Motor cortical reflex myoclonus: a case study with MEG

The need for a reliable method of predicting movement during anesthesia has existed since the introduction of anesthesia. This paper proposes a recognition system, based on the autoregressive (AR) modeling and neural network analysis of the electroencephalograph (EEG) signals, to predict movement following surgical stimulation. The input to the neural network will be the AR parameters, the hemodynamic parameters blood pressure (BP) and heart rate (HR), and the anesthetic concentration in terms of the minimum alveolar concentration (MAC). The output will be the prediction of movement. Design of the system and results from the preliminary tests on dogs are presented in this paper. The experiments were carried out on 13 dogs at different levels of halothane. Movement prediction was tested by monitoring the response to tail clamping, which is considered to be a supramaximal stimulus in dogs. The EEG data obtained prior to tail clamping was processed using a tenth-order AR model and the parameters obtained were used as input to a three-layer perceptron feedforward neural network. Using only AR parameters the network was able to correctly classify subsequent movement in 85% of the cases as compared to 65% when only hemodynamic parameters were used as the input to the network. When both the measures were combined, the recognition rate rose to greater than 92%. When the anesthetic concentration was added as an input the network could be considerably simplified without sacrificing classification accuracy. This recognition system shows the feasibility of using the EEG signals for movement during anesthesia.     

A case of Noonan syndrome with cortical dysplasia

A retrospective review of 173 men with clinical stage B2-C prostate cancer treated by small-volume arc radiotherapy to 5200 cGy in 16 fractions over 4 weeks was undertaken. At 5 years, clinical local failure rates were 14% for stage B2 and 18% for stage C. Five-year survival rates were 81 and 61%, respectively. No discernible differences were detected between a policy of encompassing the planning target volume by the 90% or 95% isodose. The limitations of this retrospective evidence and that of the literature are discussed. In the context of resource limitations affecting radiation oncology, prospective assessment of this technique is required to determine the true outcome.     

A case of cortical amusia in a patient with musical ability

CLINICAL CASE: A women who had previously had musical ability presented with bilateral embolic damage to both superior temporal convolutions. For the first few days, she had complete cortical deafness with reception aphasia. This evolved to a slight Wernicke's aphasia and reception amusia. The amusia was characterized by inability to understand lyrics and tunes, and in this patient has persisted a year and a half later. CONCLUSIONS: It is postulated that the inability to understand the words of songs is due to damage to the first left temporal convolution, whilst the amusia of tunes is due to damage to the first right temporal convolution.     

An immunohistochemical study of Purkinje cells in a case of hereditary cerebellar cortical atrophy

We report an immunohistochemical study of Purkinje cells located in the molecular layer (ectopic Purkinje cells) and in the Purkinje cell layer (orthotopic Purkinje cells) of a patient who died young and had been diagnosed with hereditary cerebellar cortical atrophy from both clinical and neuropathological findings. All the ectopic and orthotopic Purkinje cells were immunoreactive with an anti-calbindin-D antibody, confirming that these stained cells were Purkinje cells. The perikarya of some ectopic and orthotopic Purkinje cells were stained by an antibody to phosphorylated neurofilament. In contrast, Purkinje cells of three normal controls did not react with this antibody. This finding of an abnormal accumulation of phosphorylated neurofilaments in the perikarya may be due to abnormal phosphorylation. Moreover, the regions around the cell bodies of some ectopic and orthotopic Purkinje cells were intensely immunoreactive with an antibody to synaptophysin, which suggests an abnormal increase in presynaptic terminals. It is suggested that ectopia of Purkinje cells, accumulation of phosphorylated neurofilament in the perikarya and an abnormal increase in presynaptic terminals around the soma of the Purkinje cells may be relevant to the pathophysiology of Purkinje cell degeneration in this case. In addition, the relationship between phosphorylated neurofilament and synaptophysin reactivity is discussed.     

A computer simulation study of cortical imaging from scalp potentials

In this paper, computer simulation studies were conducted to test the feasibility of imaging brain electrical activity from the scalp electroencephalograms. The inhomogeneous three-concentric-sphere head model was used to represent the head volume conductor. Closed spherical dipole layers, consisting of several thousand uniformly distributed dipoles, were used to reconstruct the cortical potential maps corresponding to neuronal sources located inside the brain. Simulation results indicate that the present procedure can image both cortical and deep sources, and for the cortical sources, a spatial resolution as high as 1.2 cm can be achieved.     

Spatial-temporal organization of the functions of cortical neurons in a conditioned reflex to time

The impulse activity of neurons in the motor cortex of cats during the development of a conditioned food-procuring reflex in relation to a time interval of 2 min (CRT) was analyzed. It was demonstrated, by comparing the behavioral and neurophysiological correlates of the formation of the conditioned food-procuring reaction, that its formation is accompanied by extremely complex systemic transformations which are different for neuronal micro- and macrostructures. The systemic processes in the micro- and macrostructures differed with respect to the specific characteristics of spatial distribution, and with respect to the number, strength, and stability of the manifestation of the functional connections. The capacity of the neurons for functional orientation even at the initial levels of the formation of the reaction, an increase in the per cent of incidence of functional connections in the second half of the conditioned reflex interval, and the substantial destabilization of all neuronal units at the last, highest level of formation of the conditioned reflex food-procuring reaction were common to the micro- and macrostructures in this form of learning.     

A case study versus science.

Comments on the article by R. J. Sternberg and W. M. Williams (see record 1997-04591-002) regarding the empirical validity of the Graduate Record Examination in predicting graduate student performance in psychology. It is argued that Sternberg and Williams's study suffers from severe range restriction in the predictor and the criteria and from unreliable criteria. It is agreed that the study was correctly characterized as a case study rather than a validation study; however, a case study from a very selective school adds little or nothing to the scientific knowledge base unless it considers fundamental factors such as range restriction in the predictor and criterion and their reliability. A more empirical approach is suggested if this line of research is to make a contribution to science. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A case study in communication disorders

Often, children with language disorders exhibit other more subtle delays or deviance in social, communicative, and cognitive development. By focusing on these three areas, the clinician can understand the developmental context in which the language delay manifests. This approach includes the following: gathering information, psychological and communicative examinations, psychiatric examination, and medical evaluation.     

案例教学法在金融学课程教学中的应用

在金融学教学中引入案例教学法,能充分调动学生学习的能动性,体现学生在课堂教学中的主体地位,同时也有助于增强教师的教学、科研能力,最终达到提高课堂教学质量的目的。     

Hispanic assessment: A case study.

Comments that there are 3 types of misuses of psychological instruments with ethnic minorities; inappropriate test selection, poor test administration, and misinterpretation of test results. A case study (19-yr-old Spanish-speaking female) that illustrates these misuses, together with professional apathy, is presented, possible remedial measures are suggested. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Malignant eccrine acrospiroma. A case study

A 37-year old patient was anaesthetised twice within 4 weeks for surgery of a vertebral disc prolapse. The first anaesthesia was performed with volatile anaesthetics without any anomalies. After the second operation in total intravenous anaesthesia with propofol and alfentanil the excitatory form of a central anticholinergic syndrome occurred. The application of physostigmine resulted in an immediate and complete disappearance of the symptoms.     

A case study of a multiple personality.

A 15 year old Indian girl is reported to have 2 secondary personalities; one, a middle aged woman, the other, a young man. The secondary personalities were exceptionally well formed and would change about twice a week. Hypnosis was used to bring up the dissociated personalities. A discussion of multiple personality was carried out in terms of repression and identification. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A case of early-onset cortical cerebellar atrophy with rhythmic skeletal myoclonus in the left upper limb

A 19-year-old man developed progressive unsteady gait and speech disturbance two years ago. He recently noticed muscle twitches in the left limb. Neurological examination revealed scanning speech, saccadic ocular movement, ataxia of trunk and limbs predominant on the left side. Rhythmic myoclonus was present at rest around the left shoulder and arm, and amplified by raising the left arm. There was no myoclonus in the soft palate. MRI revealed only a cerebellar atrophy. This patient was diagnosed as having cortical cerebellar atrophy with rhythmic skeletal myoclonus (RSM). Tc-99m ECD SPECT showed a decrease in the blood flow of the right thalamus when the myoclonus was enhanced by raising the left upper limb, which suggests that the cerebello-thalamo-cortical system as well as Guillain-McIlaret triangle is involved in the development of RSM.     

Angiosarcoma of the heart. A case study

Angiosarcoma of the heart is a rare neoplasm. The clinical manifestations are surprisingly consistent, but the diagnosis is rarely made before death. A patient with such a tumor was described here and the current literature was reviewed. Venous angiography and pericardiectomy are recommended in patients with hemorrhagic pericardial tamponade when the cause is unclear.     

Fragile ''X'' syndrome. A case study

Aim of this paper is to assess the validity of bone scanning for radiation therapy treatment planning in the skeletal system. Radiation therapy treatment planning in the skeletal system is based on plain film radiographs and bone scanning. Between January 1, 1993 and June 30, 1994, 228 patients were irradiated due to malignancies in the skeletal system. Included were bone metastases, lymphomas, sarcomas and bone invasion of neuroblastoma. The morphological display of the plain film radiographs and the bone scintigraphies were compared and modifications of the target volume due to the scan findings quantified. In 17 of 228 patients (7.5%) the target volume was modified by at least 2 cm due to tumor invasion depicted by radionuclide scanning only. Bone scintigraphy enables a sensitive display of bony invasion in skeletal malignancies. Because of a scan induced alteration of the target volume in 7.5% of the cases, bone scanning cannot be abandoned in RT treatment planning.     

A disease management case study on asthma

This paper provides an overview of how one pharmacy benefits manager, MedImpact Pharmaceutical Management, Inc. (San Diego, California), approaches its disease management (DM) program for asthma. This group's experience with DM counters the common but fallacious belief that reduction of component costs leads to reduction of total expenditures. In fact, greater expenditures on certain components (in particular, drug therapies and preventive and follow-up visits to physicians) can result in greatly reduced overall expenditures by reducing hospitalizations and emergency department treatments for asthmatic patients. The program addresses four essential components of DM: physician intervention, patient empowerment, health risk management, and pharmaceutical care. For each of these areas, careful statistical analysis, effective education, and integrated management can help improve patient care while reducing overall costs.     

A PET study on cortical and subcortical control of pelvic floor musculature in women

The possibility of hepatitis B virus (HBV) infection in HBsAg-negative patients has been shown. However, an "inapparent" coinfection by HBV in hepatitis C virus (HCV)-positive patients generally is not taken into account in clinical practice. Mechanisms responsible for resistance to interferon (IFN) have not been completely clarified. The aim of this study was to investigate whether an "inapparent" coinfection by HBV in anti-HCV-positive chronic liver disease patients may influence IFN response. Fourteen anti-HCV positive, HBsAg-negative but serum HBV DNA-positive patients by PCR and 111 anti-HCV-positive, HBsAg-negative and HBV DNA (PCR)-negative patients with chronic hepatitis were treated with 3 MU of recombinant alpha-2a IFN 3 times weekly for 12 months. Serum HBV DNA and HCV RNA were determined before treatment, after 6-12 months and in coincidence with ALT flare-up by PCR. HBV PCR was performed using primers specific for the S region of the HBV genome and HCV PCR with primers localised in the 5'NC region of HCV genome. IgM anti-HBc was tested using IMx Core-M Abbott assay. By the end of treatment, ALT values had become normal in 4/14 HBV DNA-positive patients (28%), but all "responders" (4/4) relapsed between 2 and 5 months after therapy. All but one patient were HCV RNA-positive before treatment, 6 were also both HBV DNA and HCV RNA-positive during ALT flare-ups. In 5 patients, only HBV DNA and in 3 patients, only HCV RNA was detected when transaminase values increased. All patients remained HBsAg-negative and anti-HCV-positive. IgM anti-HBc was detected both before treatment and during ALT elevation in 3 patients and only during ALT relapse in 3 others. Of the 111 anti-HCV positive, HBsAg-negative and HBV DNA (PCR)-negative patients with chronic hepatitis, a biochemical response to IFN treatment was observed in 54% of the cases. Relapse of ALT values was observed in 47% of the cases during a follow-up of 1 year after treatment. "Inapparent" HBV/HCV coinfection may be implicated in cases of resistance to IFN treatment. In addition, HBV replication may persist in patients in whom HCV replication was inhibited by IFN treatment. The pathogenic role of HBV in liver disease was confirmed by detection of IgM anti-HBc in some cases; the appearance of these antibodies only after IFN treatment suggests that IFN may exert a selective role in favour of HBV. Further studies will show the effect of different treatment schedules. HBV DNA and/or IgM anti-HBc detection with very sensitive methods may be important both as a prognostic factor and as a tool for better understanding interviral relationships and mechanisms involved in multiple hepatitis virus infections.     

A clinical study of a case of phobia.

Describes a 41-yr-old unmarried woman with a plethora of phobia-like symptoms and panic attacks. Symptoms include sensations of unreality, wildness, confusion, visualizations of convulsion, fear of insanity, fear of death, and fear of railway trains. The phobia of insanity and death is seen to be at the root of S's other phobias and attacks. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)