Examining the diagnostic utility of EEG power measures in children with attention deficit/hyperactivity disorder.

OBJECTIVE: This study investigated the diagnostic utility of EEG power during eyes-closed resting conditions for children with attention-deficit/hyperactivity disorder (AD/HD). METHODS: Subjects consisted of 253 boys with AD/HD combined type and 67 age-matched controls. EEG was recorded from 21 sites during an eyes-closed resting condition and was Fourier transformed to provide estimates for total power and absolute and relative power in delta, theta, alpha and beta bands. Factor analysis was used to group sites into frontal, central and posterior regions, with these data subjected to cluster analysis. Logistic regression was performed on the entire AD/HD sample versus control, for AD/HD clusters versus control, and then for each AD/HD cluster independently versus control, using total, absolute and relative power measures. RESULTS: Logistic regression performed on the clusters independently produced the best classification results, with a sensitivity of 89.0% and a specificity of 79.6%, with an overall classification accuracy of 87.0%. CONCLUSIONS: The obtained classification results are supportive of an independent diagnostic test for AD/HD based on EEG power at rest. SIGNIFICANCE: This is the first study to investigate sensitivity and specificity of EEG power for AD/HD in a resting condition.     

Remission of the polycystic ovarian condition (PCO) in the rat following hemiovariectomy

The estradiol valerate-induced polycystic ovarian condition in the rat represents a normal ovarian response to aberrant endocrine stimuli. Although we have shown that removal of one polycystic ovary (hemiovariectomy) results in restoration of cyclicity and normal morphology in the remaining ovary by 1 week, nothing is known about the process of recovery or about the role of the hypothalamo-pituitary unit in initiating recovery. We have therefore examined ovaries at 3, 12, 24, 48, and 120 hours following removal of the contralateral polycystic ovaries. The ovarian content and size distribution of healthy and atretic follicles was determined, as well as the occurrence of follicular cysts, type III large follicular structures, and corpora lutea. The plasma LH pattern was also examined at a short postoperative interval. At 3 hours, there was a significant increase in mean ovarian weight that coincided with the emergence of healthy large secondary follicles. By 12 hours, there was a significant sustained diminution in the number of atretic follicles of all sizes, but the total number of healthy follicles did not increase significantly until 120 hours. The cystic follicles had all but disappeared by 120 hours because of mechanical compression by newly developing ovarian tissue. Ovarian recovery is, therefore, biphasic, consisting of a very early diminution in atresia coincident with, and perhaps caused by, a major alteration in the plasma LH pattern. The second phase is characterized by a wave of follicular recruitment and development.     

Visual associative agnosia: a clinico-anatomical study of a single case.

A single case study of a patient with visual associative agnosia is described. The patient had well preserved language, spatial, visual, and perceptual abilities but nevertheless was impaired in recognising visually presented common objects. It is argued that his deficit cannot be accounted for in terms of a disconnection syndrome. Behavioural and anatomical (MRI scan) evidence for focal unilateral dysfunction is presented. It is concluded that the left hemisphere plays a crucial role in recognising the meaning of common objects.     

High dorsal column cordotomy plus subdiaphragmatic vagotomy prevents acute lonizing radiation sickness in cats

Our purpose was to determine the effects on acute radiation sickness of interrupting afferent neural pathways that converge upon the medullary vomiting center but which bypass the emetic chemoreceptor trigger zone in the area postrema. A comparison was made of the vomiting response and other signs of sickness in three groups of chronic cats surgically prepared as follows: high spinal cord section of the dorsal columns, subdiaphragmatic vagotomy, and the combination of procedures. Every cat was exposed over the whole body to 45 Gy ⁶⁰Co γ-radiation which was effective in evoking emesis in 11 of 12 normal cats. Neither cordotomy alone (8 cats) nor vagotomy alone (2 cats) reliably blocked the vomiting response but they separately delayed its onset. On the other hand, the cordotomy prevented the loss of appetite and behavioral malaise that was invariably caused by the irradiation in normal cats. Finally, the combination of cordotomy and vagotomy protected all of 3 cats against the entire radiation syndrome. These cats then vomited appropriately in response to the injection of deslanoside which induces emesis through an action on the area postrema. Histological examination of the lower medulla revealed no damage of the area postrema resulting from the cordotomies. We conclude that acute radiation sickness in the cat is signaled through afferent neural pathways originating in the abdomen and that the area postrema does not participate in the causation of this syndrome.     

The role of noninvasive testing in the evaluation of chronic venous problems

Noninvasive instrumentation is now available to evaluate venous function in patients with a wide variety of chronic venous problems. The present analysis attempts to review the use of directional flow detection by Doppler ultrasound, venous refilling or maximal venous outflow by plethysmography, and the newly introduced venous imaging techniques (B-mode and duplex scanning) in evaluation of patients with varicose veins, the postphlebitic syndrome, sequelae after acute deep-vein thrombosis, and venous reconstructive surgery. Venous refilling time recorded by the photoplethysmograph is the simplest technique for assessment of venous dysfunction, and it can identify venous stasis or ulcer as a result of long saphenous vein insufficiency. Both the B-mode and the duplex scan allow direct examination of venous valve motion and determination of valve competency. The latter technique holds promise in the evaluation of venous valve reconstructive surgery and, more important, in accurate assessment of venous valve damage following acute deep-vein thrombosis.

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Resumen La instrumentación no invasiva se halla actualmente disponible para evaluar la función venosa en pacientes con una amplia variedad de problemas venosos crónicos. El presente estudio trata de revisar el uso de la detección de flujo direccional por Doppler de ultrasonido, la repleción venosa o el flujo venoso máximo por pletismografía, y de las nuevas técnicas de imagenología (modo B y escanografía duplex) en la valoración de pacientes con venas varicosas, el síndrome postflebítico, las secuelas de la trombosis venosa profunda, y la cirugía venosa reconstructiva. El tiempo de repleción venosa registrado por pletismografía es la técnica más simple para la valoración de la disfunción venosa, y es capaz de identificar estasis venosa o ulceración como resultado de insuficiencia de la vena safena mayor de larga duración. Tanto el modo B como la escanografía permiten el examen directo del movimiento valvular venoso y la determinación de la competencia valvular. Esta Última técnica es promisoria en cuanto a la evaluación de la cirugía reconstructiva de las válvulas venosas y, muy importante, en la determinación precisa de daño valvular después de una trombosis venosa profunda.

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Résumé Une instrumentation non invasive est maintenant disponible pour évaluer la fonction veineuse chez les malades qui présentent une large variété de problèmes veineux chroniques. L'article tente de passer en revue la détermination du flux veineux par le Doppler, le remplissage veineux ou l'écoulement veineux maximum par la pléthysmographie, les nouveaux procédés d' imagerie veineux (ultrasonographie en temps réel et double ultrasonographie) pour étudier les varices, le syndrome post-phlébitique, les séquelles de la thrombose aiguË veineuse profonde, et la chirurgie reconstructive veineuse. Le temps de remplissage veineux déterminé par la photo-pléthysmographie représente la technique la plus simple pour apprécier le fonctionnement veineux anormal et la méthode permettant d'identifier la stase veineuse ou l'ulcère résultant d'une insuffisance de la veine saphène longue. L'ultrasonographie en temps réel et la double ultrasonographie permettent l'exploration directe de la motilité de la valve veineuse et l'appréciation de la compétence valvulaire. La dernière méthode porte la promesse de pouvoir juger de la valeur de la chirurgie reconstructive valvulaire veineuse et, fait plus important, d'apprécier exactement l'altération valvulaire secondaire à la thrombose veineuse profonde.

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Supported in part by the Conrad Jobst Foundation, the Seabury Foundation, and the Northwestern Vascular Foundation.     

Intraarticular epithelioid sarcoma

A case of an intraarticular epithelioid sarcoma is presented. The patient was a 35 year old man who presented with a 10 months history of a chronic monoarthritis. The MRI showed a diffuse lesion involving the synovial membrane of the knee. There was a marked increased signal on T2 weighted images. Most epithelioid sarcomas involve the subcutaneous tissues of the hands or feet. This presentation is unusual and this entity should be considered in the differential diagnosis of an intraarticular proliferative process.