Auditory Agnosia for Environmental Sounds in Alzheimer's Disease: Not Hearing and Not Listening?

Auditory agnosia for environmental sounds (AES) is an example of central auditory dysfunction. It is presumed to be independent of language deficits and in presence of normal hearing. We undertook a detailed neuropsychological assessment including environmental sound naming and recognition in 34 clinically mild Alzheimer's disease (AD) patients and 29 age-matched healthy control subjects.

Are retired physicians suitable for the coaching of clerks?

Objectives: To assess whether clerks need coaches, for which issues, and whether retired physicians are able to support clerks.

Methods:  The study combines both qualitative and quantitative methods and the perspectives of both coaches and clerks. Clerks starting their first clerkship were randomised between having a coach (n=61) and not having a coach (n=59).

Effects of CBRN decontaminants in common use by first responders on the recovery of latent fingerprints--assessment of the loss of ridge detail on glass.

Following a CBRN incident, first responders use decontamination procedures to reduce the risk of exposure. The effect of decontamination on forensic trace material has, however, not been fully examined. This study sought to evaluate the effect of five different physical or chemical decontamination materials on the recovery of latent fingerprints.

Anthropological neurology: symptoms and their meanings according to Joseph Prick (1909-1978).

This article describes the life and work of the Dutch neurologist Joseph Prick (1909-1978) and his idea of an anthropological neurology. According to Prick, neurological symptoms should not only be explained from an underlying physico-chemical substrate but also be regarded as meaningful. We present an outline of the historical and philosophical context of his ideas with a focus on the theory of the human body by the French philosopher Maurice Merleau-Ponty (1908-1961) and the concept of anthropology-based medicine developed by Frederik Buytendijk (1887-1974).

Acute severe memory impairment as a presenting symptom of multiple sclerosis: a clinical case study with 3D double inversion recovery MR imaging.

We present the case of a 21-year-old woman with acute memory impairment. It was initially not recognized as organic in nature. Repeated neuropsychological testing confirmed severely disturbed encoding and recall.

Botulinum toxin type A in simple motor tics: short-term and long-term treatment-effects.

To determine the short-term and long-term treatment-effects of botulinum toxin type A in simple motor tics, we analyzed 15 consecutive patients (18 tics) with simple motor tics that were treated every 3 months with injections of BTX-A. Efficacy (rated on a 4-level scale) and duration of effect of the first 2 and last 2 (if treated 5 times or more) treatments were recorded, as well as latency of response, changes of premonitory urges (PMUs) and possible side effects. Total number of treatments for each tic varied from 2 to 50 (mean 11, median 6).

Successful intra-arterial thrombolysis beyond the accepted 6-hour time window in two young patients.

Two young women with ischemic stroke successfully underwent intra-arterial thrombolysis (IAT) 10 and 11h, respectively after stroke onset. A 23-year-old (case 1) and a 22-year-old woman (case 2) who developed severe neurological deficits (NIHSS 20 and 13, respectively) were presented to our hospital 9h after onset of the symptoms. In case 1 a CT angiography (CTA) revealed an occlusion of the left middle cerebral artery (MCA) and in case 2 CTA showed a large embolus at the left carotid bifurcation, almost entirely occluding the internal carotid artery.

[Explaining symptoms: body-object and body-subject].

Background: Medically unexplained somatic symptoms present a real challenge to modem medicine. They occur frequently and are often chronic.

Aim: To discuss the physician's approach to these symptoms.

[A meningioma resulting in drastic changes in behavior and life course].

Three patients, a 59-year-old woman, a 51-year-old man and a 66-year-old woman presented at a neurological or neurosurgical outpatient clinic after their lives had been drastically affected by behavioural changes. Neither the patients nor their relatives or friends were aware that the behavioural changes may be caused by a medical problem. The cause, a large meningioma, became obvious only after physical symptoms occurred a few years later.

The Bordetella pertussis virulence factor P.69 pertactin retains its immunological properties after overproduction in Escherichia coli.

Bordetella pertussis is re-emerging in several countries with a high vaccine uptake. Analysis of clinical isolates revealed antigenic divergence between vaccine strains and circulating strains with respect to P.69 pertactin.

NF-kappa B activation in airways modulates allergic inflammation but not hyperresponsiveness.

Airways display robust NF-kappaB activation and represent targets for anti-inflammatory asthma therapies, but the functional importance of NF-kappaB activation in airway epithelium remains enigmatic. Therefore, transgenic mice were created in which NF-kappaB activation is repressed specifically in airways (CC10-IkappaBalpha(SR) mice). In response to inhaled Ag, transgenic mice demonstrated significantly ameliorated inflammation, reduced levels of chemokines, T cell cytokines, mucus cell metaplasia, and circulating IgE compared with littermate controls.

Gilles de la Tourette's syndrome with and without obsessive-compulsive disorder compared with obsessive-compulsive disorder without tics: which symptoms discriminate?

Stereotyped repetitive behaviors occur in Gilles de la Tourette's Syndrome (GTS) and obsessive-compulsive disorder (OCD). The present study was undertaken to compare the distribution of obsessive-compulsive and Tourette-related impulsive behaviors in GTS with (+) OCD, GTS without (-) OCD, tic-free OCD, and control subjects. Fourteen GTS + OCD, 18 GTS-OCD, 21 OCD-tic, and 29 control subjects were evaluated using a semistructured interview designed to assess GTS and OCD-related repetitive behaviors.

Repetitive behaviors in Tourette's syndrome and OCD with and without tics: what are the differences?

Gilles de la Tourette Syndrome (GTS) and obsessive-compulsive disorder (OCD) share obsessive-compulsive phenomena. The aims of this study were to compare the OC symptom distribution between GTS and OCD and to investigate whether a subdivision of these phenomena into obsessions, compulsions and 'impulsions' is useful in distinguishing GTS and OCD patients. Thirty-two GTS, 31 OCD (10 with tics, 21 without tics) and 29 control subjects were studied using the Leiden repetitive behaviors semi-structured interview to assess GTS as well as OCD-related behaviors.

The relationship between types and severity of repetitive behaviors in Gilles de la Tourette's disorder and obsessive-compulsive disorder.

Background: This study investigated which categories of obsessive-compulsive and Tourette-related behaviors in Gilles de la Tourette's disorder and obsessive-compulsive disorder (OCD) without tics are experienced as most severe across the study groups and what the differences are in symptom distribution between the study groups.

Method: Fourteen subjects with both Tourette's disorder and OCD, 18 subjects with Tourette's only, 21 subjects with OCD (no tics), and 29 control subjects were studied using a semistructured interview designed to equally assess Tourette- and OCD-related behaviors according to DSM-III-R criteria. Each reported repetitive behavior was evaluated on the presence of anxiety and on goal-directedness.

[Asystole due to complex partial epilepsy].

A 56-year-old man was seen in the Emergency Room because of sudden and transient loss of consciousness. An asystole was diagnosed with 10 S duration after which a pacemaker was implanted. The patient had experienced such collapses before, preceded by odd smell sensations.

Non-linear analysis of the electroencephalogram in Creutzfeldt-Jakob disease.

Creutzfeldt-Jakob disease is a rare, neurological, dementing disorder characterised by periodic sharp waves in the electroencephalogram (EEG). Non-linear analysis of these EEG changes may provide insight into the abnormal dynamics of cortical neural networks in this disorder. Babloyantz et al.

Use of non-linear EEG measures to characterize EEG changes during mental activity.

Non-linear EEG analysis provides a possibility for studying the dynamical changes in cortical networks related to mental activity. In this study the correlation dimension D2 was used to study local changes in complexity, and the mutual dimension Dm was used to assess changes in the dynamical coupling between different brain areas. EEGs were recorded in 25 healthy subjects under three conditions: (1) eyes closed, (2) eyes open, and (3) mental arithmetic with eyes closed (serial subtraction of 7s from 1000).

Altered attentional processing of background stimuli in Gilles de la Tourette syndrome: a study in auditory event-related potentials evoked in an oddball paradigm.

In 24 adults and 29 children both with Gilles de la Tourette syndrome and in 24 control adults and 17 control children we studied auditory event-related potentials (ERP's) evoked in 2 different oddball paradigms: a passive listening paradigm (PLP) in which subjects had only to attend tones (260 standards, 40 deviants), followed by an active discrimination paradigm (ADP) in which subjects had to press a microswitch in response to the deviant tones. In the adult Tourette patients the PLP disclosed between 200-300 msec at all derivations (Fz, Cz, Pz, C3, C4, P3, P4) a significantly more negative activity than in the controls. In the Tourette children such a result was only found at Fz.

EEG changes during mental activation.

Desynchronization of the EEG in relation to mental activity can be demonstrated through various means. The acceleration spectrum entropy (ASE) is a method that quantifies the desynchronization of the EEG. It is a measure of the randomness or irregularity of a time series and ranges from 0 (straight line) to 100 (discrete random signal).

Mental play in Gilles de la Tourette's syndrome and obsessive-compulsive disorder.

A new phenomenon, found only in Gilles de la Tourette (GTS) patients, and which we have called 'mental play', is described. It was compared with the phenomenon of counting, which occurred in both GTS and obsessive-compulsive patients. In the GTS patients both mental play and counting were best characterised as playful impulsions.

Carbamyl phosphate synthetase-1 deficiency discovered after valproic acid-induced coma.

Valproic acid induced coma is presented in an adult patient without a history of metabolic disease. Liver biopsy revealed a reduction in activity of carbamyl phosphate synthetase-I, an enzyme obligated for transformation of ammonia to urea in the urea cycle. After recovery CT scan follow-up showed marked cerebral atrophy which did not exist prior to the state of coma.