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Recent investigations have suggested that elevation of the eyes is associated with a marked increase in EEG alpha activity. Our experiments showed that vertical eye elevation had no direct influence on alpha activity. In Preliminary and Main Groups of thirteen and twenty-two subjects, an EEG electronic scorer was used to measure the amount of time that alpha activity was present from the left and right hemispheres in the following comparisons: (a) eye positions ahead vs. up in the light, (b) eyes ahead vs. up in the dark and (c) eyes open vs. closed in the light. In the Main Group, fixation targets for the eye-ahead and eye-up positions and electro-oculogram records of eye position were added. In the dark, where differential visual input was eliminated, the alpha index did not increase when the eyes were elevated. Differences in alpha activity related to eye position in the light condition were decreased when differential visual input was decreased by the use of fixation targets. The effects of variables confounded with eye position, e.g. patterned visual input to the retina, accomodation, fixation, and effort required to maintain a specified eye position, are discussed. In these experiments, the main variable that determined i increase in alpha activity was reduction in visual input, either by closing the eyes or extinguishing t the lights.

Word and nonsense visual stimuli were presented to eight normal adult subjects. The words were consonant-vowel-consonant trigrams, such as CAT, and each letter was presented separately in sequence. The nonsense syllables were paired for the first two positions: only the third position consonant was changed. The subject's task was to decide whether or not the stimuli formed a word and to make a motor answer response. Cortical evoked responses were recorded from the vertex, left parietal and right parietal areas. Responses from each letter in the sequence were analyzed separately, both to the words and to the nonsense syllables. No consistent differences were noted between VERs to word stimuli and VERs to nonsense syllables. The amplitude of responses to third position stimuli was significantly greater than of those to first position stimuli in all subjects. These differences were maximal at 450–550 msec following stimulus presentation and were most prominent at the vertex electrode. The increased positive amplitudes of the late components of the visual evoked response were related to the subject's decision making process. In separate experiments the task-relevant meaningful stimulus was switched to first position consonants and then the increased amplitude occurred after the first response. No consistent differences were found between responses from the left and right hemispheres. The application of these techniques to the study of various types of reading disabilities was briefly discussed.

Background Understanding longitudinal variability of the microbiome in ill patients is critical to moving microbiome-based measurements and therapeutics into clinical practice. However, the vast majority of data regarding microbiome stability are derived from healthy subjects. Herein, we sought to determine intra-patient temporal microbiota variability, the factors driving such variability, and its clinical impact in an extensive longitudinal cohort of hospitalized cancer patients during chemotherapy. Methods The stool (n = 365) and oral (n = 483) samples of 59 patients with acute myeloid leukemia (AML) undergoing induction chemotherapy (IC) were sampled from initiation of chemotherapy until neutrophil recovery. Microbiome characterization was performed via analysis of 16S rRNA gene sequencing. Temporal variability was determined using coefficients of variation (CV) of the Shannon diversity index (SDI) and unweighted and weighted UniFrac distances per patient, per site. Measurements of intra-patient temporal variability and patient stability categories were analyzed for their correlations with genera abundances. Groups of patients were analyzed to determine if patients with adverse outcomes had significantly different levels of microbiome temporal variability. Potential clinical drivers of microbiome temporal instability were determined using multivariable regression analyses. Results Our cohort evidenced a high degree of intra-patient temporal instability of stool and oral microbial diversity based on SDI CV. We identified statistically significant differences in the relative abundance of multiple taxa amongst individuals with different levels of microbiota temporal stability. Increased intra-patient temporal variability of the oral SDI was correlated with increased risk of infection during IC (P = 0.02), and higher stool SDI CVs were correlated with increased risk of infection 90 days post-IC (P = 0.04). Total days on antibiotics was significantly associated with increased temporal variability of both oral microbial diversity (P = 0.03) and community structure (P = 0.002). Conclusions These data quantify the longitudinal variability of the oral and gut microbiota in AML patients, show that increased variability was correlated with adverse clinical outcomes, and offer the possibility of using stabilizing taxa as a method of focused microbiome repletion. Furthermore, these results support the importance of longitudinal microbiome sampling and analyses, rather than one time measurements, in research and future clinical practice. Electronic supplementary material The online version of this article (doi:10.1186/s13073-017-0409-1) contains supplementary material, which is available to authorized users.

When you cannot measure, your knowledge is meager and not satisfactory. —Lord Kelvin. There are a number of changes visible in the retinal arteries and veins of patients with early or late hypertension. The most frequent are narrowing of the arteries (spasm), changes in caliber (so-called spasm or atheroma), tortuosity, mottling of the arterial reflex, "silver wire" arteries and arteriovenous nicking. We have chosen the last of these lesions for study because (1) arteriovenous nicking is easily and accurately identified after one has sufficient practice, (2) it is the most constant change present in all forms of long-standing hypertension and (3) it never occurs except in patients who have or have had hypertension. Wagener has stated that "spasm" never occurs except in hypertensive patients. Our experience has confirmed this repeatedly, but the phenomenon is largely confined to patients with exceedingly high diastolic pressure (so-called malignant hypertension) and consequently is not

THE FIRST paper of this series was a report in 1942 of the relation of retinal arteriovenous nicking to the size of the heart in ambulatory hypertensive patients.1The studies which were reported on at that time began in the late 1930's, and within the past two years my colleagues and I have had the opportunity to reexamine some of these earlier patients. During the earlier studies we made careful notes on the appearance of each lesion, in particular those of retinal arteries, so that we were able in this reexamination a decade later to note the changes in the lesion that had taken place over the years. The present report deals with the results of such examinations. In our first paper we saw a need for careful evaluation of the various degrees of arteriovenous nicking. Prior to this time, we could find no report that the lesion varied in

Excerpt The first paper of this series1included a description of the first reported case of a primary tumor of the heart recognized before death in a patient in whom there was no previous knowledge...

Many of the previous volumes in the series Clinics in Developmental Medicine have concentrated on selected aspects of the neurological examination in children, such as Nos. 21/22, Neurological Examination of Children, by Paine and Oppee, and No. 1, The Neurological Examination of the Infant, by Andre-Thomas et al. The present volume, No. 38, deals with examination techniques in eliciting minor neurological signs, primarily motor abnormalities in children ages 3 through 10. The authors propose a standardized technique for making a quantitative evaluation of the neurological examination. The tests are ones commonly used by most pediatric neurologists, but the authors have developed a scoring system, 0-2, 0-3, etc, for recording deviations from normal patterns. It is analogous to the physchological tests of Reitan, where elements of the neurological exam are given a numerical score and incorporated into the total evaluation. The whole area of minor neurological dysfunction, often called "soft signs,"

This book is the result of the Proceedings of the Fifth Symposium of the Society for the Study of Inborn Errors of Metabolism held at Newcastle upon Tyne, England in 1967. The book consists of 14 papers on the genetics, biochemistry, and pathology of muscle diseases and central nervous system degenerative diseases. In general, the emphasis is on the review of recent developments in these fields, rather than the authors' presentation of their original material. The overall level of the symposium is very good. The chapters by D. N. Raine and H. Jatzkewitz on recent advances in the biochemistry of the sphingolipidoses are outstanding. Their discussion of the nomenclature and classification of the ganglioside diseases (Tay-Sachs) in terms of their biochemical abnormalities is very useful. Diagrams and explanations showing the biochemical interrelationships of such entities as the amaurotic idiocies, Krabbe's globoid leukodystrophy, metachromatic leukodystrophy, Fabry's disease, and Gaucher's disease

This is the second edition of Dr. Dekaban's book, which first appeared in 1959. The text has a standard format with sections on various neurological diseases, most of which are well described. The author's primary aim is to cover the period from birth to 6 years of age. The influence of mental and motor development on the manifestations of neurological disease in children is emphasized throughout. Many recent advances have not been incorporated in this revised edition. For example, there have been remarkable developments in pediatric neuroradiology, particularly in cerebral and spinal cord angiography. In this book's illustrations, there are 17 x-ray films of the skull and 17 air studies, but no arteriograms and only one myelogram. There is also the glaring omission of the problems of hyperactivity, and of learning disabilities, subjects of increasing importance in pediatric neurology. Some sections on therapy are grossly inadequate, particularly in the field

This case is reported principally because the esophagus was so dilated that it led to a clinical and roentgen diagnosis of fluid in the pleural cavity, and an aspiration of the esophageal fluid was made through the chest wall. This interesting clinical mistake has not heretofore been reported, as far as I have been able to determine from the literature. The case is interesting also because of the slight degree of dysphagia. This, of course, was a factor in forming the error in diagnosis. L. W., a Negro, aged 35, admitted to Baylor Hospital out-patient department, April 19, 1932, stated that he had been working as a chauffeur and had been in fair health until February 26. On that day, as he was riding on a street car, he felt a sudden pain in the pit of his stomach and he "broke out in a cold sweat." He got off

This new book on mental retardation emphasizes physical abnormalities associated with various diseases and syndromes. The case material was primarily derived from the Walter E. Fernald State School, Waverly, Mass, and the authors are associated with this institution, the Massachusetts General Hospital, and the Harvard Medical School.The clinical conditions are divided into seven different aspects: metabolic and endocrine diseases, progressive diseases of unknown cause, acquired conditions associated with mental retardation, chromosomal abnormalities, central nervous system malformations, syndromes of multiple deformities, and neurocutaneous syndromes with mental retardation. The illustrations are on the right pages and the text and references are on the left pages.The format is similar to that of two other excellent books, Recognizable Patterns of Human Malformation by D.W. Smith and Atlas of Mental Retardation Syndromes by S.S. Gellis and M. Feingold. The present book is more extensive than the other two publications and in many ways