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PubMed1994

The discovery of the relationship between mast cells, histamine and IgE.

Two years after graduating from medical school, Ivan Mota decided to spend a year doing postgraduate training. Little did he realise that he was embarking on a course that would see him lay the foundations for modern research into allergy and anaphylaxis. Here, he recounts his own tale.

Anaphylaxis↗
PubMed1988

Priming of semantic autobiographical knowledge: a case study of retrograde amnesia.

The case of a 36-year-old man who suffers dense retrograde and anterograde amnesia as a result of closed-head injury that caused extensive damage to his left frontal-parietal and right parieto-occipital lobes is described. Patient K.C. has normal intelligence and relatively well-preserved perceptual, linguistic, short-term memory, and reasoning abilities. He possesses some fragmentary general knowledge about his autobiographical past, but he does not remember a single personal event or happening from any time of his life. He has some preserved expert knowledge related to the work he did for 3 years before the onset of amnesia, although he has no personal recollections from that period. Some features of K.C.'s retrograde amnesia can be interpreted in terms of the distinction between episodic and semantic memory, and in terms of the distinction between episodic and semantic autobiographical knowledge. K.C.'s semantic knowledge, but not his episodic knowledge, showed progressive improvement, or priming, in the course of the investigation.

Adult↗
PubMed1988

Severe remote memory loss with minimal anterograde amnesia: a clinical note.

We describe a patient who presented with apparent human Klüver-Bucy syndrome. After pharmacological treatment, his problems gradually resolved, with the exception of some unconcern about this present situation, a mild naming and word list generation deficit, a severe remote memory loss and, in comparison, a minimal anterograde memory disturbance. He has been able to relearn certain details of his personal past. These relearned memories are independent of a sense of personal intimacy. The "relearned memory" was frequently associated with a memory of how and when the information had been reacquired. The results suggest that anterograde and retrograde memory functions may, in at least certain patients, be dissociable. The apparently absolute loss of personal memories indicates that either a retrieval deficit or storage depletion are plausible hypotheses of the remote memory loss in this patient.

Amnesia↗
PubMed1988

Semantic, episodic, and autobiographical memory in a postmeningitic amnesic patient.

This study is concerned with the semantic and episodic memory performance of a highly intelligent and intellectually unimpaired patient, K.J., who became amnesic following meningitis. Although densely amnesic he showed unimpaired performance on tests of vocabulary and verbal fluency, while both speed and accuracy on semantic category judgment and sentence verification tests are unimpaired. It is concluded that semantic memory performance may be intact despite dense amnesia. However, this does not necessarily imply separate semantic and episodic memory systems. K.J. showed an impaired capacity for registering new material in semantic memory, and apparently normal autobiographical memory for events occurring well before his illness. The simplest interpretation of our results would therefore appear to be in terms of the sparing of old and overlearned memories rather than the specific preservation of semantic memory.

Amnesia↗
PubMed1989

Initiation of closed-chest cardiopulmonary resuscitation basic life support. A personal history.

Modern external (closed-chest) cardiopulmonary resuscitation (CPR) basic life support (BLS) gives everyone anywhere a chance to initiate the reversal of death from airway obstruction, apnea, or pulselessness. The history of modern CPR has its roots around 1900, but lay dormant for half a century, until in the 1950s several fortunate circumstances merged to allow for documentation of Steps A (airway control by head-tilt and jaw-thrust), B (breathing control by mouth-to-mouth ventilation), and C (circulation control by closed-chest cardiac massage, i.e. chest compressions) and their combination into BLS Steps A-B-C. BLS is only for borderline emergency oxygenation, i.e. Phase I of the life support chain. Both the non-authoritarian environment of the U.S.A. and several role players with keen interest in resuscitation were needed to enable the systematic research (Steps A and B), a chance rediscovery (Step C), and the integration of BLS with advanced life support (ALS, drugs and defibrillation, transferred from open-chest CPR) and brain-oriented prolonged life support (PLS, intensive care) to result in the development of an effective cardiopulmonary-cerebral resuscitation system. A fertile environment led rapidly to the development of resuscitation delivery systems in hospitals and communities. This paper is a story told by one of the role players.

History, 20th Century↗
PubMed1994

History of medical and biological ultrasound at the University of Pennsylvania.

We briefly review my early contacts with bioacoustics and the bioacoustic work at the University of Pennsylvania that took place from the early 1950s to 1975. It was carried out with E. L. Carstensen, K. Li, A. Smith, H. Pauly, J. Reid, P. Edmonds and many students. The emphasis was first on basic biophysical studies. The work with E. Carstensen and H. Pauly was primarily concerned with the mechanism causing the high absorption typical for tissues and cell suspensions. Macromolecular content was shown to be largely responsible for the absorption. Practical applications concerned the relative merits of electromagnetic and ultrasonic diathermy techniques. P. Edmonds extended the range of macromolecular studies to 100 MHz and initiated work on the attenuation in lung tissues. After J. Reid came to Pennsylvania, the development of echocardiography took place.

Biomedical Engineering↗
PubMed1989

The origin of thrombolytic therapy.

The origin of thrombolytic therapy is briefly reviewed. It began 40 years ago with the demonstration that the injection into patients of a partially purified activator of the native plasminogen-plasmin enzyme system was capable of dissolving clotted blood and fibrinous loculations in the chest. However, the application of this form of therapy for the dissolution of intravascular thrombi had to await a series of further developments, including extensive purification of the thrombolytic agents, evidence that plasminogen activators would be more appropriate than plasmin for thrombolysis and proof, first in animals and then in humans, that thrombi could be dissolved by the systemic administration of plasminogen activators. The first study of thrombolytic therapy in acute myocardial infarction was reported in 1958. However, despite many studies conducted during the next 20 years, with encouraging reductions in mortality, thrombolytic therapy for acute myocardial infarction became established only when angiography provided visual evidence of the presence of a thrombus obstructing an infarct-related artery and of the achievement of prompt lysis with the administration of thrombolytic agents.

Coronary Disease↗
PubMed1991

Historical vignette celebrating the 30th anniversary of diagnostic ambulatory electrocardiographic monitoring and data reduction systems.

The ambulatory electrocardiographic (ECG) monitor is a device developed approximately 30 years ago to detect, locate and document hemodynamic insufficiency states in target organs with compromised regional arterial circulations. These insufficiency states are usually silent until they are suddenly precipitated by secondary remote, hemodynamically significant cardiac arrhythmias, hypotensive states caused by internal hemorrhage or reduced cardiac output including cardiogenic shock. Insufficiency events cause serious regional dysfunction, resulting in transitory or permanent damage of the remote target organs (brain, heart, splanchnic and renal) often causing paralytic ileus, gangrene of the gut or rectum, myocardial infarction or cerebral stroke. Comprehensive experimental studies conducted in the author's laboratory over a period of years (1946-1971) proved that such remote ischemic states are often recurrent and can cause serious, irreparable damage, but whenever the cause of the regional ischemic state was treated promptly it could reverse the insufficiency state. Practical ambulatory ECG diagnostic monitors and data reduction systems were developed to diagnose these elusive precipitating pathophysiologic events that might coincide with the patient's symptoms and thus determine the most appropriate preventive therapy.

Electrocardiography, Ambulatory↗