with the ability to inhibit ACTH stimulated adrenocortical steroidogenesis. They show a high degree of specificity in that they do not inhibit the action of angiotensin II in the adrenal cortex. Four corticostatins have been isolated from rabbit lung extracts and peritoneal neutrophil extracts and one from human neutrophils. Among them corticostatin I, CSI, is the most potent with an I.D.50 of 25 nM. Corticostatin activity is different from other published inhibitory factors such as TGF-B and ANF, which inhibit basal and angiotensin II stimulated steroidogenesis. Other factors such as macrophage secreted products, and septic shock plasma factors which have not been fully characterized also have suppressive activity on ACTH induced adrenocortical steroidogenesis in vitro. It is not yet clear whether there is any relationship between corticostatins and these macrophage products and shock plasma factor. Corticostatins do not inhibit dbcAMP induced steroidogenesis, however they do inhibit the accumulation of cAMP in response to ACTH in rat adrenal cell suspensions. Binding studies show that CSI is a competitive inhibitor of ACTH, probably acting by blocking, the address recognition site of the receptor. There is wide variation in the potency of the corticostatins ranging from an ID50 of 100 ng/ml for CSI to a completely inactive analog, HP1. In this paper we will describe the purification of the corticostatins and some recent results obtained on their mechanism of action.
Headaches in hospitalized cocaine users.
We reviewed the medical records of 283 cocaine users consecutively admitted to a municipal hospital and identified 37 patients (13.1%) complaining of headaches. These patients were divided into three groups. Three patients had migraine-like headaches and transient hemiparesis associated with cocaine use. Five patients had headaches associated with cocaine withdrawal. In 29 patients headaches were not clearly associated with cocaine. Twenty-two of the 29 had chronic daily headaches; nine of these patients were depressed. Three had focal brain lesions with chronic daily headache or acute onset global headache. The four remaining patients had other headaches. Based on these findings, we conclude that: (1) Headache is a common complaint in hospitalized cocaine users; (2) Cocaine may occasionally trigger a syndrome which resembles hemiplegic migraine. The potential mechanisms of this syndrome will be discussed; (3) Hospitalized cocaine users who present with headaches most frequently have depression with suicidal ideation, often associated with cocaine withdrawal; and (4) Structural brain disease in these patients may result from a variety of causes.
A medically oriented eclectic psychoanalytic psychiatrist.
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Aspartame as a dietary trigger of headache.
Many dietary factors have been implicated as possible precipitants of headache. There have been recent differences of opinion with regard to the effect of the artificial sweetener aspartame as a precipitant of headache. To assess the importance of aspartame as a dietary factor in headache, 190 consecutive patients of the Montefiore Medical Center Headache Unit were questioned about the effect of alcohol, carbohydrates and aspartame in triggering their headaches. Of the 171 patients who fully completed the survey, 49.7 percent reported alcohol as a precipitating factor, compared to 8.2 percent reporting aspartame and 2.3 percent reporting carbohydrates. Patients with migraine were significantly more likely to report alcohol as a triggering factor and also reported aspartame as a precipitant three times more often than those having other types of headache. The conflicting results of two recent placebo-control studies of aspartame and headache are discussed. We conclude that aspartame may be an important dietary trigger of headache in some people.
Safety and effectiveness of cranial electrotherapy in the treatment of tension headache.
One hundred patients were enrolled in a multicenter double-blind study to evaluate the safety and effectiveness of the Pain Suppressor Unit, a cranial electrotherapy stimulator for the symptomatic treatment of tension headaches. Treatment consisted of extremely low level, high frequency current applied transcranially. Pain scores before and after 20 minute treatments of individual headaches as well as patient and physician global evaluations were the primary efficacy variables. Following use of the active unit, patients reported an average reduction in pain intensity of approximately 35%. Placebo patients reported a reduction of approximately 18%. The difference was statistically significant (p = 0.01). The active unit was rated as moderately or highly effective in 40% by physicians, and in 36% by patients. Both physicians and patients scored the placebo unit moderately or highly effective for only 16%. The difference in ordered outcomes was statistically significant (p = 0.004). Approximately 10% of patients in each group reported at least one minor adverse experience. Cranial electrotherapy stimulation is distinct from TENS, and is safe and often effective in ameliorating the pain intensity of tension headaches. It should be considered as an alternative to the chronic usage of analgesics.
The immune-hypothalamic-pituitary-adrenal axis.
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Differential diagnosis of viral hepatitis based on hepatitis viral markers.
192 patients of acute viral hepatitis (AVH) from three different hospitals of Madras metropolitan area during November 1985 to January 1986 were investigated for serologic markers of hepatitis A virus (anti HAVIgM) and hepatitis B virus (HBsAg, HBeAg, anti HBcIgM and anti HBs) by Enzyme linked immunosorbent assay (ELISA). While the overall pattern of AVH in Madras as revealed from the study showed Hepatitis A to be 36.4%, Hepatitis B 34.4% and Non-A Non-B 29.1%, the pattern differed significantly when areawise categorisation was done. The major AVH type in Government General Hospital was Hepatitis B (48.9%). While it was hepatitis A (46.9%) in Government Stanley Hospital and Non-A Non-B (40.0%) in Military Hospital. Using anti HBcIgM marker of Hepatitis B Virus and anti HAVIgM it was possible to make out that 13.5% of the cases, currently suffering from hepatitis A were either HBV carriers (8.3%) or cases convalescing from a previous Hepatitis B attack (5.3%). Various combinations of HBV markers positivity were observed and their diagnostic significance inferred.
Structure of a novel human granulocyte peptide with anti-ACTH activity.
We report the purification, structure and biological properties of a peptide of novel sequence from human granulocytes that inhibits ACTH stimulated synthesis of corticosterone in rat adrenal cell suspensions. The peptide HP-4 is homologous to a previously described human granulocyte peptide HP-1 that has no anti-ACTH activity.